A Bizarre Cause of Acute Appendicitis in a Pediatric Patient: An Ingested Tooth.
A Bizarre Cause of Acute Appendicitis in a Pediatric Patient: An Ingested Tooth.
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小儿患者急性阑尾炎的怪异原因：摄入的牙齿。
DOI：
10.3390/children10010108
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发表时间：
2023-01-04
期刊：
影响因子：
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中科院分区：
文献类型：
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(1)背景：在所有可能的原因中，异物是小儿阑尾炎最罕见的原因。在大多数情况下，摄入的异物通过胃肠道而不会引起症状。然而，那些穿过阑尾腔的异物不能再次进入结肠，可能会导致急性阑尾炎。到目前为止，已经描述了各种异物进入阑尾并引起急性阑尾炎，如种子，针，牙签，植物材料，甚至头发。牙齿或牙科植入物作为急性阑尾炎的一个原因已经被描述在少数情况下。据我们所知，这是第一个描述的情况下，牙齿引起急性阑尾炎的儿科人口。(2)病例介绍：一名14岁男性患者到急诊科就诊，主诉右下腹疼痛和呕吐，持续约24小时。在此之前，患者健康，无伴随疾病。体格检查显示右下腹有压痛和保护。白色血细胞计数为17.1 × 109/L，中性粒细胞计数为91.1%，C反应蛋白为39.3 mg/dL。腹部超声检查显示阑尾增厚、发炎，直径为11 mm，阑尾周围有游离液体。阑尾底部可见一个9 × 6 mm异物。患者被诊断为急性阑尾炎，并在同一天进行了紧急腹腔镜阑尾切除术。术中发现坏疽性阑尾炎，并将其切除，无并发症。在检查取出的标本后，确定患者的阑尾炎是由吞下的牙齿引起的。后来才知道，患者在入院前一天运动时折断了一颗侧切牙，自己并不知道是吞下的，患者恢复良好，术后第二天出院。(3)结论：虽然是一个非常罕见的事件，急性阑尾炎可以引起吞咽的牙齿。这个病例强调了对急诊科疑似急性阑尾炎的儿科患者进行全面病史的重要性，以确定是否有可能导致急性阑尾炎的促发事件。
(1) Background: Among all possible causes, foreign bodies are the rarest cause of appendicitis in the pediatric population. In the majority of cases, ingested foreign bodies pass through the gastrointestinal tract without causing symptoms. However, those foreign bodies that pass through the lumen of the vermiform appendix cannot re-enter the colon and may cause acute appendicitis. So far, various foreign bodies have been described to enter the appendix and cause acute appendicitis, such as seeds, needles, toothpicks, plant material, or even hair. Tooth or dental implants as a cause of acute appendicitis have been described in only a few cases. To our knowledge, this is the first described case of the tooth causing acute appendicitis in the pediatric population. (2) Case presentation: A 14-year-old male patient presented to the emergency department complaining of pain in the right lower quadrant of the abdomen and vomiting that persisted for approximately 24 h. Until then, the patient was healthy and had no concomitant diseases. Physical examination revealed guarding and tenderness in the right lower abdominal quadrant. The white blood cell count was 17.1 × 109/L with a neutrophil count of 91.1% and a C-reactive protein of 39.3 mg/dL. Ultrasonography of the abdomen revealed a thickened, inflamed appendix with a diameter of 11 mm and free periappendicular fluid. A 9 × 6 mm foreign body at the base of the appendix was visualized. The patient was diagnosed with acute appendicitis, and an emergency laparoscopic appendectomy was performed on the same day. Intraoperatively, gangrenous appendicitis was noted and removed without complications. Upon examination of the removed specimen, it was determined that the patient’s appendicitis had been caused by an ingested tooth. As it later turned out, the patient had broken a lateral incisor while playing sports the day before admission without knowing that he had swallowed it. The patient recovered well and was discharged the day after surgery. (3) Conclusion: Although an extremely rare event, acute appendicitis can be caused by a swallowed tooth. This case highlights the importance of a thorough history in pediatric patients who present to the emergency department with suspected acute appendicitis to determine if there is a precipitating event that may have caused acute appendicitis.
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发表时间：
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期刊：
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影响因子：
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作者：
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DOI：
10.5152/dir.2022.201048
发表时间：
2022-11
期刊：
Diagnostic and interventional radiology (Ankara, Turkey)
影响因子：
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通讯作者：
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