Internal Herniation Due to Appendix Vermiformis Rotation: A Rare Case of an Acute Abdomen
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Tarih
2012
Yazarlar
Dergi Başlığı
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Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Internal herniasyon otopsi olgularının %0.2-0.9 da ortaya çıkan nadir bir durumdur. 84 yaşında kadın hasta karında ileri dere- cede distansiyon ile kliniğimize başvurdu. Karın muayenesinde sağ tarafta daha belirgin olmak üzere yaygın hassasiyet, rebaund ve defans mevcuttu. Akut karının etyolojisinin belirlenmesi amacıyla hasta acil olarak operasyona alındı. Laparotomi sonrası gözlemde apendiks vermiformisin yaklaşık 12 cm uzunluğunda olduğu ve kendi etrafında 360 derece rotasyon yaparak çekuma yapıştığı gözlendi. Rotasyon yaparak bir çember oluşturan apendiksin içine yaklaşık 30 cm lik bir terminal ileum ansının girdiği ve bu segmentin iskemik olduğu ve 1 cm lik kısımdan perfore olduğu tespit edildi. Ayrıca bu rotasyondan çekumun da etkilendiği ve çekumda da iskemik değişiklikler gözlendi. Hastaya sağ hemikolektomi, segmenter ince barsak rezeksiyonu yapıldı. Takiplerinde sorun olmayan hasta postoperatif 10. günde taburcu edildi. Literatürde çok çeşitli internal herniasyon vakaları yayınlanmasına rağmen, benzerine rastlamadığımız apendiksin rotasyonu sonucu internal herniasyon gelişen bir vakayı sunmayı amaçladık.
Internal herniation is a rare occurrence that appears in about 0.2-0.9% of autopsy cases. An 84-year-old female patient presented to our clinic with severely distended the abdomen .Abdominal examination revealed tenderness and rebound mainly in the right side of the abdomen. Following the laparatomy it was observed that the appendix vermiformis was about 12 cm in length and was adhered to the cecum having rotated around itself at 360 degrees. It was also seen that a terminal ileum loop of about 30 cm. had penetrated into the appendix forming a circle having rotated around itself and that this segment was ischemic and a portion was perforated for a length of 1 cm. Further, this rotation had also affected the cecum which showed ischemic changes. A right hemilectomy and segmenter small bowel resection were performed. There were no problems during the follow-ups the patient was discharged on the tenth postoperative day. Although there are several reports detailing various kinds of internal herniation published in literature.
Internal herniation is a rare occurrence that appears in about 0.2-0.9% of autopsy cases. An 84-year-old female patient presented to our clinic with severely distended the abdomen .Abdominal examination revealed tenderness and rebound mainly in the right side of the abdomen. Following the laparatomy it was observed that the appendix vermiformis was about 12 cm in length and was adhered to the cecum having rotated around itself at 360 degrees. It was also seen that a terminal ileum loop of about 30 cm. had penetrated into the appendix forming a circle having rotated around itself and that this segment was ischemic and a portion was perforated for a length of 1 cm. Further, this rotation had also affected the cecum which showed ischemic changes. A right hemilectomy and segmenter small bowel resection were performed. There were no problems during the follow-ups the patient was discharged on the tenth postoperative day. Although there are several reports detailing various kinds of internal herniation published in literature.
Açıklama
Anahtar Kelimeler
Internal herniation, Appendix rotation, Acute abdomen, İnternal herniasyon, Apendiks rotasyonu, Akut karın
Kaynak
European Journal of General Medicine
WoS Q Değeri
Scopus Q Değeri
Cilt
9
Sayı
4
Künye
Yıldırım, M. A., Erikoğlu, M. (2012). Internal herniation due to appendix vermiformis rotation: A rare case of an acute abdomen. European Journal of General Medicine, 9, 4, 295-297.
