Misdiagnosis of appendicular abscess in 1 case.doc

 PAGE \* MERGEFORMAT 4 Misdiagnosis of appendicular abscess in 1 case [Keywords:] appendix abscess, misdiagnosis Acute appendicitis is a common acute abdomen surgery one child, an illness serious than adults. However, children with early onset in children is often the first medical treatment, if atypical clinical presentation and lack of physician awareness of this disease is easily misdiagnosed. now admitted to our department Misdiagnosis of 1 case of abscess following appendectomy. A medical record Children, male, 8 years old, 3 days because of abdominal pain, fever 2, diarrhea 1, at March 30, 2007 admission. Children in the March 28 start of abdominal pain, paroxysmal increased to Cullen staggering. vomiting, stomach contents 4, volume, non-ejection. no headaches. The next day the highest temperature reached fever 39.2 ℃, no cough, no runny nose, diarrhea, admission day, day 4 to 5 times loose stools solution, less, no sticky jelly. urine as usual, loss of appetite. has been in our clinic with cefuroxime 3, double Huang Lianjing point 2 days, still fever, abdominal pain above the abdomen and Cullen staggering. on the evening of March 30 with acute gastric enteritis income homes. admission examination: body temperature 39.6 ℃, blood pressure 100/65 mm Hg, God, clear, smooth breathing, acute pain face, throat congestion, swollen tonsils grade Ⅱ, no leakage, no abnormal heart and lung auscultation, abdomen soft, umbilical next week and xiphoid tenderness, Maxwell was no point tenderness. Hospital auxiliary examination: blood analysis WBC 13.2 ~ 22.2 × 109 / L, N 77.5% ~ 85.8%, RBC and PLT were within normal range. CRP 154 ~ 169 mg / L, ESR 56mm/1h, liver and kidney function and myocardial enzymes in the normal range, Blood culture (-, blood K +, Na +, Cl-, Ca2 +, CO2CP were in the normal range, stool: yellow loose stools, WBC 5 ~ 8/HP, RBC 3 ~ 4/HP, urine analysis : normal, abdominal B-: the liver, gallbladder, pancreas and spleen were normal, ab