모호한 복부 통증의 환자에서 대장내시경으로 진단된 충수돌기염 3예 |
손성동ㆍ장영운ㆍ조근형ㆍ황보영ㆍ심재준ㆍ장재영ㆍ김효종ㆍ김병호 |
경희대학교 의과대학 내과학교실 |
Three Cases of Appendicitis Diagnosed by Colonoscopy in Patients with Atypical Presentations |
Seong Dong Sohn, M.D., Young Woon Chang, M.D., Kun Hyung Cho, M.D., Young Hwangbo, M.D., Jaejun Shim, M.D., Jae Young Jang, M.D., Hyo Jong Kim, M.D. and Byung Ho Kim, M.D. |
Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Korea |
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Abstract |
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The diagnostic considerations are broad for patients who clinically present with obscure abdominal pain. Acute appendicitis can be diagnosed according to the clinical signs and symptoms, yet this can often be extremely challenging. Difficulties particularly arise when the presentation is atypical. Investigations that may help include laboratory tests, non-invasive imaging and laparoscopy. We experienced 3 cases of acute appendicitis that were diagnosed by colonoscopy. The colonoscopy revealed a bulging of the appendix into the cecal lumen. The mucosa was erythematous and edematous with pus draining from the appendiceal orifice. These findings were suggestive of appendicitis, which was confirmed after surgical appendectomy. In our experience, making the colonoscopic diagnosis of appendicitis might be helpful for patients with atypical symptoms, but colonoscopy should not be used for the diagnosis in the beginning if appendicitis is initially suspected. (Korean J Gastrointest Endosc 2010;41:52-55) |
Key Words:
Appendicitis, Colonoscopy |
주요어:
충수돌기염, 대장내시경 |
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