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Revista chilena de pediatría

versión impresa ISSN 0370-4106

Resumen

VILLALON U., Hernán et al. Acute perforated appendicitis with pre-surgical diagnosis and bilateral inguinal hernia in preterm infants. Rev. chil. pediatr. [online]. 2020, vol.91, n.6, pp.936-940.  Epub 21-Oct-2020. ISSN 0370-4106.  http://dx.doi.org/10.32641/rchped.vi91i6.1538.

Introduction:

Acute neonatal appendicitis is a rare pathology, with few reports in the last 30 years. Since its clinical presentation and imaging studies are non-specific, most cases are diagnosed during a surgical pro cedure.

Objective:

To describe a neonatal case of acute perforated appendicitis associated with later appearance of inguinal hernia, with pre-surgical diagnosis and treated through laparoscopy.

Clinical Case:

A 17-day-old preterm female newborn presented with fever, irritability, and increased milk intolerance. Physical examination showed abdominal distention, tenderness and both, abdominal X- ray and ultrasound showed compatible images with acute perforated appendicitis. Once the diagnosis was confirmed, we performed an appendicectomy through laparoscopy. Two weeks later, during an outpatient visit, we observed a bilateral inguinal hernia which was confirmed by ultrasound, and then it was surgically corrected.

Conclusion:

Acute appendicitis should be considered within the differential diagnosis in neonates with acute abdominal symptoms, mainly in premature infants. In this case, ultrasound scan allowed us to make the pre-operative diagnosis. The possible association with inguinal hernias should motivate to examine inguinal ducts during imaging assessment and surgical procedure.

Palabras clave : Acute Appendicitis; Newborn; Premature; Acute Neonatal Abdomen; Neonatal Inguinal Hernia; Ultrasound; Pre-Surgical Diagnosis.

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