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[Intrathoracic acute appendicitis. A case report]
R Fahed1, L Menassa-Moussa, C Sader-Ghorra
1Service d'imagerie médicale, Hôtel-Dieu de France, boulevard Alfred-Nacchache, Achrafieh, Beyrouth, Liban. reinefahed@gmail.com
Summary
Intrathoracic appendicitis, a rare condition, was diagnosed in a child with a Bochdalek hernia. Early imaging is crucial for diagnosing abdominal issues linked to congenital diaphragmatic hernias.
Area of Science:
- Pediatric Surgery
- Diagnostic Imaging
- Gastroenterology
Background:
- Intrathoracic appendicitis is a rare condition.
- Congenital diaphragmatic hernias can present atypically in children.
- Nonspecific abdominal pain can mask serious underlying conditions.
Observation:
- A 6-year-old boy presented with nonspecific abdominal pain and elevated C-reactive protein (CRP), but no fever.
- Initial chest X-ray suggested a diaphragmatic hernia, confirmed by ultrasound.
- A CT scan revealed acute appendicitis within the thorax, associated with a right posterolateral Bochdalek hernia.
Findings:
- The case highlights a rare instance of intrathoracic appendicitis.
- Atypical presentation of abdominal diseases is common with late-presenting congenital diaphragmatic hernias.
- Delayed diagnosis or misdiagnosis can occur due to subtle clinical signs.
Implications:
- Radiological investigation is recommended for diaphragmatic hernias, even with subtle symptoms.
- Early detection of gastrointestinal complications associated with hernias is vital.
- This case underscores the importance of comprehensive imaging in pediatric abdominal emergencies.
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