Analysis of a case of combined diagnosis and treatment of pinworm related appendicitis with dual mirrors
双镜联合诊治蛲虫相关阑尾炎1例分析

摘要

目的 探讨结肠镜联合经口胆胰直视化子镜诊治蛲虫相关阑尾炎的临床价值与操作要点。方法 对1例17岁反复腹痛的蛲虫相关阑尾炎女性患者，采用奥林巴斯290结肠镜联合9Fr唯德康经口胆胰直视化子镜行内镜直视阑尾炎治疗术，直视下探查阑尾腔并同步行冲洗驱虫治疗，术后予阿苯达唑0.4g顿服。结果 术中明确蛲虫定植阑尾腔为发病原因，术后患者腹痛即刻缓解，低热消失，术后第3日出院，出院后2周、1月、3月随访无腹痛复发，血常规嗜酸细胞指标恢复正常。结论 双镜联合技术可实现蛲虫相关阑尾炎的精准诊断与微创治疗，诊疗一体的优势显著，为特殊病因阑尾炎的诊治提供了新路径。

Abstract

Objective To explore the clinical value and operational points of colonoscopy combined with oral cholangiopancreatography in the diagnosis and treatment of pinworm related appendicitis.
Methods A 17-year-old female patient with recurrent abdominal pain and appendicitis related to pinworms was treated with an Olympus 290 colonoscope combined with a 9Fr Weidekang oral cholangiopancreatography for endoscopic treatment of appendicitis. The appendiceal cavity was explored under direct vision and treated with flushing and deworming simultaneously. After surgery, albendazole 0.4g was given orally.
Results During the operation, it was confirmed that the colonization of pinworms in the appendix cavity was the cause of the disease. The patient's abdominal pain immediately relieved and low-grade fever disappeared after the operation. The patient was discharged on the third day after the operation. Follow up visits at 2 weeks, 1 month, and 3 months after discharge showed no recurrence of abdominal pain, and the eosinophil index in the blood routine returned to normal.
Conclusion   The dual mirror combined technique can achieve precise diagnosis and minimally invasive treatment of pinworm related appendicitis, with significant advantages in integrated diagnosis and treatment, providing a new path for the diagnosis and treatment of appendicitis with special causes.