Open AccessNon-surgical contraindication for acute appendicitis with secondary thrombocytopenia: A case report
Author(s) -
Haihong Zhang,
Guo-Li Gu,
Xiangyang Zhang,
Qin Fan,
Xinyan Wang,
Xueming Wei
Publication year - 2015
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v21.i9.2836
Subject(s) - medicine , hepatosplenomegaly , abdominal pain , contraindication , appendicitis , differential diagnosis , blood test , splenectomy , surgery , pathological , complete blood count , acute abdominal pain , physical examination , radiology , gastroenterology , pathology , spleen , alternative medicine , disease
A 26-year-old man presented with migrated right lower abdominal pain and without any history of hematological systemic diseases. Blood routine test showed a leukocyte count of 22.74 × 10(9)/L, with 91.4% neutrophils, and a platelet count of 4 × 10(9)/L before admission. The case question was whether the team should proceed with surgery. Obviously, a differential diagnosis is essential before making such a decision. Acute appendicitis was easily diagnosed based on clinical findings, including migrating abdominal pain, a leukocyte count of 22.74 × 10(9)/L and the result of abdominal computed tomography scan. However, it was not clear whether the severe thrombocytopenia was primary or secondary. So smear of peripheral blood and aspiration of bone marrow were ordered to exclude hematological diseases. Neither of the tests indicated obvious pathological hematological changes. There was no hepatosplenomegaly found by ultrasound examination of the liver and spleen. Therefore, operative intervention may be a unique clinical scenario in acute severe appendicitis patients with secondary thrombocytopenia.