Non-surgical contraindication for acute appendicitis with secondary thrombocytopenia: A case report

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 × 109/L, with91.4% neutrophils, and a platelet count of 4 × 109/L before admission.The case question was whether the te...

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Bibliographic Details
Published in:World journal of gastroenterology : WJG 2015-03, Vol.21 (9), p.2836-2839
Main Authors: Zhang, Hai-Hong, Gu, Guo-Li, Zhang, Xiang-Yang, Fan, Qin, Wang, Xin-Yan, Wei, Xue-Ming
Format: Article
Language:English
Subjects:
Abdominal Pain - etiology
Adult
Appendectomy
Appendicitis - complications
Appendicitis - diagnosis
Appendicitis - surgery
Bone Marrow Examination
Case Report
Contraindications
Diagnosis, Differential
Humans
Male
Platelet Count
Predictive Value of Tests
Risk Factors
Severity of Illness Index
Thrombocytopenia - blood
Thrombocytopenia - diagnosis
Thrombocytopenia - etiology
Thrombocytopenia
Appendicitis
Infection
Fever
Appe
Tomography, X-Ray Computed
Treatment Outcome
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Summary: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 × 109/L, with91.4% neutrophils, and a platelet count of 4 × 109/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 × 109/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.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v21.i9.2836