Patient admitted to hospital with abdominal pain, only to be operated on a day later when appendicitis had already ruptured.

Doctor Nguyen Truong Giang examines patient Nguyen Van Hieu after appendectomy surgery - Photo: TAN LUC

On September 28th, patient Nguyen Van Hieu (53 years old, residing in Mang Yang district, Gia Lai province) was being monitored at Hung Vuong Gia Lai Hospital after emergency surgery for a ruptured appendix.

Ultrasound does not detect appendicitis

Mr. Nguyen Van Hung, the patient's son, said that at noon on September 23, he took his father to the emergency room because of a stomachache.

The doctor ordered an ultrasound, X-ray, and several other tests, then diagnosed him with a bowel infection. Mr. Hieu was given intravenous fluids, painkillers, and antibiotics, but his abdominal pain persisted.

By noon the following day, seeing his father in severe abdominal pain, Hung informed the doctor to order a CT scan, which revealed that Mr. Hieu's appendix had ruptured, requiring emergency surgery.

The family was quite upset, claiming that the hospital failed to detect the problem in time, leading to a ruptured appendix and endangering the patient's life.

Therefore, a request for verification and clarification has been submitted to the Department of Health .

Speaking to Tuoi Tre Online , a representative from Hung Vuong Gia Lai Hospital said that patient Nguyen Van Hieu has a unique anatomical structure, unlike typical cases.

Accordingly, the patient's appendix was not located in the right iliac fossa but was instead turned backward behind the cecum under the liver. Therefore, initial diagnostic measures and ultrasound upon admission did not detect appendicitis.

During monitoring, upon noticing the patient's progressively worsening abdominal pain, doctors performed a CT scan of the abdomen and discovered a ruptured appendix. The hospital mobilized skilled surgeons to perform open surgery to treat the ruptured appendix, clean the abdominal cavity, and insert a drainage tube.

Currently, the patient's condition is stable, recovering well after surgery, responsive, and may be discharged in the next few days.

Is this a rare case, difficult to diagnose accurately?

Dr. Bui Truong Giang, deputy director of the hospital, said that medical literature records a small number of patients whose body structures are not in the correct anatomical position.

Therefore, the pain symptoms are atypical, leading to inaccurate clinical and paraclinical examination results. In many cases, by the time inflammation is detected, the appendix has already ruptured.

Regarding this case, Dr. Giang said that fortunately, the appendix rupture was detected and treated early, and the surgery was successful. The patient responded well to the post-operative period and is now gradually stabilizing.

The hospital acknowledged that the initial diagnostic process was challenging in determining the patient's condition due to the rarity of the case and its anatomical abnormalities. Following the incident, the hospital convened a professional council meeting to learn from the experience.

Mr. Giang also stated that the hospital decided to waive all medical fees to share the burden with the patients and their families.

Speaking to Tuoi Tre Online , patient Nguyen Van Hieu said that the pain in the appendix area has subsided, but he still experiences considerable pain at the surgical site.

Source: https://tuoitre.vn/dau-bung-nhap-vien-den-1-ngay-sau-moi-duoc-mo-khi-ruot-thua-da-vo-2024092807304016.htm