特殊人群急性阑尾炎影像学检查及治疗新进展

急性阑尾炎是一种常见病和多发病，结合临床表现、实验室检查诊断典型阑尾炎并不困难，但是对于一些临床表现不典型，阑尾位置变异又高度怀疑阑尾炎的患者，尤其是对于儿童、孕妇及老年患者的诊断显得较为困难。此时，结合影像学检查对于诊断具有重要意义，检查手段包括超声、CT、磁共振影像、钡剂灌肠X线、结肠镜等。诊断明确后，开腹手术作为急性阑尾炎的经典手术方案曾经在临床上被广泛使用，而腹腔镜阑尾切除术作为一种新的微创手术已被人们接受。近年来，内镜下逆行阑尾炎治疗作为一种创新性手术引起国内外学界的广泛关注，在未来可能成为治疗急性阑尾炎的一种新模式。本文就急性阑尾炎，尤其特殊人群急性阑尾炎的诊断及治疗进展做一综述。

Advances in imaging diagnosis and treatment of acute appendicitis in special populations

Acute appendicitis is a common and frequent disease. It is not difficult to diagnose typical appendicitis by laboratory examination combined with clinical manifestations. However, for some highly suspected patients with atypical clinical manifestations and variable location of appendicitis, it is difficult to diagnose, especially in children, pregnant women, and elderly patients. Currently, imaging examinations, including CT, MRI, barium enema X-ray, and colonoscopy, are important for appendicitis diagnosis. Laparotomy has been widely used in acute appendicitis after a clear diagnosis is achieved. Despite this, laparoscopic appendectomy, a minimally invasive procedure, has been accepted. In recent years, endoscopic retrograde appendicitis therapy, as a kind of innovative surgery, has attracted wide attention from scholars and may become a new model for the treatment of acute appendicitis in the future. This article reviews the diagnosis and treatment of acute appendicitis in special populations.