An 11-year-old boy without any medical history presented with a 4-day history of vomiting and abdominal pain, followed by appearance of fever and decreased energy. Physical examination showed a blood pressure of 90/60 mm Hg, a pulse rate of 120/min, a temperature of 40°C, oxygen saturation of 93% on air, and diffuse abdominal contracture. Laboratory values showed hyperleukocytosis (24,000/mm3), hemoglobin of 15 g/L, prothrombin time of 48%, and creatinine of 127 mmol/L. An abdominal computed tomography (CT) showed a thick perforated appendix, an abundant intraperitoneal effusion, and pneumoperitoneum. There were air bubbles in the Wirsung canal, parietal pneumatosis of the duodenum and the jejunum, and hepatic portal venous gas (figure 1). Thromboses of the mesenteric vein, splenic vein, and portal vein were suspected due to the CT scan findings. A contrast enhancement study was not performed because of the elevated creatinine. The boy was admitted to the department of pediatric surgery for …

中文翻译：

---

儿童阑尾炎罕见的致命并发症：门静脉炎

一名没有任何病史的 11 岁男孩因呕吐和腹痛 4 天就诊，随后出现发烧和精力减退。体格检查显示血压 90/60 mm Hg，脉搏 120 次/分钟，体温 40°C，空气中氧饱和度 93%，弥漫性腹部挛缩。实验室检查结果显示白细胞增多症 (24,000/mm3)，血红蛋白为 15 g/L，凝血酶原时间为 48%，肌酐为 127 mmol/L。腹部计算机断层扫描 (CT) 显示阑尾厚穿孔、大量腹腔积液和气腹。Wirsung 管内有气泡，十二指肠和空肠壁积气，肝门静脉积气（图 1）。由于 CT 扫描结果，怀疑肠系膜静脉、脾静脉和门静脉的血栓形成。由于肌酐升高，未进行对比增强研究。这名男孩因……被送往小儿外科。