阑尾粘液囊肿的影象学诊断和外科治疗

Imaging diagnosis and surgical management of mucocele of the appendix

作者对２４例阑尾粘液囊肿进行的回顾性分析，结果表明：阑尾粘液囊肿的常见临床表现有急、慢性右下腹痛（７０．８％），右下腹压痛（７０．８％）和腹部包块（５４．２％）。由于临床表现的非特异性，所以，术前诊断相当困难。本病在Ｂ超和ＣＴ检查上可表现为右下腹或右侧盆腔类圆形囊性肿物；Ｘ线钡灌肠检查为盲肠或回肠末端有类圆形软组织块，盲肠向外上方移位并出现弧形压迹；纤维结肠镜检查为盲肠内侧半球形隆起病变，表面光滑，粘膜正常。大多数阑尾粘液囊肿仅行阑尾切除即可，但如囊肿延及盲肠或为恶性病变时，则需行右半肠切除。

Abstract cases of mucocele of the appendix were analyzed retrospectively.The results showed that the common clinical manifestations were acute or chronic pain and tedenness in the right lower abdominal quadrant (70.8%) ,and abdominal mass ( 54.2%) .Preoperative diagnosis is extremely difficult,because clinical manifestations are nonspecific.This lesion may present as ovoid cystic mass in the right lower quadrant or in the right pelvic region on ultrasonography and computed tomography examination, on barium enema studies,a sharply circumscribed ovoid soft tissue mass was seen overlapping the cecum and terminal ileum and causing displacement of the cecum superiolaterally;endoscopically,itappears as a submucosal projection with intact overlying mucosa in the cecum.In most patients,an appendectomy alone was proved curative.However,in patients with the cecum involved by the lesion of mucocele or lesions of malignance,right hemicolectomy may be required.