孤立性盲肠溃疡3例报告并文献复习

Benign Solitary Cecal Ulcer:Reports of 3 Cases and Review of the Literature

目的:探讨孤立性盲肠溃疡的诊断和治疗。方法:回顾性分析3例孤立性盲肠溃疡的诊断和治疗并复习相关文献。结果:3例患者均术前误诊为急性阑尾炎,术中见盲肠2例呈急性炎症改变,1例为慢性炎症改变,3例均行右半结肠部分切除,术后标本病理检查证实,溃疡基底为肉芽组织,有炎细胞浸润包括淋巴细胞、巨纤维细胞、嗜酸性粒细胞等,表现为急性和慢性炎症。结论:孤立性盲肠溃疡是一种原因未明的少见疾病,钡剂灌肠或CT检查难以与盲肠癌鉴别,最终确诊需要对结肠镜活检标本或手术切除标本进行病理检查。如无并发症可行保守治疗。

Objective:To investigate the diagnosis and treatment of benign solitary cecal ulcers.Methods:The clinical data of 3 cases of benign cecal ulcers were analyzed retrospectively and the literature was reviewed.Results:All 3 patients were misdiagnosed as the acute appendicitis before operation and were performed right hemicolectomy.Pathological examination showed there was granulation tissue with infiltration of inflamatory cells including lymphocytes,fibroblasts,eosinophils at the bottom of the ulcus,which indicated acute and chronic inflamation.Conclusions:Benign solitary cecal ulcer is an uncommon lesion whose etiology remains unknown.Differential diagnosis between benign solitary cecal ulcerand cecum carcinoma could not be made by radiographic techniques,such as barium enema and CT,and the final diagnosis couldbe made by pathological examination.Expectant treatment should be adopted if no complications occured.