阑尾粘液囊肿的临床分析

Clinical Analysis of Appendiceal Mucoceles

目的探讨阑尾粘液囊肿和腹膜假性粘液瘤的诊治方法。方法13例阑尾沾液囊肿患者,6例行单纯阑尾切除术;2例行回盲部切除;2例行右半结肠切除术;2例急诊行阑尾切除术后,因术后病理为阑尾粘液性囊腺癌而再次行右半结肠切除术;1例术中发现阑尾囊肿破裂合并腹膜假性粘液瘤,行右半结肠切除术,吸净腹水后用生理盐水和5-Fu冲洗腹腔,术后化疗1次。结果所有患者均手术成功;除外1例因意外失随访,其余随访均无复发。结论本病罕见,以右下腹痛与包块为主诉的患者应警惕本病。B超与消化道造影可能是较为简便经济的诊断方法。严格掌握手术适应证,疑有本病时应认真探查腹腔。

Objective To investigate the diagnostic and treatment methods of appendiceal mucoceles and peritoneal pseudomyxoma. Methods Thirteen eases of appendieeal mucoceles were enrolled in this study, Six eases underwent appendectomy, two eases ileocecal resection, two cases right colectomy, and two cases appendectomy in emergency followed by right colectomy because their postoperative pathological diagnosis was appendiceal muco- cystadenocarcinoma. Ruptured appendiceal mucocele and peritoneal pseudomyxoma were found during operation in one case,then right colectomy was performed, ascites was removed and abdominal cavity was washed with normal sahne and 5 - Fu solution. Systemic chemotherapy was given to this patient after operation, Results Operation was successful in all the patients. Except one case not followed up, the other patients remained free of disease after operation. Conclusion Appendiceal mucoceles is uncommon. The patients should be suspected suffering from this disease when chief complaints are right lower abdominal pain and mass. B - type ultrasonography and other necessary digestive image examinations are economical and inexpensive diagnostic method of appendiceal mucoceles. It is necessary to explore the whole abdominal cavity carefitlly when this disease is suspected during operation.