阑尾周围脓肿误诊为卵巢肿瘤行手术治疗的经验教训

Experience of periappendiceal abscess misdiagnosed as ovarian tumor

目的提高对阑尾周围脓肿的诊断与鉴别诊断水平。方法回顾分析26例阑尾周围脓肿误诊为卵巢肿瘤行手术治疗的原因及预防措施。结果26例患者术前均误诊为卵巢肿瘤行手术治疗,术中发现为阑尾周围脓肿行脓肿引流或阑尾切除治愈,其中4例患者术中损伤肠管行肠修补、局部引流而治愈(1例并发肠瘘)。结论阑尾周围脓肿误诊为卵巢肿瘤而手术,易导致严重并发症。术前仔细询问病史,细致体格检查,全面分析辅助检查结果,认真做好诊断和鉴别诊断,能减少或避免阑尾周围脓肿的误诊误治。

Objective To discuss the reason and precaution of the periappendiceal abscess misdiagnosed as ovarian tumor. Methods 26 patients with periappendiceal abscess misdiagnosed as ovarian tumor were analyzed. Results The patients were misdiagnosed as ovarian tumor before operation and cured through the abscess drainage or appendectomy. Among them, 4 case of bowel injury were underwent intestinal reparation and local drainage. Conclusion It easily leads to serious complications, if the patients with periappendiceal abscess are misdiagnosed as ovarian tumor and underwent the operation. To reduce or avoid the misdiagnosis and mistreatment periappendicular abscess, it is necessary to ask in detail about case history, carry out meticulous physical examination, thoroughly analyze the examination results and conscientiously diagnose and discriminate before the operation.