32例结肠癌合并阑尾炎的病例分析

Analysis of 32 patients with colon cancers co-existing with appendicitis

目的探讨结肠癌合并阑尾炎的原因,减少误诊漏诊概率。方法对哈尔滨医科大学附属第一医院2006年1月至2013年3月期间的1 094例结肠癌患者进行回顾性分析。结果在1 094名结肠癌患者中,有31例首诊时都诊断为急性阑尾炎,行阑尾切除术;1例诊断为阑尾周围脓肿,非手术治疗。其中6名患者术中发现回盲部肿瘤,24名患者术后1年内被诊断结肠癌,1名患者术后切口不愈合,引流管持续引出褐色液体,1例非手术治疗复发。结论结肠癌本身临床症状不典型,当并存阑尾炎时往往表现出阑尾炎的症状,容易造成误诊漏诊。因此临床医生对阑尾炎患者应提高警惕,术前应仔细询问病史,及时行相关检查,必要时术中探查,以减少误诊漏诊的概率。

Objective To explore the reason of colon cancer with appendicitis and reduce the rate of misdiagnosis. Methods We car-ried out analysis retrospectively to analyze 1 094 hospitalized patients with colon cancer in the First Affiliated Hospital of Harbin Medical Uni- versity from January 2006 to March 2013. Results Among 1 094 colon cancer patients,31 patients who firstly diagnosed with acute appendi-citis received appendectomy, 1 patient with appendiceal abscess received non-surgical treatment. Among 31 patients with acute appendicitis ,6 patients were found to be with ileocecal tumors during surgeries;24 patients were diagnosed with colon cancer within one year;incision of l patient did not heal, with continuous drainage of brown liquid;the appendicitis of 1 patient who received non-surgical treatment was recur-rent. Conclusion As lack of typical symptoms,colon cancer is prone to misdiagnose and diagnose incorrectly when the cancer co-exists with appendicitis and symptoms of appendicitis were showed firstly. Therefore, clinicians should be vigilant for patients with appendicitis. In order to induce the rate of misdiagnosis, it is essential that requesting disease history carefully, timely and relevant inspection and appropriate cx-ploratory surgery for the patients with appendicitis.