右半结肠癌误诊急性阑尾炎113例原因分析

Misdiagnosis on right colon cancer as acute appendicitis：an ananlysis of 113 cases

目的 探讨右半结肠癌致急腹症患者误诊为急性阑尾炎的原因及预防措施.方法回顾性分析我院2001年1月至2010年12月收治的113例误诊为急性阑尾炎的结肠癌患者临床资料.结果 10年间我院共收治以急性阑尾炎为首诊的患者2686例,其中113（4.21％）例最终确诊为结肠癌.其中在术前确诊38例,在术中确诊65例,在术后根据病理或继发症状确诊10例.结肠癌患者术前、术中确诊率为91.2％.结论 急性阑尾炎在术前需与右半结肠癌进行细致的鉴别诊断,能够显著地降低结肠癌患者的误诊率及避免延误患者的治疗.应引起临床重视.

Objective To investigate the causes of misdiagnosis on right colon cancer as acute appendicitis in patients with acute abdomen. Methods The clinical data of 113 patients with right colon cancer who were misdiagnosed as acute appendicitis were retrospectively reviewed. Results In 2686 cases with first impression of acute appendicitis, 113 cases （4.21% ）had the final diagnosis of right colon canc- er. The diagnosis was preoperatively confirmed in 38 cases,intraoperatively confirmed in 65 cases and post- operatively confirmed in 10 cases. The preoperative and intraoperative diagnosis rate was 91.2%. Conclu- sion Acute appendicitis should be differentiated from right colon cancer preoperatively. It can decrease the misdiagnosis rate of right colon cancer and avoid delayed treatment,which should be it can improve the effect of the patient, which should be paid attention in clinical practice.