原发性阑尾肿瘤9例诊治报告

The Diagnosis and Treatment of Primary Tumor of the Appendix in 9 Cases

目的 总结原发性阑尾肿瘤的诊治经验。 方法 分析 9例原发性阑尾肿瘤的诊治经过。 结果 原发性阑尾肿瘤临床较少见 ,其症状体征无特异性 ,术前几乎不能明确诊断 ,常误诊为急慢性阑尾炎、右下腹炎性包块等 ,二次手术率高。 结论 凡有以下表现者应考虑本病 ,作相应处理 :①阑尾炎症状不典型 ,近期又复发 ,或表现为阑尾脓肿 ,积极治疗效果不佳 ,或一度消退又复发。②右下腹肿块。③术后表现阑尾粗大或短缩 ,壁增厚 ,腔闭塞 ,或根部有坚硬肿块者。④阑尾切除术后形成长期不愈的瘘管。⑤不明原因的下消化道出血、回结肠套叠等。阑尾肿瘤均应手术 ,视具体情况行阑尾切除术或右半结肠切除术 ,或根治性右半结肠切除术。

Objective To sum up the experiences of the diagnosis and the treatment for primary tumor of the appendix(PTA). Methods The processes of diagnosis and treatment of primary tumor of the appendix were analyzed in 9 cases. Results It was hardly to make a definite diagnosis of primary appendiceal tumor before the operation, because of the lack of specific symptoms and signs of the disease. It was frequently misdiagnosed as acute or chronic appendicitis or inflammatory mass of the RLQ in these patients. The rate of second operation was high. Conclusions Frozen section should be made if atypical acute or chronic appendicitis, appendiceal abscess or inflammatory mass of the RLQ is found during the operation. For idiopathic illeocolic intussuception or lower GI bleeding, further corresponding investigation is necessary.