恶性肿瘤腹腔淋巴结转移发生阑尾穿孔的原因及诊治

Diagnosis and Treatment of Appendix Perforation Accompanied by Carcinoma with Celiac Lymph Node Metastasis

报告2例恶性肿瘤腹腔淋巴结广泛转移发生阑尾穿孔。认为盖尾穿孔快、迅速形成弥漫性腹膜炎的原因可能与回盲部转移淋巴结直接压迫阑尾管壁、大网膜萎缩、机体免疫功能低下、腹腔放射治疗及全身化学治疗有关；指出临床表现与阑尾病理生理变化不一致是导致误诊的主要原因，对治疗措施进行分析。

It was reported that 2 carcinoma cases with the lymphnode metastasis were accompanied by appendix perforation. The reason of quick appendix perforation and peritornitis diffusion might be relevant to appendix pressed by the ileocecal lymph nodes netastasized, greateromentum atrophy, immunologic function deficiency of the patients, radiation therapy of abdominal cavity and general chemotherapy. The clinical manifestations didn't comepond to the appendicalpathophysiologic changes, which was the main reason of delayed diagnosis. The prevention and treatment of appendix perforation were discussed.