阑尾腺癌误诊原因分析

Causal Analysis of Misdiagnosed Primary Adenocarcinoma of the Appendix

目的 探讨阑尾腺癌的误诊原因及对策。方法 结合文献对 6例阑尾腺癌进行回顾性分析。结果 6例分别误诊为急性、慢性阑尾炎和回盲部肿瘤。误诊原因 :1临床医师对本病缺乏认识 ;2术前未进行全面的体检和一些辅助检查如 B超、X线钡剂造影、血 CEA等 ;3术中未做病理检查。结论 对 4 0岁以上阑尾炎患者 ,应仔细查找癌肿的表现 ,阑尾局部肿块 ,管径大于 2 cm,或管壁增厚。

Objective To explore the cause of and countermeasure against misdiagnosis of primary adenocarcinoma of the appendix(PPA).Methods Six cases of misdiagnosed PAA were reviewed retrospectively.Results All six patients were misdiagnosed as acute appendicitis(4 cases),chronic appendicitis(1 case) or mass in right lower abdomen (1 case) respectively, and correct diagnoses were made by postoperative pathological examination.The cause of misdiagnosis included:① doctors' lack of knowledge of PPA;② comprehensive physical examination and some supplementary examination such as B ultrasonic examination,Barium enema examintion,serum CEA determination undone;③ intraoperative pathologic examination undone.Conclusion Patients over 40 years with appendicitis should be paid much attention to,and intraoperative pathologic examination should be performed if local mass,cirrhosis,thickened wall and diameter more than 2cm were found.