粪石性阑尾炎合并回盲部穿孔手术方式探讨分析

Investigation and analysis of surgical measures for stercoral appendicitis complicated with ileocecal perforation

目的探讨分析粪石性阑尾炎合并回盲部穿孔的手术方式。方法回顾性分析5例粪石性阑尾炎合并回盲部穿孔患者的临床资料,其中本院首次手术3例;外院手术后转入本院继续治疗2例。结果本院手术患者因术中即发现合并回盲部穿孔,及时手术处理后无一例并发症发生。外院转入患者经过再次手术后,均治愈出院。结论粪石性阑尾炎,尤其是腹膜后位、回肠后位、盲肠后位及外侧位的粪石性阑尾炎很容易合并回盲部穿孔,所以术中如发现是腹膜后位、回肠后位、盲肠后位及外侧位的粪石性阑尾炎,一定要探查确定是否存在回盲部的穿孔,若粪石所在部位阑尾已经穿孔一定要找到粪石,才能有效减少术后肠瘘、腹腔脓肿等不必要的术后并发症。

Objective To investigate and analyze surgical measures for stercoral appendicitis complicated with ileocecal perforation. Methods Clinical data of 5 patients of stercoral appendicitis complicated with ileocecal perforation were retrospectively analyzed. There were 3 cases received their first operation in our hospital, and the other 2 cases were transferred into our hospital for further treatment. Results Intraoperative detection of ileocecal perforation in the 3 cases provided successful operation, without any complications. Transferred cases were cured after second operation and discharged from hospital. Conclusion It is easy for stercoral appendicitis, especially retroperitoneal, ileum, cecum and outside stercoral appendicitis, to be complicated with ileocecal perforation. Therefore, detection of ileocecal perforation is necessary during operation for stercoral appendicitis. Detection of stercorolith after perforation is essential to reduce postoperative complications of intestinal fistula and abdominal abscess