外科隐匿性阑尾82例回顾性探讨

A retrospective investigation on 82 cases of surgical concealed appendices

目的 对外科隐匿性阑尾原因进行临床分析和探讨。方法 收集我院自 1965年至 2 0 0 2年间共住院手术切除阑尾 12 698例病历资料 ,从中归纳出 82例隐匿而难找阑尾。结果 术中扩大麦氏切口 74例 ,经左麦氏切口切除阑尾 2例 ,经旁正中切口转换为右半结肠切除术 4例 ,误诊 2例 ,其中 1例为升结肠肿瘤 ,另 1例为结肠肝曲癌肿。结论 在普外科隐匿而难找阑尾确实有一定比例 ,解决问题的关键是细致探查。术中发现接近正常的阑尾病例必须考虑到结肠肿瘤的可能。

Objective To investigate the etiologic factors of surgical concealed appendices.Methods The data about 12 698 cases of appendectomies performed during 1965～2002 in our hospital were collected,and 82 cases of concealed appendices were analyzed.Results Among 82 cases of concealed appendices,there were 76 cases of complemental enlarged Mc Burney incision and 2 cases of left Mc-Burney incision,and 4 cases which were changed into right hemicoloctomy from para-median incision.Misdiagnosis happened in 2 cases which had been proved as ascending colon tumor in one case and hepatic flexure carcinoma in another.Conclusion The surgical concealed appendices do occur in a certain proportion in general surgery.The meticulous exploration is necessary to solve the problem.The possibility of colon carcinoma should be considered in the case of almost normal appendix.