Appendiceal mucocele: Case reports and review of current literature

The mucocele of the appendix is an uncommon disorder which is often asymptomatic but sometimes causes acute appendicitis-like symptoms. Sometimes, patients with mucocele can present with confusing symptoms. Preoperative suspicion and diagnosis of appendiceal mucocele are important. Ultrasonography and computed tomography are useful tools for the diagnosis of appendiceal mucocele. It may be also recognised by colonoscopy as a smooth submucosal lesion of the cecum. Optima management of the mucocele could be achieved through accurate preoperative diagnosis. Preoperative diagnosis is a major component for minimizing intra-operative and post-operative complications. We herein report five cases and discuss the diagnostic methods and surgical treatment.

Ciliated hepatic foregut cyst： report of first case in China and review of literature

Objective: To report the first case of ciliated hepatic foregut cyst in China, and review of literature to introduce the characteristics of this disease for doctors to recognize this disease.Method: Report the clinical procedure of diagnosis and treatment for the first case of ciliated hepatic foregut cyst in China, and to review the embryologic genesis, incidence,clinical manifestation, radiologic features and therapeutic principle of this disease. Results: We performed the resection for ciliated hepatic foregut cyst under laparoscopy; the patient recovered well after the procedure. Conclusion: Ciliated hepatic foregut cyst is quite rare clinically, belongs to non-parasitic,solitary and unilocular cystic lesion, is always less than 4cm in diameter, mostly seen in the left lobe, and has the tendency of malignant change. It should be removed as soon as diagnosed.

Pancreatic tuberculosis masquerading as pancreatic serous cystadenoma

Solitary pancreatic involvement of tuberculosis is rare, especially in an immunocompetent individual, and it may be misdiagnosed as pancreatic cystic neoplasms. Pancreatic cystic neoplasms are being identified in increasing numbers, probably because of the frequent use of radiology and advances in endoscopic techniques. However, they are composed of a variety of neoplasms with a wide range of malignant potential, and it is often difficult to differentiate pancreatic tuberculosis mimicking cystic neoplasms from benign or malignant pancreatic cystic neoplasms. Non-surgical diagnosis of pancreatic tuberculosis is inconclusive and continues to be a challenge in many cases. If so, then laparotomy should be employed to establish the diagnosis. Therefore, pancreatic tuberculosis should be kept in mind during the differential diagnosis of solitary cystic masses in the pancreas. We report a patient who had solitary pancreatic tuberculosis masquerading as pancreatic serous cystadenoma.

CONGENITAL CHOLEDOCHAL CYST——REPORT OF 56 CASES

The aim of this paper is to describe the mechanism, clinical manifestation, diagnosis and surgical management of congenital choledochal cyst. [WT5”BX] Methods.[WT5”BZ] From 1984 to 1997, 56 cases of congenital choledochal cyst were reviewed. Among them, 8 patients were male, 48 patients were female, the age ranges from 12 to 50 years old with an average of 26 3. [WT5”BX] Results.[WT5”BZ]The main clinical manifestation includes jaundice, abdominal pain and abdominal mass. All of them were confirmed by ultrasonography, while 39 cases were performed ERCP and PTC with the same diagnosis. Fifty one patients were performed cystectomy and hepatojejunostomy, two cases were performed cystjejunostomy because of diffused angioma and severe hemorrhage respectively, external drainage was performed in one case with emergent cholangitis, the other two cases were reported malignancy through biopsy and operation was abandoned. [WT5”BX] Conclusions. [WT5”BZ]Ultrasound diagnostics is essential to accurately diagnose the cyst, preoperative ERCP is helpful for differentiating pancreatic duct from bile duct, while MRCP is a reliable method; cystectomy and cholangiojejunostomy is recommended, laparoscopic procedure is becoming more and more accepted.

DIAGNOSIS AND SURGICAL TREATMENT OF BRONCHOGENIC CYSTS

Between 1974 and 1993, 22 patients with bronchogenic cysts were operated on in our hospital; there were 14 men and 8 women, ranging in age from 11 to 62 years. The cyst locations were mediastinal in 13 (59.1%) and intrapulmonary in 9 (40. 9%). There were symptoms (chest pain and recurrent bronchiolits) in 20 patients (91%). The preoperative complications included infection in the lung and in the cyst and dysphagia due to esophageal compression. Chest pain was the main symptom in mediastinal cyst and recurrent infection of lung in intrapulmonary cyst. Plain chest radiograms showed that a round shadow, occasional air-fluid levels, and peripheral calcification may be found in cysts. An operation is the best treatment for cysts. All cysts were completely excised. No postoperative cornphcations. late complications, or recurrence developed in our patients.

卵巢子宫内膜异位囊肿破裂56例临床分析

目的 探讨卵巢子宫内膜异位囊肿破裂的临床特点及疗效.方法 对本院收治的卵巢子宫内膜异位囊肿破裂56例,按2003年6月为界分A、B两组,A组：1998年6月至2003年5月收治25例,所有病例均行开腹手术,其中15例行保留生育功能手术,8例行保留卵巢功能手术,2例行根治性手术.B组：2003年6月至2008年6月收治31例,其中2例行开腹根治性手术,20例行腹腔镜下保留生育功能手术并同时行宫腔镜通液（治疗和判断输卵管通畅情况）,9例腹腔镜下保留卵巢功能手术.比较2组疗效.结果 卵巢子宫内膜异位囊肿破裂56例,占妇科急腹症0.58%,占卵巢子宫内膜异位囊肿4.55%.A组术前误诊率[32.0%（8/25）]、[36.0%（9/25）]高于B组[3.2%（1/31）]、[6.5%（2/31）],差异均有统计学意义（χ2=6.50,P〈0.01）;B组妊娠率及足月分娩率高于A组（P〈0.01）,而2组盆腔内异Ⅲ～Ⅳ期及保留生育功能手术病例数比较差异均无统计学意义（P〉0.05）.结论 卵巢子宫内膜异位囊肿破裂误诊率高,应签别临床症状及体征可减少误诊,一旦确诊及时手术和药物治疗,有利于降低复发率,提高生育率及生活质量.

上颌骨后牙区囊肿16例诊治分析

目的总结上颌骨后牙区囊肿的临床特点及诊治体会。方法选择16例上颌骨后牙区囊肿患者,进行临床、影像检查,并进行手术治疗、病理诊断。结果颌骨囊肿9例,牙源性角化囊肿3例,根尖周囊肿1例,上颌窦囊肿2例,含牙囊肿1例;单囊性阴影,含或不含阻生齿或多生牙,累及或不累及上颌窦。结论注意解剖结构的特殊性,防止漏诊、误诊以及选择恰当的治疗方法 。

小儿纵隔肠源性囊肿30例诊治分析

目的:探讨小儿纵隔肠源性囊肿的病因、诊断及治疗。方法:回顾性分析30例纵隔肠源性囊肿患儿的临床资料。结果:28例表现为呼吸系统症状,2例无症状。术前查B超27例,CT 20例,M R I 8例,均提示为边界清晰的囊性肿物。结论:纵隔肠源性囊肿表现为呼吸系统压迫和感染症状,影像学检查是本病诊断的可靠依据,囊肿切除是有效的根治方法。

舌下腺囊肿口外型25例分析

目的探讨舌下腺囊肿口外型的误诊原因及诊治要点。方法对25例舌下腺囊肿口外型病例进行回顾性分析。结果 25例患者经手术摘除舌下腺后,有1例复发,其余24例观察1a后无复发,效果满意。结论运用穿刺及磁共振检查可明确诊断舌下腺囊肿口外型,口内全部摘除舌下腺是治疗口外型囊肿的最佳方法。

子宫圆韧带囊肿5例诊治分析

目的探讨子宫圆韧带囊肿的形成,加强妇科医生对子宫圆韧带囊肿诊断和治疗。方法回顾2005-2010年间承德钢铁公司职工医院住院手术治疗子宫圆韧带囊肿患者5例,分析误诊原因,提高妇科医生对子宫圆韧带囊肿的认识,减少误诊误治,避免医疗纠纷。结果 5例子宫圆韧带囊肿患者均存在一定的误诊,其中3例被误诊为腹股沟斜疝,2例经B超检查回报为腹股沟囊性病变,没有能够在术前明确诊断为子宫圆韧带囊肿。结论妇科医生通过对腹股沟肿物的体格检查,B超分析能够鉴别子宫圆韧带囊肿和腹股沟疝,得出正确诊断,减少误诊时间和误诊率。该病的主要为手术治疗。

舌下腺囊肿口外型23例诊治分析

目的:探讨舌下腺囊肿口外型的临床特征、误诊原因及诊治要点,旨在减少误诊,提高诊治水平。方法:收集经山东省昌乐县人民医院诊治的23例舌下腺囊肿口外型病例,并对其临床资料进行回顾性分析。结果:23例中,舌下-颌下型6例,颌下型17例,误诊7例,所有病例均行手术摘除舌下腺治愈。结论:下颌舌骨肌发育缺陷,舌下腺穿过该肌裂孔或间隙突入颌下区是本病发生机制,以口内切口完整摘除舌下腺是根治口外型囊肿的最佳方法。

骶前囊肿继发肛瘘2例诊治分析

笔者近5a来共收治2例骶前囊肿继发感染合并肛瘘的患者,均多次手术治疗,瘘道反复发作,经久不愈,经切除囊肿、瘘道和直肠瘘口清创缝合后痊愈。现将其诊断及治疗体会报告如下。

阑尾黏液囊肿误诊为急性阑尾炎1例分析

对阑尾黏液囊肿误诊为急性阑尾炎1例分析如下。1病历摘要男，36岁。主因右下腹持续性疼痛12h急诊入院。入院前12h．患者无明显诱因出现右下腹疼痛，疼痛呈持续性。进行性加剧。无恶心、呕吐、血尿、尿痛等症状。

上颌骨后牙区牙源性角化囊性瘤30例诊治分析

目的对上颌骨后牙区牙源性角化囊性瘤的诊治进行分析。方法选择病理为上颌骨后牙区牙源性角化囊性瘤患者30例,均行刮除手术治疗;术后随访观察治疗效果。结果牙源性角化囊性瘤患者临床表现不一,受累牙齿有/无松动,影像学上呈单囊或多囊性阴影,含或不含阻生齿或多生牙,上颌窦底受累情况不同;随访期间复发5例,上颌窦瘘2例。结论注意上颌骨后牙区解剖结构的特殊性,防止漏诊、误诊以及选择恰当的治疗方法。