Majeski James
Am J Surg. 2003 Aug;186(2):129-31. doi: 10.1016/s0002-9610(03)00187-9.
Diverticulum of the vermiform appendix is rarely encountered. Previous reports in the literature indicate that appendiceal diverticulum without inflammations are asymptomatic.
During the past 10 years, 217 patients have been evaluated in our office for chronic lower abdominal pain. Six patients in this group were unusual in that no diagnosis could be made after a complete history, physical examination, and multiple imaging and laboratory studies. Each patient had a normal computed tomography scan of the abdomen, upper endoscopy, colonoscopy, barium enema, and small bowel enteroclysis. Each of the 6 patients underwent an exploratory laparoscopy and appendectomy.
All 6 patients in this series had acquired diverticulum of the appendix with inspissated intraluminal secretions without histological evidence of inflammation. The age range was 37 to 57 years. Most patients were male, and most had a single diverticulum projecting into the mesoappendix. All 6 patients had complete resolution of their chronic abdominal pain after the laparoscopic appendectomy.
An unusual cause of mild chronic abdominal pain can be the presence of appendiceal diverticulum with inspissated intraluminal secretions. The evaluation of these patients is usually normal. Exploratory laparoscopy with appendectomy should be the final evaluation for patients with mild chronic abdominal pain.
阑尾憩室很少见。文献中先前的报道表明，无炎症的阑尾憩室无症状。
在过去10年中，我们科室对217例慢性下腹痛患者进行了评估。该组中有6例患者情况特殊，在完成全面的病史采集、体格检查以及多项影像学和实验室检查后仍无法做出诊断。每位患者的腹部计算机断层扫描、上消化道内镜检查、结肠镜检查、钡剂灌肠和小肠灌肠造影均正常。这6例患者均接受了腹腔镜探查和阑尾切除术。
该系列中的所有6例患者均有后天性阑尾憩室，腔内分泌物浓稠，无炎症的组织学证据。年龄范围为37至57岁。大多数患者为男性，大多数有单个憩室突入阑尾系膜。所有6例患者在腹腔镜阑尾切除术后慢性腹痛均完全缓解。
轻度慢性腹痛的一个不常见原因可能是存在伴有腔内浓稠分泌物的阑尾憩室。对这些患者的评估通常正常。对于轻度慢性腹痛患者，腹腔镜探查并阑尾切除术应作为最终评估手段。
