Todd R David, Sarosi George A, Nwariaku Fiemu, Anthony Thomas
Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Am J Surg. 2004 Nov;188(5):500-4. doi: 10.1016/j.amjsurg.2004.07.017.
Patients with appendiceal tumors (AT) frequently present with the same signs and symptoms as acute appendicitis (AA). The purpose of this study was to identify the incidence of AT in a population of patients greater than 60 years of age thought to have AA, and to identify presenting factors that can help differentiate the 2 disease processes.
An institutional review board-approved, retrospective review was performed identifying all patients greater than 60 years old who underwent either appendectomy or colectomy after presenting with signs and symptoms of AA from Janaury 1997 to April 2004. Patient records were examined for demographic variables, presenting signs and symptoms, and pathology.
A total of 34 patients fit the entry criteria; 8 (24%) had AT. Average duration of symptoms was significantly longer (4.9 +/- 1.9 versus 2.3 +/- 0.3 days; P = 0.01) and hematocrit lower (36.5 +/- 2.3 versus 42.4 +/- 1.0%; P = 0.01) for patients with AT compared with patients with AP. No other significant differences in presenting signs and symptoms were noted.
There is an increased incidence of appendiceal neoplasms among elderly patients presenting with signs and symptoms of AA. Distinction between AT and appendicitis is difficult preoperatively, but AT should be suspected when patients present with longer duration of symptoms or reduced hematocrit.
阑尾肿瘤（AT）患者常表现出与急性阑尾炎（AA）相同的体征和症状。本研究的目的是确定在被认为患有AA的60岁以上患者群体中AT的发病率，并确定有助于区分这两种疾病过程的表现因素。
进行了一项经机构审查委员会批准的回顾性研究，确定了1997年1月至2004年4月期间所有60岁以上出现AA体征和症状后接受阑尾切除术或结肠切除术的患者。检查患者记录中的人口统计学变量、表现出的体征和症状以及病理学情况。
共有34例患者符合纳入标准；8例（24%）患有AT。与AP患者相比，AT患者的平均症状持续时间明显更长（4.9±1.9天对2.3±0.3天；P = 0.01），血细胞比容更低（36.5±2.3对42.4±1.0%；P = 0.01）。在表现出的体征和症状方面未发现其他显著差异。
在出现AA体征和症状的老年患者中，阑尾肿瘤的发病率有所增加。术前区分AT和阑尾炎很困难，但当患者症状持续时间较长或血细胞比容降低时，应怀疑患有AT。
