Guzmán-Valdivia Gilberto
Department of General Surgery, Regional General Hospital No. 1 "Gabriel Mancera", Mexican Institute of Social Security (IMSS), Mexico City, Mexico, USA.
World J Surg. 2006 Jun;30(6):1038-42. doi: 10.1007/s00268-005-0104-z.
Acute appendicitis of amebic origin is considered a rare cause of acute appendicitis.
The clinical notes for 4093 patients over the age of 16 who had undergone appendectomy were reviewed. Particular attention was paid to the histopathologic results, separating out those cases where trophozoites were seen in the appendix. These cases were considered to be of amebic origin.
A total of 93 cases reported lesions suggestive of amebiasis (2.3%). This study analyzed 86 of these cases. Comparing the cases in this study against the cases of patients with acute appendicitis in general (excluding the cases of amebic origin), no differences were found in relation to the distribution or presentation according to sex or in the degree of inflammation of the appendix, the incidence of surgical wound infection, or general complications. By contrast, the study noted a statistically significant difference in the age at presentation: Acute appendicitis of amebic origin presents principally among those under 20 years of age and is accompanied by a higher frequency of fecal fistula (2.3%).
Acute appendicitis of amebic origin is not seen frequently, and in general it does not behave any differently from other cases of acute appendicitis, except in its earlier presentation and its greater incidence of fecal fistula. The condition is suspected clinically whenever a cecum of hard, "cardboard-like" consistency is discovered.
阿米巴源性急性阑尾炎被认为是急性阑尾炎的罕见病因。
回顾了4093例16岁以上接受阑尾切除术患者的临床记录。特别关注组织病理学结果，筛选出阑尾中发现滋养体的病例。这些病例被认为是阿米巴源性的。
共有93例报告有提示阿米巴病的病变（2.3%）。本研究分析了其中86例。将本研究中的病例与一般急性阑尾炎患者的病例（不包括阿米巴源性病例）进行比较，在性别分布或表现、阑尾炎症程度、手术伤口感染发生率或一般并发症方面未发现差异。相比之下，该研究指出在发病年龄上存在统计学显著差异：阿米巴源性急性阑尾炎主要发生在20岁以下人群中，且伴有较高的粪瘘发生率（2.3%）。
阿米巴源性急性阑尾炎并不常见，总体上其表现与其他急性阑尾炎病例并无不同，只是发病较早且粪瘘发生率较高。临床上只要发现盲肠质地坚硬如“硬纸板样”，就应怀疑此病。
