Rudloff Udo, Malhotra Sandeep
Department of Surgery, New York University Medical Center, New York, NY 11040, USA.
Surg Today. 2007;37(6):514-7. doi: 10.1007/s00595-006-3435-y. Epub 2007 May 28.
Few cases of volvulus of an appendiceal mucocele have been reported. The mechanism of torsion seems to be similar to that suggested for ovarian or appendegeal torsion, where a solid organ or mass fixed onto a narrow stalk is a precondition. We report the case of a young woman who presented with signs and symptoms of acute appendicitis. Computed tomography showed a cystic mass of fluid consistency in the right lower quadrant. An emergency laparoscopy revealed a 720 degrees torsion of a gangrenous mucocele around the proximal part of the appendix. We performed a laparoscopic appendectomy and she recovered uneventfully. The presentation of volvulus of an appendiceal mucocele can mimic other common conditions. Prompt surgical intervention is essential to prevent gangrene and perforation. The combination of a cystic, right lower quadrant mass, and clinical findings suggestive of acute appendicitis should alert the clinician to include volvulus of an appendiceal mucocele in the differential diagnosis.
阑尾黏液囊肿扭转的病例报道较少。扭转机制似乎与卵巢或附件扭转相似,即实体器官或肿物固定于狭窄蒂部是其前提条件。我们报告一例年轻女性,表现为急性阑尾炎的症状和体征。计算机断层扫描显示右下腹有一液性密度的囊性肿物。急诊腹腔镜检查发现一个坏疽性黏液囊肿在阑尾近端发生了720度扭转。我们进行了腹腔镜阑尾切除术,患者恢复顺利。阑尾黏液囊肿扭转的表现可类似其他常见疾病。及时的手术干预对于预防坏疽和穿孔至关重要。右下象限囊性肿物合并提示急性阑尾炎的临床表现应提醒临床医生在鉴别诊断中考虑阑尾黏液囊肿扭转。