Chaar Cassius Iyad Ochoa, Wexelman Barbara, Zuckerman Kaye, Longo Walter
Department of General Surgery, Yale New Haven Hospital, New Haven, CT, United States.
Am J Surg. 2009 Jul;198(1):122-8. doi: 10.1016/j.amjsurg.2008.08.023. Epub 2009 Feb 27.
Intussusception of the appendix is a rare disease that constitutes a diagnostic challenge to the surgeon. The literature on this condition is limited to case reports. The demographics, presentation, and treatment remain debatable in the absence of a comprehensive review of the literature.
This article reports a case of a 40-year-old woman who presented with intussusception of the appendix caused by endometriosis. A comprehensive review of the English literature in PubMed was performed. The trends in incidence, sex predilection, presentation, and treatment of appendiceal intussusception were derived based on the reports of 191 patients.
The incidence was more common in adults (76%) than in children (24%). Female patients (72%) were 2 times more affected in adults than in children, whereas male patients (58%) seem to be more affected in the pediatric population. Intussusception of the appendix has most commonly a chronic presentation (63%). Endometriosis (33%) and inflammation (76%) were the most common pathologic findings in adults and children, respectively. Only 49% of patients were treated by simple appendectomy; 49% patients underwent partial colectomy; and 2% of patients had their appendixes endoscopically removed.
阑尾套叠是一种罕见疾病,对外科医生来说是一项诊断挑战。关于这种疾病的文献仅限于病例报告。在缺乏对文献全面综述的情况下,其人口统计学特征、临床表现和治疗方法仍存在争议。
本文报告了一例由子宫内膜异位症引起阑尾套叠的40岁女性病例。对PubMed中的英文文献进行了全面综述。基于191例患者的报告得出了阑尾套叠的发病率、性别偏好、临床表现和治疗趋势。
阑尾套叠在成人中(76%)比在儿童中(24%)更常见。女性患者(72%)在成人中的受影响程度是儿童的2倍,而男性患者(58%)在儿科人群中似乎受影响更大。阑尾套叠最常见的表现为慢性(63%)。子宫内膜异位症(33%)和炎症(76%)分别是成人和儿童中最常见的病理发现。只有49%的患者接受了单纯阑尾切除术;49%的患者接受了部分结肠切除术;2%的患者通过内镜切除了阑尾。