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一例实施了腹腔镜阑尾切除术的阑尾克罗恩病病例。

A case of appendiceal Crohn's disease in which a laparoscopic appendectomy was performed.

作者信息

Hayama Tamuro, Matsuda Keiji, Shibuya Hajime, Akahane Takuya, Horiuchi Atsushi, Shimada Ryu, Aoyagi Yoshiko, Nakamura Keisuke, Yamada Hideki, Ishihara Soichiro, Nozawa Keijiro, Watanabe Toshiaki

机构信息

Department of Surgery, Teikyo University School of Medicine, Kaga, Itabashi-ku, Tokyo, Japan.

出版信息

Int Surg. 2010 Oct-Dec;95(4):338-42.

Abstract

A 74-year-old female had occasionally experienced right lower abdominal pain in the past. She underwent a barium enema examination during a medical checkup, which revealed a wall irregularity around the appendix, but the appendix itself was not visualized. The patient was referred to our hospital for possible appendiceal neoplasm. Colonoscopy revealed a tumor-like protrusion with marked redness at the entrance to the appendix. Pathologic analysis of biopsy specimens revealed only inflammatory cells. Differential diagnosis of appendiceal Crohn's disease or appendiceal neoplasm was made, and laparoscopic appendectomy was performed. Pathologic examination revealed inflammation in all layers of the appendiceal wall and noncaseating epithelioid cell granuloma, and a diagnosis of appendiceal Crohn's disease was made. The postoperative course was uneventful, and the patient was discharged from the hospital 3 days after surgery. No sign of recurrence has been observed up to now, 6 months after surgical treatment.

摘要

一名74岁女性过去偶尔会出现右下腹疼痛。她在一次体检中接受了钡灌肠检查,结果显示阑尾周围肠壁不规则,但阑尾本身未显影。该患者因可能患有阑尾肿瘤被转诊至我院。结肠镜检查发现阑尾开口处有一个肿瘤样突出物,伴有明显发红。活检标本的病理分析仅显示炎性细胞。对阑尾克罗恩病或阑尾肿瘤进行了鉴别诊断,并实施了腹腔镜阑尾切除术。病理检查显示阑尾壁各层均有炎症以及非干酪样上皮样细胞肉芽肿,最终诊断为阑尾克罗恩病。术后恢复顺利,患者术后3天出院。手术治疗6个月后的现在,未观察到复发迹象。

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