Laalim Said Ait, Toughai Imane, Benjelloun El Bachir, Majdoub Karim Hassani Ibn, Mazaz Khalid
Department of General Surgery, B. CHU Hassan II. Fez. Morocco.
Int J Surg Case Rep. 2012;3(9):445-7. doi: 10.1016/j.ijscr.2012.04.019. Epub 2012 May 22.
Appendiceal intussusception is a very rare disease that is found in only 0.01% of patients who have undergone an appendectomy. Clinical symptoms vary and some patients are asymptomatic. Laparoscopic surgery for appendiceal tumors is still controversial. We present a case of intussusception of the appendix with a mucinous cystadenoma treated by laparoscopic surgery.
We report a case of 47 year-old-women patient who presented with a six month history of intermittent right lower abdominal pain. Abdominal computer tomography CT showed appendiceal mass with intussusception. A laparoscopic right hemicolectomy was performed because the tumor involved the entire appendix. Histopathological examination revealed mucocele due to mucinous cystadenoma of appendix.
Appendiceal intussusception to the cecum caused by mucocele of the appendix is extremely rare. It is very difficult to diagnose the presence of an intussuscepted appendix pre-operatively and investigations will usually include colonoscopy and CT scan. An appendicular intussusception should not be reduced by colonoscopy. Laparoscopic surgery for appendiceal tumors is still controversial; the main concerns to be addressed are the adequacy of resection and intraperitoneal rupture of the tumor. Our patient successfully underwent laparoscopic surgery without any complications.
Appendiceal intussusception to the cecum caused by mucocele of the appendix is a rare cause of abdominal pain and difficult to diagnose. The laparoscopic surgery for appendiceal tumors is safe, feasible, and even may be beneficial.
阑尾套叠是一种非常罕见的疾病，仅在0.01%的接受阑尾切除术的患者中发现。临床症状各不相同，一些患者没有症状。腹腔镜手术治疗阑尾肿瘤仍存在争议。我们报告一例阑尾套叠合并黏液性囊腺瘤经腹腔镜手术治疗的病例。
我们报告一例47岁女性患者，有6个月间歇性右下腹痛病史。腹部计算机断层扫描（CT）显示阑尾肿块伴套叠。由于肿瘤累及整个阑尾，遂行腹腔镜右半结肠切除术。组织病理学检查显示阑尾黏液性囊腺瘤导致黏液囊肿。
阑尾黏液囊肿引起的阑尾套叠至盲肠极为罕见。术前很难诊断出套叠的阑尾，检查通常包括结肠镜检查和CT扫描。结肠镜检查不应试图复位阑尾套叠。腹腔镜手术治疗阑尾肿瘤仍存在争议；主要关注的问题是切除的充分性和肿瘤的腹腔内破裂。我们的患者成功接受了腹腔镜手术，没有任何并发症。
阑尾黏液囊肿引起的阑尾套叠至盲肠是腹痛的罕见原因，且难以诊断。腹腔镜手术治疗阑尾肿瘤是安全、可行的，甚至可能有益。
