Nixon Martha, Verwey Jes, Akoh Jacob A
Gastroenterology, Surgery & Renal Services Directorate, Plymouth Hospitals NHS Trust, Derriford Hospital, Plymouth, UK.
Clin Pract. 2011 Dec 30;2(1):e4. doi: 10.4081/cp.2012.e4. eCollection 2012 Jan 1.
Appropriate management of appendix mass is based on an accurate diagnosis of the underlying pathology. This is a report of a complex patient presenting with an appendix mass, whose surgery was deferred due to severe co-morbidities and who later died from severe metastatic disease. A 65-year-old lady presented with right iliac fossa pain and a mass. She was treated for an appendix mass initially and when the mass failed to resolve after four weeks, she was thoroughly investigated for the possibility of a tumour. Severe co-morbities had a significant impact on her management as definitive surgery was delayed. She represented 10 months after the initial admission with small bowel obstruction and died of metastatic caecal cancer. Management of appendix mass must entail a careful approach to investigating and treatment with emphasis on early intervention if the mass does not resolve promptly. This will avoid delayed diagnosis, treatment and a detrimental impact on prognosis.
阑尾包块的恰当处理基于对潜在病理状况的准确诊断。本文报告了一名患有阑尾包块的复杂患者,因其严重的合并症而推迟了手术,最终死于严重的转移性疾病。一名65岁女性出现右下腹疼痛并伴有包块。她最初被当作阑尾包块进行治疗,四周后包块未消退,遂对其进行全面检查以排查肿瘤的可能性。严重的合并症对其治疗产生了重大影响,导致确定性手术延迟。她在初次入院10个月后因小肠梗阻再次就诊,最终死于盲肠转移性癌。阑尾包块的处理必须采取谨慎的检查和治疗方法,若包块未迅速消退则应强调早期干预。这将避免诊断和治疗的延迟以及对预后产生不利影响。