成人阑尾与粪石的关系。
Association between the appendix and the fecalith in adults.
机构信息
The Department of Surgery, General Hospital, Port-of-Spain, Trinidad, West Indies.
出版信息
Can J Surg. 2015 Feb;58(1):10-4. doi: 10.1503/cjs.002014.
BACKGROUND
We sought to determine the association between the presence of a fecalith and acute/nonperforated appendicitis, gangrenous/perforated appendicitis and the healthy appendix.
METHODS
We retrospectively analyzed appendectomies performed between October 2003 and February 2012. We collected data on age, sex, appendix histology and the presence of a fecalith.
RESULTS
During the study period, 1357 appendectomies were performed. Fecaliths were present in 186 patients (13.7%). There were 94 male (50.5%) and 92 female patients, and the mean age was 32 (range of 10-76) years. The fecalith rate was 13%- 16% and was nonexistant after age 80 years. The main groups with fecaliths were those with acute/nonperforated appendicitis (n = 121, 65.1%, p = 0.041) and those with a healthy appendix (n = 65, 34.9%, p = 0.003). The presence of fecaliths in the gangrenous/perforated appendicitis group was not significant (n = 19, 10.2%, p = 0.93). There were no fecaliths in patients with serositis, carcinoid or carcinoma.
CONCLUSION
Our data confirm the theory of a statistical association between the presence of a fecalith and acute (nonperforated) appendicitis in adults. There was also a significant association between the healthy appendix and asymptomatic fecaliths. There was no correlation between a gangrenous/perforated appendix and the presence of a fecalith. The fecalith is an incidental finding and not always the primary cause of acute (nonperforated) appendictis or gangrenous (perforated) appendicitis. Further research on the topic is recommended.
背景
我们旨在确定粪石的存在与急性/非穿孔性阑尾炎、坏疽性/穿孔性阑尾炎和健康阑尾之间的关联。
方法
我们回顾性分析了 2003 年 10 月至 2012 年 2 月期间进行的阑尾切除术。我们收集了年龄、性别、阑尾组织学和粪石存在的数据。
结果
在研究期间，进行了 1357 例阑尾切除术。186 例（13.7%）患者存在粪石。其中 94 例为男性（50.5%），92 例为女性，平均年龄为 32 岁（10-76 岁）。粪石率为 13%-16%，80 岁后不存在。主要有粪石的组是急性/非穿孔性阑尾炎组（n = 121，65.1%，p = 0.041）和健康阑尾组（n = 65，34.9%，p = 0.003）。坏疽性/穿孔性阑尾炎组粪石的存在无显著差异（n = 19，10.2%，p = 0.93）。在浆膜炎、类癌或癌患者中没有粪石。
结论
我们的数据证实了粪石的存在与成人急性（非穿孔性）阑尾炎之间存在统计学关联的理论。健康阑尾和无症状粪石之间也存在显著关联。坏疽性/穿孔性阑尾与粪石的存在之间没有相关性。粪石是一种偶然发现，并不总是急性（非穿孔性）阑尾炎或坏疽性（穿孔性）阑尾炎的主要原因。建议对此主题进行进一步研究。
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