Chaouch Mohamed Ali, Dougaz Mohamed Wejih, Khalfallah Mehdi, Jerraya Hichem, Nouira Ramzi, Bouasker Ibtissem, Dziri Chadli
Department B of Surgery, Charles Nicolle Hospital, Tunis, Tunisia.
Clin J Gastroenterol. 2019 Dec;12(6):574-577. doi: 10.1007/s12328-019-00981-z. Epub 2019 Apr 10.
Retaining the etiology of a cystic lesion in the right iliac fossa can be difficult. Appendicular hydatid cyst is a very uncommon cause of a such lesion. In some cases, diagnosis is not obvious. It can radiologically mimic an appendix mucocele, a complicated ovarian cyst, an appendicular lymphangioma or an abscess. Our case highlights the difficulties encountered in this kind of situation and despite the contribution of imaging. We present a case of a 75 years-old woman presented with a right lower quadrant continuous pain. Abdominal CT-scan revealed a multilocular cystic and hydro-aeric mass. The diagnosis of an appendiceal mucocele complicated with gelatinous peritonitis was suspected. An open debulking surgery with right hemicolectomy was performed. The pathological exam has concluded to an infected appendicular hydatid cyst with thick calcified walls. The aim of this work is to report a case of an appendicular hydatid cyst that has imitated an appendicular mucocele to discuss the importance of differential diagnostic reflections and the appropriate treatment.
确定右髂窝囊性病变的病因可能具有挑战性。阑尾包虫囊肿是导致此类病变的一种非常罕见的原因。在某些情况下,诊断并不明显。其在影像学上可能类似阑尾黏液囊肿、复杂的卵巢囊肿、阑尾淋巴管瘤或脓肿。我们的病例突出了在这种情况下遇到的困难,尽管有影像学检查的帮助。我们报告一例75岁女性,表现为右下腹持续性疼痛。腹部CT扫描显示一个多房性囊性气液性肿块。怀疑诊断为阑尾黏液囊肿并发胶冻样腹膜炎。进行了开放性减瘤手术并切除右半结肠。病理检查结果为感染性阑尾包虫囊肿,囊壁增厚且钙化。本文旨在报告一例模仿阑尾黏液囊肿的阑尾包虫囊肿病例,以探讨鉴别诊断思考及适当治疗的重要性。