Bajcurová Kristýna, Novák Petr, Korčáková Eva, Mírka Hynek, Geiger Jan, Rajal Petr, Daum Ondřej, Podolcová Marcela
Department of Imaging Methods, Charles University Medical School and Teaching Hospital in Pilsen, Alej Svobody 923/80, 304 60, Pilsen, Czech Republic; Biomedical Centre, Charles University Medical School in Pilsen, Alej Svobody 1655/76, 323 00, Pilsen, Czech Republic.
Department of Surgery, Charles University Medical School and Teaching Hospital in Pilsen, Alej Svobody 923/80, 304 60, Pilsen, Czech Republic.
Int J Surg Case Rep. 2019;58:37-40. doi: 10.1016/j.ijscr.2019.03.051. Epub 2019 Apr 5.
Shortly after an operation infection, intraabdominal abscess, seroma, haemorrhage or development of paralytic ileus may occur. Postoperative adhesions, nonspecific abdominal pain without signs of obstruction, incisional hernia and appendicitis or mucocele in appendiceal stump present common late complications. We present a unique case of a late complication after appendectomy.
The case report describes a unique expansion in the ascending colon of a young athlete with long-lasting abdominal pain in the lower right quadrant. Colonoscopy showed a lesion in a wall of the ascending colon. Computed tomography (CT) confirmed a cystoid formation of high content density in a wall of the caecum. A right hemicolectomy was performed. Histology showed a lesion located in the submucosa with intestinal lining and stroma rich in lymphoid cells. These are the typical attributes of the wall of the appendix. Other parts of the wall were not demonstrated, and there was no communication with the lumen of the native bowel.
A submucosal cavity filled with acellular matter, which were probably disintegrated epithelioid structures, and calcifications were found in the ascending colon, while no intestinal cell atypia or dysplasia was found. The case cannot be classified under any previously presented diagnosis.
手术后不久可能会发生感染、腹腔内脓肿、血清肿、出血或麻痹性肠梗阻。术后粘连、无梗阻迹象的非特异性腹痛、切口疝以及阑尾残端的阑尾炎或黏液囊肿是常见的晚期并发症。我们报告一例阑尾切除术后晚期并发症的独特病例。
该病例报告描述了一名年轻运动员升结肠出现独特扩张，伴有右下腹长期腹痛。结肠镜检查显示升结肠壁有病变。计算机断层扫描（CT）证实盲肠壁有高密度囊样结构。进行了右半结肠切除术。组织学检查显示病变位于黏膜下层，有肠黏膜和富含淋巴细胞的间质。这些是阑尾壁的典型特征。未发现肠壁其他部分，且与原肠腔无连通。
在升结肠发现一个充满无细胞物质（可能是解体的类上皮结构）的黏膜下腔以及钙化，未发现肠细胞异型性或发育异常。该病例无法归类于之前提出的任何诊断。
