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一例表现为无痛性脐部脓性分泌物的阑尾黏液性囊腺瘤。

A case of appendiceal mucinous cystadenoma which presented as painless purulent umbilical discharge.

作者信息

Al Buainain Latifa, Al Khaldi Turki, Tahseen Wael Mohamed

机构信息

General Surgery Department, Bahrain Defence Force Hospital Royal Medical Services, West Riffa, Bahrain.

Plastic Surgery and Burn Department, Bahrain Defence Force hospital Royal Medical Services, West Riffa, Bahrain.

出版信息

BMJ Case Rep. 2019 Aug 22;12(8):e229222. doi: 10.1136/bcr-2019-229222.

Abstract

A 57-year-old obese, diabetic woman, presented with 1 day history of purulent umbilical discharge. She was vitally stable and afebrile. Abdominal examination revealed a full abdomen with purulent discharge from the umbilicus, swelling with erythema and induration surrounding the umbilicus. Lab tests were normal. Initial impression was abdominal wall abscess. Ultrasound showed subcutaneous fluid collection. Non-contrast CT showed collection and abdominal wall defect at the umbilicus. On exploration of the abscess cavity, there were two defects (umbilical and supraumbilical) with appendix protruding through the umbilical defect and a part of a small bowel and omentum adherent to the other defect. Wash was given, bowel and omentum were released and appendectomy was performed. Histopathology showed mucinous cystadenoma with periappendicitis. We would like to highlight the rare occurrence of an appendiceal mucinous cystadenoma in such a clinical presentation.

摘要

一名57岁的肥胖糖尿病女性,有1天脓性脐部排出物病史。她生命体征稳定,无发热。腹部检查发现全腹,脐部有脓性排出物,脐周肿胀伴红斑和硬结。实验室检查正常。初步诊断为腹壁脓肿。超声显示皮下液体积聚。非增强CT显示脐部有液体积聚和腹壁缺损。在探查脓肿腔时,发现两个缺损(脐部和脐上),阑尾通过脐部缺损突出,一部分小肠和网膜附着于另一个缺损处。进行了冲洗,松解了肠管和网膜,并实施了阑尾切除术。组织病理学显示为黏液性囊腺瘤伴阑尾周围炎。我们想强调这种临床表现中阑尾黏液性囊腺瘤的罕见发生情况。

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本文引用的文献

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Man With Abdominal Wall Abscess.患有腹壁脓肿的男性。
Ann Emerg Med. 2016 Oct;68(4):e75-6. doi: 10.1016/j.annemergmed.2016.03.006.
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The abdominal wall lumps and bumps: cross-sectional imaging spectrum.腹壁肿块:影像学表现。
Can Assoc Radiol J. 2014 Feb;65(1):9-18. doi: 10.1016/j.carj.2012.02.001. Epub 2012 Aug 9.
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Abdominal wall abscess: more than meets the eye.腹壁脓肿:远不止表面所见。
BMJ Case Rep. 2010;2010. doi: 10.1136/bcr.08.2009.2151. Epub 2010 Feb 8.

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