Abebe Engida, Abebe Kirubel
Department of Surgery SPHMMC, Addis Ababa, Ethiopia.
Ethiop J Health Sci. 2019 May;29(3):417-419. doi: 10.4314/ejhs.v29i3.16.
Appendicitis is the most common cause of acute abdomen. The diagnosis of appendicitis can be easy when it presents with the classical symptoms or is very challenging when present with atypical presentation. Around 20-30% of patients operated on for appendicitis have appendicolithiasis. Appendicolithiasis are usually small in size, and are called giant when more than 2cm in size.
A 36 years old man was referred from a district hospital with a diagnosis of cecal cancer. His complaints were right lower quadrant (RLQ) abdominal mass of 03 months and pain of 18 months duration. Colonoscopy was normal but abdominal CT showed a RLQ mass with a dense radio-opaque shadow at its center.
Giant appendicolith is a rare condition. A high index of suspicion and careful review of imaging findings is the key in early diagnosis and improved patient outcomes.
阑尾炎是急腹症最常见的病因。当阑尾炎表现为典型症状时,诊断较为容易;而当表现不典型时,诊断则极具挑战性。接受阑尾炎手术的患者中,约20% - 30%存在阑尾结石。阑尾结石通常体积较小,直径超过2厘米时被称为巨大阑尾结石。
一名36岁男性从一家地区医院转诊而来,诊断为盲肠癌。他的症状为右下腹肿块3个月,疼痛持续18个月。结肠镜检查正常,但腹部CT显示右下腹有一肿块,中心有致密的不透X线阴影。
巨大阑尾结石是一种罕见病症。高度的怀疑指数和对影像学检查结果的仔细评估是早期诊断及改善患者预后的关键。