Sun Peiming, Jiang Fuquan, Sun Hongwei, Zhao Xiaobo, Ma Junmei, Li Chenglin, Yang Heming, Cui Yan
Department of General Surgery, PLA Strategic Support Force Characteristic Medical Center, Beijing 100101, China.
Department of Pathology, PLA Strategic Support Force Characteristic Medical Center, Beijing 100101, China.
J Gastrointest Oncol. 2020 Feb;11(1):102-107. doi: 10.21037/jgo.2019.12.01.
Appendiceal intussusception caused by mucocele of the appendix is extremely rare. In the current study, a 32-year-old woman was admitted to the department of general surgery of our hospital, complaining of persistent right, lower quadrant pain without an obvious cause for 17 hours. Physical examination indicated significant pain and tenderness in the right, lower abdominal quadrant. Blood analysis indicated that leukocyte count, the percentage of neutrophils and the serum C-reactive protein were increased. Abdominal and pelvic computed tomography revealed a well-encapsulated cystic mass surrounded by the caecum and intussusception. The appendiceal intussusception caused by mucocele of the appendix was revealed during the laparoscopic exploration. Appendectomy and partial cecectomy were conducted using the laparoscopic approach. Postoperative pathological examinations showed ileocecal intussusception and chronic inflammation, appendiceal mucocele and acute suppurative appendicitis. The patient showed satisfactory recovery that was observed during 15-months of follow-ups. This case highlights that laparoscopic appendectomy and partial cecectomy may be a beneficial, minimally invasive approach for appendiceal intussusception caused by mucocele of the appendix.
阑尾黏液囊肿引起的阑尾套叠极为罕见。在本研究中,一名32岁女性因持续17小时无明显原因的右下腹疼痛入住我院普通外科。体格检查显示右下腹有明显疼痛和压痛。血液分析表明白细胞计数、中性粒细胞百分比和血清C反应蛋白升高。腹部和盆腔计算机断层扫描显示盲肠周围有一个边界清晰的囊性肿块及套叠。在腹腔镜探查中发现了阑尾黏液囊肿引起的阑尾套叠。采用腹腔镜方法进行了阑尾切除术和部分盲肠切除术。术后病理检查显示回盲部套叠和慢性炎症、阑尾黏液囊肿及急性化脓性阑尾炎。在15个月的随访中,患者恢复情况良好。该病例表明,腹腔镜阑尾切除术和部分盲肠切除术可能是治疗阑尾黏液囊肿引起的阑尾套叠的一种有益的微创方法。