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表现为阑尾脓肿的良性多囊性腹膜间皮瘤：诊断与治疗挑战

Benign Multicystic Peritoneal Mesothelioma Presenting as Appendiceal Abscess: A Diagnostic and Therapeutic Challenge.

作者信息

Seretis Charalampos, Elhassan Ali Mohamed, Kretzmer Leo, Lim Paul, Menon Anitha Suseelan, Awodiya Afolabi, Kanchustambam Subba Rao

机构信息

Department of General Surgery, George Eliot Hospital NHS Trust, Nuneaton, Warwickshire, West Midlands, UK.

出版信息

Gastroenterology Res. 2020 Jun;13(3):117-120. doi: 10.14740/gr1278. Epub 2020 Jun 18.

DOI:10.14740/gr1278
PMID:32655729
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7331854/
Abstract

Primary peritoneal tumors are rarely encountered and their management is usually challenging for the clinicians. Especially when the patients with advanced peritoneal malignancy present as surgical emergencies, usually with symptoms of obstruction, perforation or gross space-occupying lesions, the on-call surgical team has to weigh the pros and cons of urgent versus delayed treatment and plans a safe and simultaneously oncologically beneficial therapeutic approach. Herein, we present a case of a Caucasian man who was referred as suspected complicated appendicitis by his primary care physician, with the final diagnosis being benign multicystic mesothelioma. We describe the challenges of the clinical decision making for the emergency general surgeon and relevant diagnostic and therapeutic pitfalls, which can be potentially minimized by early liaison with tertiary units specializing in the treatment of disseminated peritoneal malignancy.

摘要

原发性腹膜肿瘤很少见，其治疗通常对临床医生来说具有挑战性。尤其是当晚期腹膜恶性肿瘤患者以外科急症就诊时，通常伴有梗阻、穿孔或巨大占位性病变的症状，值班手术团队必须权衡紧急治疗与延迟治疗的利弊，并制定一种安全且同时具有肿瘤学益处的治疗方法。在此，我们报告一例白种男性病例，其初级保健医生将其作为疑似复杂性阑尾炎转诊，最终诊断为良性多囊性间皮瘤。我们描述了急诊普通外科医生临床决策面临的挑战以及相关的诊断和治疗陷阱，通过与专门治疗播散性腹膜恶性肿瘤的三级医疗单位早期联络，这些陷阱有可能被降至最低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63a7/7331854/067694e48df8/gr-13-117-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63a7/7331854/28618c702b65/gr-13-117-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63a7/7331854/e106f917f20d/gr-13-117-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63a7/7331854/c86752b44fff/gr-13-117-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63a7/7331854/99aa34b4a0f2/gr-13-117-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63a7/7331854/ce4f426f2d2e/gr-13-117-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63a7/7331854/5df5df3c9372/gr-13-117-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63a7/7331854/067694e48df8/gr-13-117-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63a7/7331854/28618c702b65/gr-13-117-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63a7/7331854/e106f917f20d/gr-13-117-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63a7/7331854/c86752b44fff/gr-13-117-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63a7/7331854/99aa34b4a0f2/gr-13-117-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63a7/7331854/ce4f426f2d2e/gr-13-117-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63a7/7331854/5df5df3c9372/gr-13-117-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63a7/7331854/067694e48df8/gr-13-117-g007.jpg

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