Al-Tarakji Mohannad, Muhammad Ali Syed, Khalaf Mohamed, Shahid Fakhar, Mohamed Sara Saeed I
Acute Care Surgery, Hamad Medical Corporation, Doha, QAT.
Acute Care Surgery, Hamad General Hospital, Doha, QAT.
Cureus. 2020 Jul 30;12(7):e9482. doi: 10.7759/cureus.9482.
Emergency appendectomy for acute appendicitis is the most common emergency surgical procedure performed all over the world. While amputating the appendix from the cecum, a small (usually less than 5 mm) stump is left behind. Below this, the suture or stapler is applied to secure the base of the appendix, which is now known as a stump. Stump appendicitis, the inflammation of appendiceal remnant after an appendectomy, is a rare phenomenon. Additionally, the incidence of adenocarcinoma in the stump of the appendix is also extremely rare and can present with the symptoms of appendicitis. Adenocarcinoma in stump appendectomy patients can present from 5-43 years after the index appendectomy surgery. The majority of patients present with symptoms similar to that of appendicitis, with right lower quadrant abdominal pain, usually diagnosed via CT scans, after which they undergo stump appendectomy. The diagnosis of adenocarcinoma is only made on the histopathology report. We engaged in a review of the relevant literature published in the English language for the last 100 years. This was conducted by reviewing Google Scholar, PubMed, and MEDLINE® databases, as well as references to all related articles. There are only six cases reported in the literature, which shows the rarity of this condition. Regarding the appropriate treatment for this rare entity, multi-disciplinary team discussions should be carried out for optimum management of the individual patients. Right hemicolectomy is the recommended procedure for all patients, and prognosis depends on the staging of the disease.
急性阑尾炎的急诊阑尾切除术是全球最常见的急诊外科手术。在从盲肠切除阑尾时,会留下一小段(通常小于5毫米)残端。在此之下,使用缝线或吻合器固定阑尾残端,即现在所知的残端。残端阑尾炎是阑尾切除术后阑尾残端的炎症,是一种罕见现象。此外,阑尾残端腺癌的发病率也极其罕见,可表现为阑尾炎症状。阑尾残端切除术后患者的腺癌可在初次阑尾切除术后5至43年出现。大多数患者表现出与阑尾炎相似的症状,即右下腹疼痛,通常通过CT扫描诊断,之后接受残端阑尾切除术。腺癌的诊断仅基于组织病理学报告。我们对过去100年以英文发表的相关文献进行了综述。这是通过查阅谷歌学术、PubMed和MEDLINE®数据库以及所有相关文章的参考文献来进行的。文献中仅报道了6例病例,这表明这种情况很罕见。对于这种罕见疾病的适当治疗,应进行多学科团队讨论,以对个体患者进行最佳管理。推荐对所有患者进行右半结肠切除术,预后取决于疾病分期。