Cestino Luca, Festa Federico, Cavuoti Giuseppe, Bonatti Luca, Soncini Stefania, Dani Luca, Quaglino Francesco
S.C. Chirurgia Generale, Ospedale Maria Vittoria, Azienda Sanitaria Locale Città di Torino, Torino, Italy.
J Surg Case Rep. 2020 Sep 25;2020(9):rjaa344. doi: 10.1093/jscr/rjaa344. eCollection 2020 Sep.
Mucinous lesions of appendix are a rare clinical entity and may be neoplastic or non-neoplastic. The diagnosis is usual incidental during computed tomography scan or colonoscopy performed for general abdominal symptoms or occasional finding during operation for acute appendicitis. For this reason, initial treatment should be tailored to the situation, aiming at complete resection of the appendix with disease-free margins: this can be achieved by simple appendectomy or more extensive resection. The pathological examination of the specimen is the key to offer the patient a correct and complete treatment, and, if a neoplastic pathology is found, the case should be discussed in multidisciplinary group. We describe three cases with different clinical presentation leading to different surgical treatment: one elective case, in which the diagnosis was suspected preoperatively; and two urgent cases, one mimicking an intussusception and another one presenting as an acute appendicitis.
阑尾黏液性病变是一种罕见的临床实体,可能是肿瘤性或非肿瘤性的。诊断通常是在因一般腹部症状进行计算机断层扫描或结肠镜检查时偶然发现,或者是在急性阑尾炎手术中偶尔发现。因此,初始治疗应根据具体情况量身定制,目标是完整切除阑尾且切缘无肿瘤:这可通过单纯阑尾切除术或更广泛的切除术来实现。标本的病理检查是为患者提供正确和完整治疗的关键,如果发现肿瘤性病理,应在多学科团队中进行讨论。我们描述了三例临床表现不同导致手术治疗方式不同的病例:一例为择期病例,术前怀疑诊断;两例为急症病例,一例类似肠套叠,另一例表现为急性阑尾炎。