Singh Mahendra Pratap
Consultant Surgeon, Private Clinic, Katara, Bhopal, Madhya Pradesh, India.
J Family Med Prim Care. 2020 Dec 31;9(12):5867-5871. doi: 10.4103/jfmpc.jfmpc_1547_20. eCollection 2020 Dec.
Mucocele of the appendix is a very rare disease entity that often discovered incidentally during surgery. It can result from both non-neoplastic and neoplastic lesions and histopathological examination is needed for confirmation. Failure to make an early preoperative diagnosis may results in its rapture and spillage of mucin contents into the peritoneal cavity leading to a disastrous complication of pseudomyxoma peritonei (PMP) that has a very bad prognosis. A clear pathological terminology and management strategies of appendiceal mucocele (AM) is lacking. This literature review aims to derive detailed information related to clinical significance of AM to avoid complication of PMP and plan appropriately during surgery according to the current evidence. The relevant articles from scientific databases such as Medline, PubMed, Google Scholar were searched and extracted using the keywords "mucocele appendix" "cystadenoma%". Data based on epidemiology, clinical manifestations, complications, pathology, diagnostic work up and management were analyzed and summarized. A meticulous surgical excision is the mainstay of treatment and open surgical approach is still preferred over laparoscopy. Preoperative diagnosis of AM is very imperative as it may harbour neoplasm and can be made utilising the imaging tools like computed tomography and ultrasonography. Primary care physicians can have a crucial role in making early detection and timely referral for appropriate management in order to avoid complications. After appendectomy, 5-year survival rate for the simple AM is 91%-100% but it reduces to 25% for the malignant AM.
阑尾黏液囊肿是一种非常罕见的疾病实体,常在手术中偶然发现。它可由非肿瘤性和肿瘤性病变引起,需要进行组织病理学检查以确诊。术前未能早期诊断可能导致其破裂,黏液内容物溢入腹腔,引发腹膜假黏液瘤(PMP)这一灾难性并发症,其预后很差。目前缺乏关于阑尾黏液囊肿(AM)明确的病理学术语和管理策略。这篇文献综述旨在获取与AM临床意义相关的详细信息,以避免PMP并发症,并根据当前证据在手术期间进行适当规划。使用关键词“阑尾黏液囊肿”“囊腺瘤%”在诸如Medline、PubMed、谷歌学术等科学数据库中搜索并提取相关文章。对基于流行病学、临床表现、并发症、病理、诊断检查和管理的数据进行了分析和总结。细致的手术切除是主要治疗方法,开放手术方式仍比腹腔镜手术更受青睐。AM的术前诊断非常重要,因为它可能含有肿瘤,可利用计算机断层扫描和超声等成像工具进行诊断。基层医疗医生在早期发现和及时转诊以进行适当管理从而避免并发症方面可发挥关键作用。阑尾切除术后,单纯AM的5年生存率为91%-100%,但恶性AM的5年生存率降至25%。