Peck J J
Department of Surgery, Scripps Memorial Hospital, La Jolla, California 92038.
Am J Surg. 1988 May;155(5):683-5. doi: 10.1016/s0002-9610(88)80144-2.
This review of 900 patients who underwent colon resection for carcinoma identified 33 patients who were explored with the preoperative diagnosis of appendicitis. In 19 patients, the appendix was acutely inflamed secondary to obstruction of the appendiceal lumen. The other 14 patients had perforating or obstructing cancer of the ascending colon or cecum. The clinical clues of a prolonged symptom history, weight loss, anemia, and a palpable mass were frequently, but not invariably, present. Results of contrast enema, computerized axial tomography, and colonoscopy in this select group were frequently misleading. The diagnosis is best made in the operating room by the thoughtful appendectomist. I recommend prompt resection and an appropriate cancer procedure in these patients. Carcinoma masquerading as appendicitis occurs more often than is generally realized and will be seen more frequently as our aging population increases.
对900例行结肠癌切除术患者的这项回顾性研究发现，有33例术前诊断为阑尾炎而接受探查的患者。19例患者的阑尾因阑尾腔梗阻而急性发炎。另外14例患者患有升结肠或盲肠穿孔性或梗阻性癌。症状持续时间长、体重减轻、贫血及可触及肿块等临床线索常常存在，但并非总是如此。在这个特定群体中，钡剂灌肠、计算机断层扫描及结肠镜检查结果常常具有误导性。最佳诊断方法是由经验丰富的阑尾切除手术医生在手术室中做出判断。我建议对这些患者迅速进行切除并实施适当的癌症治疗程序。伪装成阑尾炎的癌症比人们普遍认识到的更为常见，随着我国人口老龄化加剧，这种情况将会更频繁地出现。
