Department of Radiology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
Concord Clinical School, The University of Sydney, Sydney, New South Wales, Australia.
ANZ J Surg. 2020 Oct;90(10):1878-1887. doi: 10.1111/ans.15805.
The appendix has a unique place in surgical history. Although the first ever appendicectomy involved a fistula to the skin, fistulae involving the appendix remain uncommon and can lead to unique surgical considerations.
A systematic review of the literature was performed for case reports of appendiceal fistulae. We excluded cases in which the patient had a history of appendicectomy. Cases were categorized by site and aetiology, with information regarding relative frequency and demographics obtained.
A total of 301 case reports of fistula involving the appendix were found. The most common sites of these fistulae were to the bladder (148 cases), skin (40 cases), vasculature (19 cases), umbilicus (16 cases) and to the gastrointestinal tract. The most common aetiology in sub-analysis was appendicitis alone (150 cases), with less common causes including appendiceal adenocarcinoma (32 cases) and congenital abnormalities (18 cases). There were significantly more appendiceal fistulae in males than in females, with a ratio of 1.7:1. In patients with appendiceal adenocarcinoma as a cause for fistula, there were significantly more females than males with a ratio of 2.3:1.
In conducting a systematic review of case reports of fistulae involving the appendix, we identified 301 unique case reports, with a range of different sites and aetiologies.
阑尾在外科史上具有独特的地位。尽管首例阑尾切除术涉及到皮肤瘘，但涉及阑尾的瘘管仍然很少见，并且可能导致独特的手术考虑。
对阑尾瘘的病例报告进行了系统的文献回顾。我们排除了那些有阑尾切除术病史的病例。根据部位和病因对病例进行分类，并获得了有关相对频率和人口统计学信息。
共发现 301 例涉及阑尾瘘的病例报告。这些瘘管最常见的部位是膀胱（148 例）、皮肤（40 例）、血管（19 例）、脐部（16 例）和胃肠道。在亚分析中，最常见的病因是单纯性阑尾炎（150 例），较少见的病因包括阑尾腺癌（32 例）和先天性异常（18 例）。男性阑尾瘘的比例明显高于女性，比例为 1.7:1。在阑尾腺癌引起瘘管的患者中，女性明显多于男性，比例为 2.3:1。
在对涉及阑尾瘘的病例报告进行系统回顾时，我们发现了 301 例独特的病例报告，涉及不同的部位和病因。
