一名阑尾穿孔患者中偶然发现的急性中性粒细胞性小肠结肠炎：病例报告。
An incidental finding of ANET in a patient with perforated appendix: A case report.
作者信息
Basukala Sunil, Bhusal Ujwal, Sharma Shriya, Tamang Ayush, Gurung Suman
机构信息
Department of Surgery, Shree Birendra Hospital (SBH), Kathmandu, Nepal.
College of Medicine, Nepalese Army Institute of Health Sciences (NAIHS), Kathmandu, Nepal.
出版信息
Int J Surg Case Rep. 2021 Dec;89:106625. doi: 10.1016/j.ijscr.2021.106625. Epub 2021 Nov 23.
INTRODUCTION AND IMPORTANCE
Appendiceal neuroendocrine tumors (ANETs) are incidentally found in 0.2-0.7% of appendectomies for suspected appendicitis.
CASE PRESENTATION
A 29-year-old female presented with pain in the right lower quadrant of her abdomen for the past 48 h. On emergency appendectomy for suspected acute appendicitis, a perforated appendix was found. Histopathological examination showed grade 1 (low) ANET.
CLINICAL DISCUSSION
Appendiceal neuroendocrine neoplasms (ANENs) are commonly found at the tip of the appendix and are treated with appendectomy alone. For few ANENs located at the base, or small tumors (≤2 cm) infiltrating the submucosa, the muscularis, the subserosa layer or the mesoappendix, right hemicolectomy is recommended. However, no guidelines have been established concerning patients with appendiceal perforation in case of ANENs.
CONCLUSION
Although rare, ANETs should be considered in the differential diagnosis of acute appendicitis. Since, ANETs are rarely diagnosed preoperatively, subsequent patient evaluation after appendectomy is crucial for management of the patient.
引言与重要性
在因疑似阑尾炎而进行的阑尾切除术中，阑尾神经内分泌肿瘤（ANETs）的偶然发现率为0.2%-0.7%。
病例介绍
一名29岁女性在过去48小时内出现右下腹疼痛。在因疑似急性阑尾炎进行急诊阑尾切除术中，发现阑尾穿孔。组织病理学检查显示为1级（低级别）ANET。
临床讨论
阑尾神经内分泌肿瘤（ANENs）常见于阑尾尖端，通常仅通过阑尾切除术治疗。对于少数位于阑尾根部的ANENs，或浸润黏膜下层、肌层、浆膜下层或阑尾系膜的小肿瘤（≤2 cm），建议行右半结肠切除术。然而，对于ANENs合并阑尾穿孔的患者，尚未制定相关指南。
结论
尽管罕见，但在急性阑尾炎的鉴别诊断中应考虑ANETs。由于ANETs术前很少被诊断出来，因此阑尾切除术后对患者的后续评估对于患者的管理至关重要。
Zotero 插件