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双阑尾病例报告:老年患者中的罕见表现。

Case report of the duplex vermiform appendix: A rare presentation in an elderly patient.

作者信息

Dhannoon Amenah, Kunna Mobarak, Baynes Dawn, Hynes Seán O, Nugent Emmeline

机构信息

Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin, Ireland; Department of Surgery, University Hospital Galway, Galway, Ireland.

Department of Surgery, University Hospital Galway, Galway, Ireland.

出版信息

Int J Surg Case Rep. 2022 Mar;92:106829. doi: 10.1016/j.ijscr.2022.106829. Epub 2022 Feb 12.

Abstract

INTRODUCTION AND IMPORTANCE

Duplex appendix is a rare anatomical entity with incidence rate of 0.004 and 0.009%. Diagnosis is often missed despite growth in radiological investigations. Missed appendiceal anomalies can lead to undesirable medicolegal implications.

CASE PRESENTATION

Here we discuss a case of a 76-year-old-male who initially presented to his primary care physician with right-sided abdominal pain for several weeks. A colonoscopy was performed and demonstrated a lesion arising from the appendicular orifice. The patient underwent staging imaging including Computerised Tomography of the abdomen and pelvis which demonstrated a dilated appendix. The patient underwent a laparoscopic right hemicolectomy. He made an uneventful recovery post-operatively and at his follow-up review at 4 weeks and 2 months.

DISCUSSION

While duplex appendix has been reported in the literature, to our knowledge this is the first case report to describe duplicated appendix presenting as a colonic mass in an elderly patient.

CONCLUSION

Intra-operative examination of the cecum is paramount to rule out appendiceal anomalies and prevent medicolegal complications.

摘要

引言与重要性

双阑尾是一种罕见的解剖学实体,发病率为0.004%至0.009%。尽管放射学检查有所增加,但诊断仍常常被漏诊。阑尾异常的漏诊可能导致不良的法医学后果。

病例报告

在此,我们讨论一例76岁男性患者,他最初因右侧腹痛数周就诊于其初级保健医生处。进行了结肠镜检查,发现阑尾开口处有一个病变。患者接受了分期影像学检查,包括腹部和盆腔计算机断层扫描,显示阑尾扩张。患者接受了腹腔镜右半结肠切除术。术后恢复顺利,术后4周和2个月进行了随访复查。

讨论

虽然文献中已报道过双阑尾,但据我们所知,这是第一例描述老年患者中表现为结肠肿块的重复阑尾的病例报告。

结论

术中对盲肠进行检查对于排除阑尾异常和预防法医学并发症至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6173/8881364/0e79d9fea233/gr1.jpg

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