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阑尾自动切断和切断部分存活:罕见病例报告及文献复习。

Autoamputation of the appendix and survival of the amputated part: a rare case report and literature review.

机构信息

The Second Hospital of Dalian Medical University, Zhongshan Road, Shahekou District, Dalian, Liaoning, People's Republic of China.

Department of General Surgery, The Second Hospital of Dalian Medical University, Zhongshan Road, Shahekou District, Dalian, 116023, Liaoning, People's Republic of China.

出版信息

BMC Surg. 2022 Jun 27;22(1):249. doi: 10.1186/s12893-022-01700-1.

Abstract

BACKGROUND

Autoamputation of the appendix, i.e., complete separation of a part of the appendix without any surgical intervention, has been rarely documented in the literature in recent years. Herein, we report a case where the amputated part of the appendix was viable after autoamputation and reviewed the related literature.

CASE PRESENTATION

A 39-year-old female patient was admitted to our hospital complaining of abdominal pain and subsequently underwent an emergency laparoscopic appendectomy (LA). Intraoperatively, we found an abnormally short appendix protruding from the cecum and a strip-like tissue attached to the mesoappendix, considered a duplex appendix, was resected. Finally, in conjunction with the histopathology findings and the past medical history, the patient was diagnosed with "Pseudo-duplication of the Appendix".

CONCLUSIONS

Autoamputation of the appendix resulting in preserved tissue viability and absence of necrosis at both ends, can be termed as "Pseudo-duplication of the Appendix". This condition is very rare in clinical practice and has not been reported in China, to the best of our knowledge. It has been established that the autoamputated appendix can produce chronic inflammation, intestinal fistulae and even cancer, affecting the patient's quality of life. Accordingly, a clear diagnosis and timely management are essential. In this report, we established a novel classification for "Pseudo-duplication of the Appendix", hoping that our report will help surgeons better understand this anatomical anomaly of the appendix, to help during the differential diagnosis process and avoid confusion.

摘要

背景

近年来,文献中很少有关于阑尾自动切断(即阑尾的一部分未经任何手术干预而完全分离)的报道。在此,我们报告一例阑尾自动切断后断端存活的病例,并复习相关文献。

病例介绍

一名 39 岁女性患者因腹痛就诊于我院,随后行急诊腹腔镜阑尾切除术(LA)。术中发现阑尾异常短,从盲肠突出,阑尾系膜附着一条带状组织,考虑为双阑尾,行双阑尾切除术。最终,结合组织病理学检查结果和既往病史,诊断为“阑尾假重复畸形”。

结论

阑尾自动切断导致组织存活且两端无坏死可称为“阑尾假重复畸形”。这种情况在临床上非常罕见,据我们所知,在中国尚未有报道。已证实,自动切断的阑尾可引起慢性炎症、肠瘘,甚至癌症,影响患者的生活质量。因此,明确诊断和及时处理至关重要。在本报告中,我们为“阑尾假重复畸形”建立了一种新的分类,希望我们的报告能帮助外科医生更好地理解阑尾的这种解剖异常,有助于鉴别诊断过程,避免混淆。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c1c/9238146/f23d7a855903/12893_2022_1700_Fig1_HTML.jpg

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