Alamoudi Mohammad Y, Alkahtani Nasser M, Aldosari Yahea M, Marie Sarah, Ashmawi Abdullah Abdulrahman, Alshaalan Yazeed J, Alabdulrahman Faisal K, Yousef Zeyad, Alserhani Mohammed F
Medical Intern, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU.
Surgery, King Abdulaziz Medical City Riyadh, Riyadh, SAU.
Cureus. 2022 Nov 16;14(11):e31581. doi: 10.7759/cureus.31581. eCollection 2022 Nov.
Background Appendicitis is a common reason for hospitalization. Rarely do people with acute appendicitis have an appendiceal mass called an abscesses or inflamed phlegmon. The goal of this study was to determine the prevalence of different appendiceal tumors including neuroendocrine tumors, adenocarcinoma, carcinoid, and mucinous and evaluate patient demographic data (e.g., age and gender) at a major tertiary care center in Riyadh, Saudi Arabia. Materials and methods We conducted a cross-sectional analytical review of patient records of 1513 patients who received an appendectomy and were diagnosed with acute appendicitis from 2015 to 2020 at King Abdulaziz Medical City, Riyadh, Saudi Arabia. We used nonprobability sampling to collect the sample. The study included patients older than 14 years. We also recorded patient demographic information, including age, gender, history, and final pathology. Results The mean age of our study population was 27.9 years (standard deviation [SD], 12.3 years). Our study had 958 male patients and 555 female patients. One thousand four hundred fifty-eight patients (96.3%) had right lower quadrant (RLQ) tenderness, and 228 patients had fever (15.0%). One thousand one hundred thirteen patients (73.5%) had rebound tenderness, 1,178 had nausea (77.8%), and 1,100 had high white blood cell (WBC) counts (72.7%). One thousand four hundred eighty-six patients received laparoscopic surgery (98.2%). Most patients (95.3%; n=1,443) had no postoperative complications. Appendicitis pathology was present in 1,381 patients (91.3%). Only 15 patients (1%) had tumor-related pathology, and these patients were significantly older than patients with nontumor-related pathology (p<.001) and had less RLQ pain, rebound tenderness, and pain migration but higher WBC counts. Pain migration was significantly inversely correlated with age: as age increased, pain migration was reported less often (odds ratio, 0.99, 95% confidence interval, 0.98 to 0.99; p=0.001). Conclusion This study aimed to determine the prevalence and types of appendiceal tumors in cases of acute appendicitis and the corresponding patient demographic data at a major tertiary care center in Riyadh, Saudi Arabia. According to our results, patients with appendicitis present with fever, rebound tenderness, nausea, and high WBC count. Appendiceal masses mainly occur in a later age group with less migration of pain and high WBC count. However, migration of pain is inversely related to age. Physicians treating patients with acute appendicitis should bear these data in mind and consider the presence of appendiceal tumors in appropriate patients.
阑尾炎是住院的常见原因。急性阑尾炎患者很少会出现阑尾肿块,如脓肿或炎性蜂窝织炎。本研究的目的是确定沙特阿拉伯利雅得一家大型三级医疗中心不同阑尾肿瘤(包括神经内分泌肿瘤、腺癌、类癌和黏液性肿瘤)的患病率,并评估患者的人口统计学数据(如年龄和性别)。
我们对2015年至2020年在沙特阿拉伯利雅得阿卜杜勒阿齐兹国王医疗城接受阑尾切除术并被诊断为急性阑尾炎的1513例患者的病历进行了横断面分析回顾。我们采用非概率抽样收集样本。该研究纳入了年龄超过14岁的患者。我们还记录了患者的人口统计学信息,包括年龄、性别、病史和最终病理结果。
我们研究人群的平均年龄为27.9岁(标准差[SD],12.3岁)。我们的研究中有958例男性患者和555例女性患者。1458例患者(96.3%)有右下腹(RLQ)压痛,228例患者有发热(15.0%)。1113例患者(73.5%)有反跳痛,1178例患者有恶心(77.8%),1100例患者白细胞(WBC)计数升高(72.7%)。1486例患者接受了腹腔镜手术(98.2%)。大多数患者(95.3%;n = 1443)没有术后并发症。1381例患者(91.3%)存在阑尾炎病理表现。只有15例患者(1%)有肿瘤相关病理,这些患者明显比非肿瘤相关病理的患者年龄大(p <.001),右下腹痛、反跳痛和疼痛转移较少,但白细胞计数较高。疼痛转移与年龄呈显著负相关:随着年龄增加,疼痛转移的报告频率降低(优势比,0.99,95%置信区间,0.98至0.99;p = 0.001)。
本研究旨在确定沙特阿拉伯利雅得一家大型三级医疗中心急性阑尾炎病例中阑尾肿瘤的患病率和类型以及相应的患者人口统计学数据。根据我们的结果,阑尾炎患者表现为发热、反跳痛、恶心和白细胞计数升高。阑尾肿块主要发生在年龄较大的人群中,疼痛转移较少且白细胞计数较高。然而,疼痛转移与年龄呈负相关。治疗急性阑尾炎患者的医生应牢记这些数据,并在合适的患者中考虑阑尾肿瘤的存在。