2484 例疑似阑尾炎行阑尾切除术的女性患者中子宫内膜异位症的发生率和临床特征：一项回顾性分析。
Incidence and clinical features of endometriosis in 2484 consecutive female patients undergoing appendectomy for suspected appendicitis-a retrospective analysis.
机构信息
Department of General, Visceral and Transplantation Surgery, University Hospital Augsburg, Stenglinstrasse 2, 86156, Augsburg, Germany.
Department of Gynecology and Obstetrics, University Hospital Augsburg, University of Augsburg, Augsburg, Germany.
出版信息
Langenbecks Arch Surg. 2024 Apr 29;409(1):144. doi: 10.1007/s00423-024-03328-6.
INTRODUCTION
Endometriosis is a common condition affecting 5 to 10% of women of childbearing age. The true incidence of endometriosis of the appendix is currently unknown. Since symptoms often overlap with those of acute appendicitis, endometriosis of the appendix presents a diagnostic challenge in the emergency department. This large retrospective study investigates the incidence and perioperative clinical, radiologic, and laboratory findings, as well as possible differences between patients with and without endometriosis.
METHODS
Data from consecutive patients who underwent appendectomy for suspected appendicitis without a history of endometriosis were analyzed. Perioperative clinical, laboratory, perioperative, and histopathologic findings were compared between women with and without endometriosis.
RESULTS
Between January 2008 and June 2023, 2484 consecutive patients without a history of endometriosis underwent urgent appendectomy for suspected appendicitis. Endometriosis was detected on histopathologic examination in 17 (0.7%) patients. Signs of appendicitis were found less frequently on ultrasound in the endometriosis group compared to the non-endometriosis group (23.4% vs. 61.5%; p = 0.002; OR = 0.193; 95% CI 0.063-0.593). There were no differences in physical examination findings, duration of symptoms, degree of inflammation, surgical outcomes, or complication rates.
CONCLUSION
The incidence of endometriosis of the appendix in patients undergoing appendectomy for suspected appendicitis was higher than suggested by data from autopsy series and populations with biopsy-proven endometriosis. Patients with endometriosis of the appendix were less likely to have a positive ultrasound finding, but perioperative and histopathologic findings and severity of inflammation did not differ from patients without endometriosis, presenting diagnostic challenges for clinicians.
简介
子宫内膜异位症是一种常见的疾病，影响着 5%至 10%的育龄妇女。目前尚不清楚阑尾子宫内膜异位症的确切发病率。由于症状常与急性阑尾炎重叠，因此在急诊科，阑尾子宫内膜异位症具有诊断挑战性。这项大型回顾性研究调查了发病率以及围手术期的临床、放射学和实验室发现，以及有和没有子宫内膜异位症的患者之间的可能差异。
方法
对因疑似阑尾炎而无子宫内膜异位症病史接受阑尾切除术的连续患者进行数据分析。比较了有和没有子宫内膜异位症的女性患者之间的围手术期临床、实验室、围手术期和组织病理学发现。
结果
2008 年 1 月至 2023 年 6 月期间，连续 2484 例无子宫内膜异位症病史的患者因疑似阑尾炎而行急诊阑尾切除术。在组织病理学检查中，17 例（0.7%）患者发现有子宫内膜异位症。与非子宫内膜异位症组相比，子宫内膜异位症组的超声检查中发现阑尾炎迹象的频率较低（23.4% vs. 61.5%；p = 0.002；OR = 0.193；95%CI 0.063-0.593）。体格检查结果、症状持续时间、炎症程度、手术结果或并发症发生率无差异。
结论
在因疑似阑尾炎而行阑尾切除术的患者中，阑尾子宫内膜异位症的发生率高于尸检系列和活检证实的子宫内膜异位症患者的发生率。有阑尾子宫内膜异位症的患者超声检查阳性的可能性较低，但围手术期和组织病理学发现以及炎症严重程度与无子宫内膜异位症的患者没有差异，这给临床医生带来了诊断挑战。
Zotero 插件