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以慢性小肠梗阻为表现的阑尾腺癌:一例报告。

Adenocarcinoma of the appendix presenting as chronic small bowel obstruction: A case report.

作者信息

Sawaftah Zaid, Awashra Ameer, Odah Ali Bani, Sawafta Ahmed, Ahmad Ola, Khatib Amer, Dababat Huthayfa, Yasin Anas

机构信息

Department of Medicine, An Najah National University, Nablus, Palestine.

Department of Surgery, Tubas Turkish Governmental Hospital, Tubas, Palestine.

出版信息

Radiol Case Rep. 2024 Sep 18;19(12):5970-5974. doi: 10.1016/j.radcr.2024.08.118. eCollection 2024 Dec.

Abstract

Appendiceal carcinoma, a rare malignancy comprising less than 1% of gastrointestinal cancers, often presents diagnostic challenges due to its atypical symptoms. This report details a 68-year-old female with a history of severe anemia, gastrointestinal bleeding, and persistent abdominal symptoms, ultimately diagnosed with chronic small bowel obstruction caused by an appendiceal adenocarcinoma. Despite initial treatment for Helicobacter pylori-induced gastritis, her symptoms persisted, prompting further imaging that revealed a narrowed small bowel segment. Exploratory laparotomy uncovered a stricturing tumor 2 meters from the duodenojejunal junction, leading to en bloc resection of the tumor, appendix, and part of the lateral abdominal wall. Histopathology confirmed moderately differentiated adenocarcinoma. A multidisciplinary team recommended a complete right hemicolectomy, successfully performed despite extensive adhesions and a mesenteric abscess. Postoperatively, the patient recovered well, with ongoing management for anemia and close surveillance. This case highlights the importance of considering rare malignancies in differential diagnoses for chronic small bowel obstruction.

摘要

阑尾癌是一种罕见的恶性肿瘤,占胃肠道癌症的比例不到1%,因其症状不典型,常常带来诊断挑战。本报告详细介绍了一名68岁女性,她有严重贫血、胃肠道出血和持续腹部症状的病史,最终被诊断为由阑尾腺癌引起的慢性小肠梗阻。尽管最初对幽门螺杆菌引起的胃炎进行了治疗,但她的症状仍持续存在,促使进一步影像学检查发现小肠节段变窄。剖腹探查发现距十二指肠空肠交界处2米处有一个狭窄肿瘤,导致肿瘤、阑尾和部分侧腹壁整块切除。组织病理学证实为中分化腺癌。一个多学科团队建议进行完整的右半结肠切除术,尽管有广泛粘连和肠系膜脓肿,但手术仍成功进行。术后,患者恢复良好,正在进行贫血治疗和密切监测。该病例强调了在慢性小肠梗阻的鉴别诊断中考虑罕见恶性肿瘤的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/881d/11424757/2589534fe7f2/gr1.jpg

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