Fazio R A, Wickremesinghe P C, Arsura E L, Rando J
Am J Gastroenterol. 1982 Aug;77(8):556-8.
A 55-yr-old white woman with a polypoid filling defect in the caput cecum, on barium enema examination, had endoscopic removal of this mass. This was immediately recognized macroscopically to be an intussuscepted appendix. This case is only the second naturally inverting appendix to be removed endoscopically, and it was complicated 18 h later by local peritonitis which was heralded by acute right lower quadrant pain. Laparotomy revealed a cleanly transected base of appendix and cecal adhesions representing previous chronic inflammatory disease. Endoscopists should consider this diagnosis in all cases of mass lesions of the caput cecum. It is imperative to retrieve such lesions if polypectomy is performed, as the macroscopic diagnosis is then evident. Once the diagnosis is established, immediate surgery is advised rather than watchful waiting.
一名55岁的白人女性，在钡剂灌肠检查中发现盲肠头部有息肉样充盈缺损，经内镜切除了该肿物。肉眼立即识别出这是一个套叠的阑尾。该病例是第二例经内镜切除的自然内翻阑尾，18小时后出现局部腹膜炎，表现为急性右下腹疼痛。剖腹手术显示阑尾根部干净切断，盲肠粘连提示既往有慢性炎症性疾病。内镜医师在所有盲肠头部肿块病变的病例中都应考虑这一诊断。如果进行息肉切除术，必须取出此类病变，因为此时宏观诊断就很明显了。一旦确诊，建议立即手术而非观察等待。
