Guzmán Valdivia Gómez G, Chavelas Lluck M, Medina González E
Servicio de Cirugía General del Hospital General Regional Núm. Instituto Mexicano del Seguro Social, México, D.F.
Rev Gastroenterol Mex. 1996 Oct-Dec;61(4):362-5.
Occasionally, an unexpected colonic mass is seen during surgery and for its characteristics it is difficult to distinguish if the lesion is benign or malignant; the surgeon must define resection or realize complementary clinical and histopathological studies for the final diagnosis which allows to offer adequate treatment.
To present our experience of patients with unexpected colonic mass during abdominal surgery. We analyze clinic course and definitive pathologic diagnostic.
We reviewed 8,703 files of patients with abdominal surgery, 21 (0.24%) presented an unexpected colonic tumor. Patients were divided in two groups: the group I were studied without initial resection; group II included patients that were treated with resection.
In patients without initial resection (n = 16) 11 required definitive resection in an average of twelve days, no complications were noted between the initial and definitive surgery; in remaining 5 patients final diagnostic was ameboma which responded well to medical treatment. In patients of group II(n = 5), in three of them complications were present.
In our country ameboma must be considered in the differential diagnosis of colonic tumors, no required resection. Therefore, discovery of unexpected colonic mass during surgery, justifies to realize complementary studies before resection.
偶尔，在手术过程中会发现意外的结肠肿物，鉴于其特征，很难区分该病变是良性还是恶性；外科医生必须确定是否进行切除，或开展补充性临床及组织病理学研究以做出最终诊断，从而提供适当的治疗。
介绍我们在腹部手术中遇到意外结肠肿物患者的经验。我们分析临床病程及最终病理诊断。
我们回顾了8703例腹部手术患者的病历，其中21例（0.24%）出现意外结肠肿瘤。患者分为两组：第一组患者最初未进行切除；第二组包括接受切除治疗的患者。
在最初未进行切除的患者（n = 16）中，11例平均在12天后需要进行确定性切除，初次手术与确定性手术之间未发现并发症；其余5例患者最终诊断为阿米巴瘤，药物治疗效果良好。在第二组患者（n = 5）中，其中3例出现了并发症。
在我国，结肠肿瘤的鉴别诊断中必须考虑阿米巴瘤，无需切除。因此，手术中发现意外结肠肿物，有理由在切除前进行补充性研究。
