Platel J P, Terrier J P, Farthouat P, Thouard H, Flandrin P
Service de Chirurgie Viscérale et Vasculaire, Hôpital d'Instruction des Armées Sainte-Anne, Toulon-Naval.
Ann Chir. 1998;52(4):326-30.
The discovery of a tumour mass of the appendix, in an acute or chronic context, raises the problem of its benign or malignant, inflammatory or infectious nature. We report five cases of patients operated by the same surgical team between June 1991 and September 1996, who presented macroscopically and histologically with unusual appendicular pseudotumours: appendicular diverticulosis (n = 1), Crohn's disease localized to the appendix (n = 2), yersiniosis (n = 1), actinomycosis (n = 1). The preoperative diagnosis was acute appendicitis (n = 2) or tumour (n = 3). The postoperative course was uneventful in every case, and specific medical treatment was prescribed in two cases (yersiniosis and actinomycosis). These differential diagnoses must be considered in all appendicular diseases, but they are extremely difficult to confirm preoperatively.
在急性或慢性情况下发现阑尾肿瘤块,会引发其性质是良性还是恶性、炎症性还是感染性的问题。我们报告了1991年6月至1996年9月期间由同一手术团队进行手术的5例患者,他们在宏观和组织学上表现为不寻常的阑尾假肿瘤:阑尾憩室病(n = 1)、局限于阑尾的克罗恩病(n = 2)、耶尔森菌病(n = 1)、放线菌病(n = 1)。术前诊断为急性阑尾炎(n = 2)或肿瘤(n = 3)。所有病例术后病程均平稳,2例(耶尔森菌病和放线菌病)给予了特定的药物治疗。在所有阑尾疾病中都必须考虑这些鉴别诊断,但术前极难确诊。