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相關文獻
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頁籤選單縮合
題名 | Lymphoid Hyperplasia of Appendix Vermiformis--A Condition Causes Signs and Symptoms Mimicking Acute Appendicitis that Usually Treated with Emergent Appendectomy=闌尾類淋巴增生--臨床表徵與急性闌尾炎相似而常以闌尾切除術治療 |
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作者姓名(中文) | 劉建良; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 24:4 民80.07-08 |
頁次 | 頁756-762 |
分類號 | 416.243 |
關鍵詞 | 闌尾類淋巴增生; 臨床表徵; 急性闌尾炎; 闌尾切除術; |
語文 | 英文(English) |
中文摘要 | 自民國七十六年八月十五日至民國七十九年九月三十日之間,本院共有294病例(男性155例,女性139例)在急性闌尾炎的臨床臆斷下,接受闌尾切除術治療。其中209例經病理切片證實為急性闌尾炎。在病理上沒有炎症表徵的其它闌尾中,有25例可以發現明顯的闌尾類淋巴增生(男性8例,女性17例),其年齡最小為5歲,最大為56歲,平均31.5歲。這些病例均有與急性闌尾炎相似的臨床症狀與表徵。16例有白血球增多現象,在23例接受腹部X光攝影的病例中有6例可以發現右下腹部的局部腸阻塞,所有病例的尿液檢查都正常。17例女性病例均有照會婦產科,但在做完病史、骨盆腔檢查與超音波後,均沒有發現明確的婦產科疾病。 手術當中所見,只有12例闌尾有肉眼的變化,但大多極為輕微,只有三例有稍明顯的闌尾肥大或充血。手術均行闌尾切除術,另有一例附加腸繫膜淋巴腺切除。術後二例有極輕微的傷口感染。 術後的追蹤從13天到615天不等(平均149.1天)。其中22例在追蹤期間均無右下腹疼痛的主訴(平均追蹤152.4天)。另三例在追蹤期間曾主訴右下腹疼痛;其中有一例接受大腸鋇劑攝影檢查,發現昇行結腸有憩室併痙孿性收縮。此例的症狀,在投予抗痙孿藥物後,很快就得到緩解。 我們認為;闌尾類淋巴增生可以導致與急性闌尾炎無法區分的臨床症狀與表徵,且在接受闌尾切除術後,絕大多病例的症狀都可以得到緩解。但是這些病人在術後必需接受一段期間(六個月以上)的追蹤檢查,以免有其它重要疾病被延誤診斷。 |
英文摘要 | From Aug. 15, 1987 to Sept. 30, 1990, at Mackay Memorial Hospital, Taitung Branch, the emergent appendectomy was done on 294 patients (155 male and 139 female) under the impression of acute appendicitis. Among these patients, the pathological reports confirmed the acute appendicitis in 209 cases. The lymphoid hyperplasia of the appendix vermiformis without evidence of acute inflammatory cell infiltration was noticed in 25 patients (8 male and 17 female). The average age of these 25 patients was 31.5 years (range: 5-56 years). All these cases had clinical signs and symptoms suggesting acute appendicitis. Leukocytosis was noticed in 16 cases. During the operation, the minimal to moderate amount of ascites was noticed in 12 cases. The gross changes of the appendix vermiformis were usually minimal, only 3 cases had the significant engorgement or congestion of the appendix vermiformis. The wounded infection occurred in 2 cases, but both were mild. The postoperative follow up ranged from 13 days to 615 days (average 149.1 days). Twenty-two cases had no right lower abdomen pain throughout the follow up period (average 152.4 days). Three patients had some episodes of right lower abdominal pain during the follow-up. Among them, the diverticulum over ascending colon with spastic change was noticed on barium enema film in one case, and the symptom was easily relieved by antispasmodic drug. We concluded that lymphoid hyperplasia of the appendix vermiformis is a condition which may cause signs and symptoms mimiking acute appendicitis and appendectomy usually can relieve the symptoms effectively in most cases, and these patients should be followed up regularly for at least 6 months lest other significant diseases are overlooked. |
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