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自1976~1989年经门诊、急诊收治这种病人9例,男6例,女3例,年龄39~78岁,平均58.5岁。临床表现:入1院时均有腹痛,其中有典型转移性右下腹痛3例,畏寒发热3例,腹泻2例,既往有下腹胀感、腹痛、大便习惯改变、粘液便3例。右下腹压痛9例、反跳痛6例,扪及包块3例。术前诊断急性阑尾炎7例,其中3例术中发现回盲部癌,行一期右半结肠切除结肠回肠端对端吻合术。4例阑尾切除术后仍有腹痛,大便习惯改变,腹胀感,腹泻,粘液血便,术后1~1.5个月来院钡剂灌肠造影,结肠纤维镜检查诊断为升结肠癌行右半结肠切除术。另外2例病人人院时诊断为阑尾周围脓肿,其中1例52岁男性,抗炎治疗症状缓解经钡剂灌肠诊为回盲部癌行右半结肠切除术,其中第2例78岁女性经“B”超检查为右下腹肿瘤,手术探查发现回盲部广泛浸润粘连行回肠、横结肠短路吻合术,手术证实阑尾呈急性炎症改变。病理:回盲部癌5例,升结肠癌4例。肿块型高分化腺癌6例,溃疡性低分化腺癌3例,单纯性阑尾炎4例,化脓性阑尾炎3例,坏疽穿孔2例。
From 9 December to 1989, 9 patients were admitted to the outpatient department and emergency department. There were 6 males and 3 females, aged 39 to 78 years, with an average of 58.5 years. Clinical manifestations: abdominal pain in 1 hospital, including typical metastatic right lower quadrant pain in 3 cases, 3 cases of chills and fever, 2 cases of diarrhea, previous abdominal bloating, abdominal pain, changes in bowel habits, mucus in 3 cases. There were 9 cases of tenderness in the right lower quadrant, 6 cases of rebound tenderness, and 3 cases of hernia and mass. Preoperative diagnosis of 7 cases of acute appendicitis, of which 3 cases found operative ileocecal cancer, a right colon resection of colon ileum end-to-end anastomosis. 4 cases of abdominal pain after appendectomy, changes in bowel habits, bloating, diarrhea, mucopuraemia, 1 to 1.5 months after surgery to barium enema angiography, colonoscopy diagnosis of ascending colon cancer right colon resection . Two other patients were diagnosed as abscesses around the appendix in hospital. One of them was a 52-year-old male. Symptoms of anti-inflammatory treatment were diagnosed as ileocecal right hemi-colonectomy by barium enema. The second 78-year-old female patient The “B” ultrasonography was a tumor of the right lower quadrant. Surgical exploration revealed extensive ileocecal adhesions and ileal and transverse colon short-circuit anastomosis. The surgery confirmed acute inflammation of the appendix. Pathology: 5 cases of ileocecal cancer and 4 cases of ascending colon cancer. There were 6 cases of well-differentiated adenocarcinoma of the mass, 3 cases of ulcerative poorly differentiated adenocarcinoma, 4 cases of simple appendicitis, 3 cases of suppurative appendicitis, and 2 cases of gangrene perforation.