| 摘要 |
The incidence of appendiceal diverticulitis in pathologic specimens is 0.004-2.1%. It was reported first in 1893 by Kelynack, and it is rare in younger patients. Appendiceal diverticulitis presents as right lower quadrant pain and is an uncommon entity in younger populations. Although encountered infrequently, its possibility must be considered in the differential diagnosis of abdominal pain, especially in cases of adult patients. Since its clinical
presentation can be different from the classical picture of acute appendicitis, it is important that surgeons be aware of this condition. Patients with appendiceal diverticulitis are four times more likely to have a perforation, resulting in a 30-fold increase in mortality compared with simple appendicitis. In present studies, the incidence of appendiceal diverticulosis has been reported to be 0.88% in appendectomy specimens, which is similar to the results
of previous reports. In addition, it has been associated with a high perforation rate of 70% (in 7 of 10 patients).
It is difficult to diagnose preoperatively despite careful examination of the clinical symptoms, even with highresolution ultrasound or computer tomography scans.2e5 To add to our concern, several studies have indicated that appendiceal diverticulosis is associated with appendiceal neoplasia. A tumor occurs when cells in the appendix become abnormal and multiply without control. Tumors may be benign (noncancerous), or malignant (resulting in appendix cancerdalso termed appendiceal cancer). Once the diagnosis of appendiceal diverticular disease has been established, we recommend resection; however, some investigators doubt the potential benefit of prophylactic appendectomy. The high risk of perforation and neoplasia can change, if we can diagnose appendiceal diverticulosis accurately.
Appendectomy is highly recommended, even when appendiceal diverticulosis is asymptomatic. |
