以急性阑尾炎为表现的结肠癌的诊断与治疗

目的：分析表现为急性阑尾炎的结肠癌漏诊的原因，探讨及时诊断、治疗的措施。方法：对我院近10年收治的表现为急性阑尾炎的结肠癌27例I临床资料作回顾分析。结果：27例首次诊断急性阑尾炎(外院5例)，全部作阑尾切除，术中诊断结肠癌15例，12例作Ⅰ期结肠癌根治术，3例无法根治；漏诊12例(外院5例)，术后3天—6个月诊断结肠癌，8例作Ⅱ期结肠癌根治术，3例无法根治，1例放弃治疗。病理诊断：结肠癌26例，急性阑尾炎17例，慢性阑尾炎5例。26例治愈出院，1例放弃诊疗。随访9例，生存3年以上5例，生存5年以上4例。结论：对本病认识不足是漏诊的主要原因，提高认识、重视腹腔探查可提高诊断率，确诊后应及时Ⅰ期手术根治。

Diagnosis and Treatment of Colonic Carcinoma Manifestating as Acute Appendicitis

Objective: To explore methods for diagosis and treatment in time according to analyze reasons of misdiagnosis of colonic carcinoma manifestating as acute appendicitis. Methods: Clinical data of 27 cases colonic carcinoma manifestating as acute appendicitis in recent 10 years were reviewed. Results: The first diagnosis of all 27 cases were acute appendicitis, and all accepted appendectomy. 15 cases were diagnosed clonic carcinoma during abdominal dectection, 12 cases of whilch accepted I stage colonic carcinoma radical operations, and the rest 3 cases could not accepted radical operations. 12 misdiagnosis cases were diagnosed colonic carcinoma from 3 days to 6 month after appendectomy, 8 cases of which accepted Ustage colonic carcinoma radical operations, 3 cases could not accepted radical operation, and 1 case gave up ang treatment. Pathological diagnosis: colonic carcinoma 26 cases, acute appendicitis 17 cases, chronic appendicitis 5 cases. 3 years survival were 5 cases and 5 years survival were 4 cases among 9 cases followd up. Conclusions: The main reason of misdiagnosis was lacking of knowledge of the disease. Paying attention to abdominal dectetion and knowledge of the disease was helpful for correct diagnosis. I styage radical operation must be done in time after diagnosis.