appendix tumor
Introduction
Introduction to the appendix tumor The appendix tumor is rare and generally asymptomatic. It is often found during abdominal surgery or autopsy. The former is more malignant, the latter is more benign, and sometimes it can form acute appendicitis due to obstruction of the appendix cavity. A hard spherical mass that touches the appendix. The cut surface is yellow or grayish yellow and should be highly suspected. Adenocarcinoma is more malignant than normal carcinoid, and 15% can metastasize. basic knowledge The proportion of illness: the incidence rate of middle-aged people over 50 years old is about 0.01% Susceptible people: no special people Mode of infection: non-infectious Complications: anemia
Cause
The cause of appendicitis
Cyst formation (50%):
Blockage of the appendix cavity is the key to the formation of mucus cysts in the appendix, and the occurrence of obstruction can come from chronic inflammation of the appendix mucosa, scar contraction and foreign body incarceration, but also due to adhesion, distortion and compression of the appendix wall. The secretions in the distal appendix cavity cannot be discharged normally.
Prevention
Appendectomy
There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease. Eat foods that have anti-cancer effects, such as turtles, mushrooms, black fungus, garlic, seaweed, mustard and royal jelly. Vitamins A and C have the effect of preventing cell malignant and spreading and increasing the stability of epithelial cells. Vitamin C can also prevent the general symptoms of radiation damage, and can increase the level of white blood cells. Vitamin E can promote cell division and delay cell aging. Vitamin B1 can promote appetite and relieve symptoms caused by radiation therapy.
Complication
Iris tumor complications Complications anemia
1. When the tumor is larger or obstructs the appendix cavity, the pressure in the cavity is increased or the appendix membrane is pressed to cause appendix ischemia, congestion and secondary infection.
2. The lumps compress the bladder to appear frequent urination, urgency, etc. The compression of the ureter is characterized by lumbar pain and hydronephrosis.
Symptom
Appendicial tumor symptoms Common symptoms Abdominal pain cysts Abdominal abdominal pain Painful bloody stool Secondary infection Diarrhea Congestive appendix cavity occlusion Mucous cyst
When the tumor is large or the malignant tumor infiltrates with the surrounding tissue and adheres, the tumor can be touched in the right lower abdomen. Therefore, the history of abdominal pain should be repeatedly understood during the diagnosis. The abdominal pain of the appendix tumor has a chronic process and is treated with anti-inflammatory. After the abdominal pain and mass did not improve, in addition, malignant tumors have other symptoms of colorectal cancer, such as blood in the stool, anemia, ascites and distant metastasis.
Examine
Examination of appendix tumors
1.B-ultrasound: Abdominal B-ultrasound is not easy to find small-sized appendix tumors. When the tumor is large, the mucous cysts are round or elliptical with no echogenic area or separated echoes, neatly surrounding, clear, mild tenderness, no In the history of appendectomy, malignant tumors are mostly unevenly distributed in the hypoechoic area. There may be calcified or necrotic liquefaction areas in the middle. The boundary is irregular, and liver metastases can be found in advanced tumors.
2. X-ray barium enema
(1) In most cases, the appendix is not developed, a few proximal ends can be developed, and the distal end is interrupted. If the expectorant enters the cyst cavity, a circular or elliptical shadow can be displayed.
(2) The inner side of the lower end of the cecum is caused by the compression of the tumor. When the malignant tumor affects the cecum, the filling defect and the base are narrowed.
3. Abdominal plain film shows calcification and tumor shadow.
Diagnosis
Diagnosis and differentiation of appendix tumor
Preoperative diagnosis
The appendix tumor is difficult to diagnose before operation. It is often misdiagnosed as acute and chronic appendicitis, inflammatory mass in the right lower quadrant, etc. Any history of atypical appendicitis, long-term discomfort or dull pain in the right lower quadrant, right lower quadrant mass, lower gastrointestinal bleeding, ileoceletic intussusception If the cause is unknown, routine barium enema examination should be performed. If there are the following conditions, it may indicate the possibility of appendix tumor:
1 obvious filling defect can be seen in the tail cavity.
2 The appendix is not developed.
3 The cecum has an indentation. For the right lower abdomen mass, B-mode ultrasound or CT should be performed to improve the preoperative diagnosis rate. The fiber colonoscopy is not helpful for the diagnosis except for the basal tumor of the appendix.
2. Intraoperative diagnosis
In the appendectomy, the touch examination of the appendix is very important. If the appendix is found to be thick and invisible during the operation, the naked eye should be opened and the specimen should be cut if necessary. If necessary, the condition should not be exhausted. It is possible to completely remove the appendix and lesions. For example, the lesion should be located at the base of the appendix. All the appendix should be performed, even part of the cecum. The mesenteric treatment should be cut away from the appendix as much as possible. Pay attention to whether the mesangial lymph nodes are swollen. All the appendix specimens should be routinely paraffin-embedded. Histological examination, mucus in the appendectomy should be excluded from the mucus cyst.
