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충수 점액 낭종

Appendiceal Mucocele

대한대장항문학회지 2004년 20권 6호 p.339 ~ 343
임영철 ( Lim Young-Chul ) - 울산대학교 의과대학 외과학교실

최대화 ( Choi Dae-Hwa ) - 울산대학교 의과대학 울산대학교병원 외과
조홍래 ( Cho Hong-Rae ) - 울산대학교병원 외과
고병균 ( Ko Byung-Kyun ) - 울산대학교 의과대학 울산대학교병원 외과
남창우 ( Nam Chang-Woo ) - 울산대학교 의과대학 울산대학교병원 외과학교실
나양원 ( Nah Yang-Won ) - 울산대학교 의과대학 울산대학교병원 외과
김규열 ( Kim Kyu-Yeol ) - 울산대학교 의과대학 울산대학교병원 외과

Abstract


Purpose: An appendiceal mucocele refers to an abnormal dilatation of the appendiceal lumen by mucus. It is a rare clinical entity with a reported prevalence rate of 0.2~0.3% of all appendectomies. The purpose of our study was to identify the clinical characteristics of and the proper surgical management for appendiceal mucoceles.

Methods: The hospital records of 24 eligible patients were reviewed. We analyzed demographic data, and pathological and clinical data.

Results: There was a significant difference in size (P<0.009) between simple mucoceles (mean, 1.95 cm) and cystadenomas (mean, 3.6 cm). While ultrasonography was the most commonly used test to establish the diagnosis (14 patients), computed tomography and colonoscopy also provided fundamental information in 5 and 2 patients, respectively. An appendectomy was performed in most cases (20 cases, 83%). A cecectomy was performed in 3 cases, and an ileocecal resection was performed in only one case. Among the cases requiring a cecectomy, a laparoscopic cecectomy was performed in one case. A synchronous tumor was present in 5 cases. Three patients had gastric cancer, 1 patient had gallbladder cancer, the other one had endometriosis.

Conclusions: Our study shows that appendiceal mucoceles most frequently present as acute appendicitis and that preoperative diagnosis is difficult to make. All mucoceles should probably be removed to eliminate the chance of progression to malignancy. Also of note was the elevated incidence of associated neoplasms, especially gastrointestinal carcinomas. Some recommend surveillance colonoscopy in patients with a diagnosis of an appendiceal mucocele. We had three cases accompanied bygastric malignancy. Therefore, we suggest that surveillance gastrofiberscopy may be indicated. J Korean Soc Coloproctol 2004;20:339-343

키워드

충수 점액낭종;동시성 종양;감시 위내시경 검사
Appendiceal mucocele;Synchronous neoplasm;Surveillance gastrofiberscopy
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