RESUMO
The authors present the case of a very rare pseudomyxoma peritonei as a late complication of appendectomy. The definite diagnosis was established 11 years after appendectomy for appendiceal mucocele. In the paper the authors emphasize the need for correct retrospective evaluation of all data in patients with unusual diagnoses.
Assuntos
Apendicectomia/efeitos adversos , Apêndice , Doenças do Ceco/complicações , Mucocele/complicações , Neoplasias Peritoneais/etiologia , Pseudomixoma Peritoneal/etiologia , Adulto , Humanos , Masculino , Neoplasias Peritoneais/diagnóstico por imagem , Neoplasias Peritoneais/patologia , Neoplasias Peritoneais/cirurgia , Peritônio/patologia , Pseudomixoma Peritoneal/diagnóstico por imagem , Pseudomixoma Peritoneal/patologia , Pseudomixoma Peritoneal/cirurgia , Radiografia Abdominal , Fatores de Tempo , Tomografia Computadorizada por Raios XRESUMO
AIM: The aim of this study was to evaluate surgical options and therapeutic results of the large intestine perforation treatment, conducted by the authors' team. METHODOLOGY: During a four-year-period, a retrospective study including 53 patient subjects suffering from the large intestine perforation followed by peritonitis was conducted by the authors' team. The peritonitis-related risks were classified according to the Mannheim Peritonitis Index--the MPI score. RESULTS: The mean value of the MPI score reached 24.4 points in the assessed group. The total mortality rate reached 18.9% in the assessed group. The MPI score was significantly lower in the surviving patients group, compared to the exited patients group. Furthermore, the MPI score was significantly lower in the group of patients suffering from benign disorders of the large intestine, compared to the group of patients with malignancies. Resection with primary anastomosis (RPA), as a surgical treatment method, was successful in 32.1% of all cases in the group and in 73.9% of the patients treated using RPA. CONCLUSION: In indicated cases, the RPA method remains the appropriate surgical approach for the patients with the large intestine perforation, even when diffuse peritonitis concurs. The MPI score represents a simple and sufficiently reliable assessment system for the patients suffering from the large intestine perforation.
Assuntos
Perfuração Intestinal/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Perfuração Intestinal/complicações , Perfuração Intestinal/diagnóstico , Perfuração Intestinal/mortalidade , Masculino , Pessoa de Meia-Idade , Peritonite/etiologia , Taxa de SobrevidaRESUMO
The authors describe a rare case report of a female patient with acute appendicitis, where the course was masked by gastroenteritis complicated with sepsis with a simultaneous course of imported infection with Salmonella type C (Kentucky). The attention is drawn to the fact that even such frequent abdominal emergency as appendicitis is, may cause diagnostic hesitations, if it is masked by a simultaneous alimentary infection. In spite of the application of a broad scope of examination methods a final decision of indication for laparotomy depends on clinical findings of the examining surgeon.
