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Contribution of the appendix to ulcerative colitis by supplying pathogenic immunoglobulin G-producing cells 认领 引用
1
作者 Yusuke Izutani Takayuki Ogino +19 位作者 Shuhei Sakakibara Yosuke Kishi Yu-Chen Liu Yusuke Nakano Akio Fukada Yuki Sekido Ryuichi Kuwahara Takako Kihara Mitsunobu Takeda Tsuyoshi Hata Atsushi Hamabe Norikatsu Miyoshi Mamoru Uemura Hiroki Ikeuchi Seiichi Hirota Kiyoshi Takeda Tsunekazu Mizushima Daisuke Okuzaki Yuichiro Doki Hidetoshi Eguchi 《World Journal of Gastroenterology》 SCIE CAS 2026年第27期80-97,共18页
BACKGROUND Appendectomy reduces the occurrence and controls the severity of ulcerative colitis(UC);however,how it exerts these effects remains unclear.AIM To elucidate the contribution of appendix-associated immune re... BACKGROUND Appendectomy reduces the occurrence and controls the severity of ulcerative colitis(UC);however,how it exerts these effects remains unclear.AIM To elucidate the contribution of appendix-associated immune responses in intestinal inflammation and their relevance to the effects of appendectomy in UC.METHODS This study was conducted at Graduate School of Medicine,The University of Osaka.We included patients undergoing surgery for UC and those without inflammatory bowel disease undergoing colorectal cancer surgery as controls.Appendiceal tissues were collected from both patient groups,and macroscopically normal appendices located at least 10 cm from the tumor were used as controls.Single-cell RNA sequencing,immunohistochemistry,and flow cytometry were performed.RESULTS Single-cell RNA sequencing identified T,B,plasma,innate lymphoid,and mast cells,together with other myeloid cells in appendiceal tissues.A hallmark feature of the appendices in UC was an increase in immunoglobulin G(IgG)-expressing plasma cells.Immunohistochemistry revealed significantly reduced IgG levels in the large intestines of patients with UC who had undergone an appendectomy compared with levels in those who did not undergo appendectomy.Repertoire analysis revealed an increased production of IgG antibodies bearing an integrin-binding motif at antigen-recognition sites in patients with UC.CONCLUSION The appendix is a major site of pathogenic IgG antibody production in patients with UC,providing the immunological basis for appendectomy as a treatment for UC. 展开更多
关键词 Ulcerative colitis Appendix Appendectomy Autoantibody Immunoglobulin G
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Relationship between the appendix and ulcerative colitis:A new discovery 认领 引用 被引量：1
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作者 Xu-Jia Wu Reng-Yun Xiang +2 位作者 Pan Gong Xue-Feng Li Qian Chen 《World Journal of Gastrointestinal Endoscopy》 2026年第2期20-28,共9页
The appendix was once considered to be vestigial and useless organ.However,in recent years,research has confirmed that the appendix is associated with human immune function and exerts an anti-inflammatory effect throu... The appendix was once considered to be vestigial and useless organ.However,in recent years,research has confirmed that the appendix is associated with human immune function and exerts an anti-inflammatory effect through regulating the gut microbiota.Ulcerative colitis(UC)is a chronic and nonspecific inflammatory bowel disease associated with genetics,the environment,immunity,and alterations in the gut microbiota.Multiple studies have shown that the appendix and UC are closely related.With the advent of ultraslim subscopes allowing direct visualization(cholangioscopes),innovative methods for endoscopic diagnosis and treatment of appendicitis with appendix preservation have been successfully implemented.This has not only shifted the traditional approach to diagnosing and treating appendicitis,but has also opened the way for new insights and discoveries in exploring the relationship between the appendix and UC. 展开更多
关键词 Appendix Ulcerative colitis Inflammation Immunity Gut microbiota
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Chronic abdominal pain caused by foreign bodies in the appendix:A case report 认领 引用 被引量：1
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作者 Tao Huang Shang-Kun Li +1 位作者 Wei Wang Rui Zhang 《World Journal of Gastrointestinal Surgery》 SCIE 2025年第5期398-403,共6页
BACKGROUND Acute abdominal pain is often easy to be diagnosed because of acute abdomen,and can be treated reasonably and effectively.It is more difficult to establish the cause of chronic abdominal pain,and some patie... BACKGROUND Acute abdominal pain is often easy to be diagnosed because of acute abdomen,and can be treated reasonably and effectively.It is more difficult to establish the cause of chronic abdominal pain,and some patients repeatedly visit several hos-pitals and still cannot be diagnosed.Chronic abdominal pain caused by chronic appendicitis is such a case.If the degree of abdominal pain is mild and there is no sign of peritonitis,chronic appendicitis is not performed unless the patient re-quests it.CASE SUMMARY We report an extremely rare case of chronic appendicitis caused by a foreign body in the appendix in a 35-year-old woman.The patient had a long-term abdominal pain of unclear cause,and she was repeatedly treated in several hospitals.After antibiotic treatment,the abdominal pain was gradually relieved,but abdominal pain often recurs.We conducted abdominal computed tomography examination,and upon the advice of radiologists,we considered the possibility of foreign bodies in the appendix,and excluded other causes of abdominal pain.The patient requested and consented to laparoscopic appendectomy,and a chicken bone was found in the appendiceal cavity by postoperative incision of the appendiceal spe-cimen.Histopathological examination confirmed chronic appendicitis with fo-reign body giant cell reaction.The patient recovered and was discharged from the hospital.After 2 months of follow-up,abdominal pain did not recur,and the patient had a complete recovery.Core Tip:We report an extremely rare case of chronic appendicitis caused by a chicken bone in the appendix.The patient was 35-year-old woman,and had a long-term abdominal pain of unknown cause.Abdominal computed tomography examination suggested foreign bodies in the appendix,and laparoscopic appendectomy was performed.The postoperative specimen revealed chicken bones in the appendix cavity,and histopathological examination confirmed chronic appendicitis with giant cell reaction of foreign bodies.The patient recovered and was followed up for two months without abdominal pain.Citation:Huang T,Li SK,Wang W,Zhang R.Chronic abdominal pain caused by foreign bodies in the appendix:A case report.World INTRODUCTION Appendicitis is one of the common diseases that cause abdominal pain[1].Appendicitis can be diagnosed and treated effectively when patients with acute abdominal pain are admitted to hospital because of factors such as blockage and infection of appendicitis[2,3].However,the diagnosis of chronic appendicitis is difficult.Acute appendicitis caused by foreign bodies in the appendix is easy to diagnose because of the final surgical treatment[4-6],while chronic appendicitis caused by foreign bodies in the appendix is more difficult to diagnose because of the mild degree of abdominal pain.We here report an extremely rare case of chronic appendicitis caused by foreign bodies in the appendix.The patient had a long-term abdominal pain of unclear cause,and she was repeatedly treated in several hospitals.Abdominal color ultrasound examination indicated a coprolith in the appendiceal cavity and the appendix was normal,so the patient could not be treated with surgery.We conducted abdominal computed tomography(CT)examination,and upon the advice of radiologists,we considered the possibility of foreign bodies in the appendix,and excluded other causes of abdominal pain.The patient requested and consented to laparoscopic appendectomy,and a chicken bone was found in the appendiceal cavity by postoperative incision of the appendiceal specimen.The patient recovered and was discharged from hospital.After 2 months of follow-up,abdominal pain did not recur and the patient had a full recovery. 展开更多
关键词 Foreign body Appendix Appendicitis Chronic abdominal pain Case report
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Internal biliary diversion using appendix during liver transplantation for progressive familial intrahepatic cholestasis type 1:A case report 认领 引用
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作者 Jia-Qi Song Tao Zhou +1 位作者 Yi Luo Yuan Liu 《World Journal of Gastrointestinal Surgery》 SCIE 2025年第2期279-284,共6页
BACKGROUND Progressive familial intrahepatic cholestasis type 1(PFIC-1)is a genetic cholestatic disease causing end-stage liver disease,which needs liver transplantation(LT).Simultaneous biliary diversion(BD)was recom... BACKGROUND Progressive familial intrahepatic cholestasis type 1(PFIC-1)is a genetic cholestatic disease causing end-stage liver disease,which needs liver transplantation(LT).Simultaneous biliary diversion(BD)was recommended to prevent allograft steatosis after transplantation,while increasing the risk of infection.Here,an attempt was made to perform BD using appendix to prevent bacterial translocation after LT.CASE SUMMARY An 11-month-old boy diagnosed with PFIC-1 received ABO compatible living donor LT due to refractory jaundice and pruritus.His mother donated her left lateral segment with a graft-to-recipient weight ratio of 2.9%.Internal BD was constructed during LT using the appendix by connecting its proximal end with the intrahepatic biliary duct and the distal end with colon.Biliary leakage was suspected on the 5th day after transplantation and exploratory laparotomy indicated biliary leakage at the cutting surface of liver.The liver function returned to normal on the 9th day post-operation and maintained normal during the 15-month follow-up.Cholangiography at 10 months after transplantation confirmed the direct secretion of bile into colon.Computerized tomography scan(4 months and 10 months)and liver biopsy(10 months)indicated no steatosis in the allograft.No complaint of recurrent diarrhea,infection or growth retardation was reported during follow-up.CONCLUSION Internal BD using appendix during LT is effective in preventing allograft steatosis and post-transplant infection in PFIC-1 recipients. 展开更多
关键词 Liver transplantation Progressive familial intrahepatic cholestasis type 1 Biliary diversion Appendix Case report
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Duplicated appendix complicated by appendiceal cancer 认领 引用 被引量：2
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作者 Hugh J Freeman 《World Journal of Gastroenterology》 SCIE CAS CSCD 2011年第1期135-136,共2页
A 37-year old male presented with an acute abdomen suggestive of an appendiceal perforation.Urgent laparotomy showed a duplicated appendix with one of the lumens involved with appendicitis and a focal periappendicular... A 37-year old male presented with an acute abdomen suggestive of an appendiceal perforation.Urgent laparotomy showed a duplicated appendix with one of the lumens involved with appendicitis and a focal periappendicular abscess while the other lumen had a localized appendiceal cancer.Recognition of congenital intestinal duplications in adults is important to avoid serious clinical consequences. 展开更多
关键词 Duplicated appendix Bifid appendix Appendiceal cancer Congenital duplication.
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Appendix is a priming site in the development of ulcerative colitis 认领 引用 被引量：11
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作者 Mitsunobu Matsushita Hiroshi Takakuwa +3 位作者 Yuji Matsubayashi Akiyoshi Nishio Susumu Ikehara Kazuichi Okazaki 《World Journal of Gastroenterology》 SCIE CAS 2005年第31期4869-4874,共6页
AIM： The role of the appendix has been highlighted in the pathogenesis of ulcerative colitis （UC）. The aims of this study were to elucidate the immuno-imbalances in the appendix of UC patients, and to clarify the r... AIM： The role of the appendix has been highlighted in the pathogenesis of ulcerative colitis （UC）. The aims of this study were to elucidate the immuno-imbalances in the appendix of UC patients, and to clarify the role of the appendix in the development of UC. METHODS： Colonoscopic biopsy specimens of the appendix, transverse colon, and rectum were obtained from 86 patients with UC： active pancolitis （A-Pan; n = 15）, active letf-sided colitis （A-Lt; n = 25）, A-Lt with appendiceal involvement （A-Lt/Ap; n = 10）, inactive pancolitis （I-Pan; n = 14）, and inactive left-sided colitis （I-Lt; n = 22）, and from controls. In the isolated mucosal T cells, the CD4/CD8 ratio and proportion of activated CD4＋ T ceils were investigated, and compared with controls. RESULTS： in the appendix, the CD4/CD8 ratio significantly increased in A-Lt and A-Lt/Ap. The ratio in the appendix also tended to increase in A-Pan. In the rectum, the ratio significantly increased in all UC groups. In the appendix, the proportion of CD4＋CD69＋ （early activation antigen） T cells significantly increased in all UC groups. In the rectum, the proportion of CD4＋CD69＋ T cells significantly increased only in A-Pan. The proportion of CD4＋HLADR＋ （mature activation antigen） T cells significantly increased only in the rectum of A-Pan, but not in the otherareas of any groups. CONCLUSION： The increased CD4/CD8 ratio and predominant infiltration of CD4＋CD69＋ T cells in the appendix suggest that the appendix is a priming site in the development of UC. 展开更多
关键词 Appendix Appendectomy Ulcerative colitis Activated T cell CD4＋ T cell
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Ultrasonography of normal and abnormal appendix in children 认领 引用 被引量：11
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作者 Noh Hyuck Park Hwa Eun Oh +1 位作者 Hee Jin Park Ji Yeon Park 《World Journal of Radiology》 2011年第4期85-91,共7页
Appendicitis is the most common acute surgical emergency of childhood. Since the original report by Puylaert in 1986, the use of ultrasonography in the diagnosis of appendicitis has been the subject of considerable st... Appendicitis is the most common acute surgical emergency of childhood. Since the original report by Puylaert in 1986, the use of ultrasonography in the diagnosis of appendicitis has been the subject of considerable study. Among the reported diagnostic criteria, the maximal outer diameter (MOD) of the appendix is accepted as the one of the most reliable criteria used to differentiate between a normal appendix and acute appendicitis. However, MOD measurement is subject to inaccuracies because luminal distention by non-compressible, non-inflammatory material such as fecal material, or increased maximal mural thickness due to reactive mucosal lym-phoid hyperplasia, or a medical cause due to a generalized gastrointestinal disease, such as Crohn’s disease, can cause the measurement to exceed the upper limits of normality. The aim of this article is to introduce the spectrum of ultrasonographic findings in the normal andabnormal appendix and eventually to reduce unneces-sary surgery in children. 展开更多
关键词 Acute appendicitis Appendix Children Ultrasonography
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Mucocele of the appendix: An unusual cause of lower abdominal pain in a patient with ulcerative colitis-. A case report and review of literature 认领 引用 被引量：5
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作者 Peter Laszlo Lakatos Gabriella Gyori +5 位作者 Judit Halasz Peter Fuszek Janos Papp Balazs Jaray Peter Lukovich Laszlo Lakatos 《World Journal of Gastroenterology》 SCIE CAS 2005年第3期457-459,共3页
The authors report the case of a 60-year-old male patient. In November 2001 he developed intestinal symptoms of bloody diarrhea and abdominal pain. Colononoscopy and biopsy established the diagnosis of ulcerative coli... The authors report the case of a 60-year-old male patient. In November 2001 he developed intestinal symptoms of bloody diarrhea and abdominal pain. Colononoscopy and biopsy established the diagnosis of ulcerative colitis (proctosigmoiditis). The disease activity was moderate at the beginning. No significant laboratory alterations were found (including CEA, CA19-9), and mesalazine was started orally. He was in remission until November 2003, when he was admitted to our Outpatient Clinic for upper and right lower abdominal pain and bloody diarrhea. Colonoscopy found proctosigmoiditis with a moderate activity, gastroscopy revealed chronic gastritis, laboratory data was normal. Treatment was amended with mesalazine clysma and methylprednisolone (16 mg) orally. Symptoms ameliorated; however, right lower abdominal pain persisted. US and CT examinat'on demonstrated a pericecal cystic mass (11 cm×3.5 cm). At first pericecal abscess was suspected, as the previous US examination (6 mo earlier) had revealed normal findings. Fine needie aspiration was performed. Cytology confirmed the diagnosis of mucocele. The patientunderwent partial cecum resection and extirpation of the mucocele. He recovered well and the final histology revealed a cystadenoma of the appendix. Follow up was started. The pati雗t is now free of symptoms. Although primary adenocarcinoma of the appendix is uncommon, the authors emphasize that preoperative diagnosis of an underlying malignancy in a mucocele is important for pati雗t management; however, it is difficult on imaging studies. 展开更多
关键词 Mucocele of the appendix Lower abdominal pain Ulcerative Colitis
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Goblet cell carcinoid tumors of the appendix: An overview 认领 引用 被引量：12
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作者 Paromita Roy Runjan Chetty 《World Journal of Gastrointestinal Oncology》 SCIE 2010年第6期251-258,共8页
Goblet cell carcinoid is an enigmatic and rare tumor involving the appendix almost exclusively. Since its identification in 1969, understanding of this disease has evolved greatly, but issues regarding its histogenesi... Goblet cell carcinoid is an enigmatic and rare tumor involving the appendix almost exclusively. Since its identification in 1969, understanding of this disease has evolved greatly, but issues regarding its histogenesis, nomenclature and management are still conjectural. The published English language literature from 1966 to 2009 was retrieved via PubMed and reviewed. Various other names have been used for this entity such as adenocarcinoid, mucinous carcinoid, crypt cell carcinoma, and mucin-producing neuroendocrine tumor, although none have been found to be completely satisfactory or universally accepted. The tumor is thought to arise from pluripotent intestinal epithelial crypt-base stem cells by dual neuroendocrine and mucinous differentiation. GCCs present in the fifth to sixth decade and show no definite sex predominance. The most common clinical presentation is acute appendicitis, followed by abdominal pain and a mass. Fifty percent of the female patients present with ovarian metastases. The histologic hallmark of this entity is the presence of clusters of goblet cells in the lamina propria or submucosa stain for various neuroendocrine markers, though the intensity is often patchy. Atypia is usually minimal, but carcinomatous growth patterns may be seen. These may be of signet ring cell type or poorly differentiated adenocarcinoma. Recently molecular studies have shown these tumors to lack the signatures of adenocarcinoma but they have some changes similar to that of ileal carcinoids (allelic loss of chromosome 11q, 16q and 18q). The natural history of GCC is intermediate between carcinoids and adenocarcinomas of the appendix. The 5-year overall survival is 76%. The most important prognostic factor is the stage of disease. Appendectomy and right hemicolectomy are the main modalities of treatment, followed by adjuvant chemotherapy in select cases. There is some debate about the surgical approach for these tumors, and a summary of published series and recommendations are provided. 展开更多
关键词 Goblet cell carcinoid Appendiceal neoplasm Mucin-producing neuroendocrine tumor of appendix
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Goblet cell carcinoid of the appendix and mixed adenoneuroendocrine carcinoma: Report of three cases 认领 引用 被引量：1
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作者 Hatice Karaman Fatma Senel +2 位作者 Mustafa Güreli Turan Ekinci Omer Topuz 《World Journal of Gastrointestinal Oncology》 SCIE 2017年第7期308-313,共6页
Neuroendocrine neoplasms are the most common epithelial tumors among appendix tumors. Appendix tumors that are completely or partially composed of neuroendocrine cells are divided into two categories: Classic carcinoi... Neuroendocrine neoplasms are the most common epithelial tumors among appendix tumors. Appendix tumors that are completely or partially composed of neuroendocrine cells are divided into two categories: Classic carcinoid tumors and goblet cell carcinoid tumors(GCCT). They are known to progress more aggressively than classic(neuro) endocrine tumors. In this study, three cases with acute appendicitis symptoms are presented, including their clinical and histopathological findings. Microscopic examination detected GCCT in two cases and mixed adenoneuroendocrine carcinoma in one case, in addition to acute appendicitis. 展开更多
关键词 Appendix vermiformis Mixed adenoneuroendocrine carcinoma Goblet cell carcinoid tumors
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Goblet cell carcinoids of the appendix:Tumor biology,mutations and management strategies 认领 引用 被引量：10
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作者 Santosh Shenoy 《World Journal of Gastrointestinal Surgery》 2016年第10期660-669,共10页
Malignant neoplasms of the appendix are rare and represent less than 1% of gastrointestinal cancers.Goblet cell carcinoids(GCC) tumors are a distinctive group of heterogeneous appendiceal neoplasm that exhibit unique ... Malignant neoplasms of the appendix are rare and represent less than 1% of gastrointestinal cancers.Goblet cell carcinoids(GCC) tumors are a distinctive group of heterogeneous appendiceal neoplasm that exhibit unique clinical and pathologic features.This review focuses on the current diagnostic procedures,pathogenesis,possible signaling mechanisms and treatment options for GCC.Perspectives for future research are discussed.The tumor likely arises from pluripotent intestinal epithelial crypt base stem cells.Previous findings of Notch signaling as a tumor suppressor in Neuroendocrine tumors may have a similar role in this tumor too.Loss of Notch signaling may be the driver mutation with other successive downstream mutations likely favors them into progressing and behavior similar to poorly differentiated adenocarcinoma with minimal neuroendocrine differentiation.A multidisciplinary approach is suggested for optimal outcomes.Surgery remains the main treatment modality.Simple appendectomy may be sufficient in early stages while right hemicolectomy is recommended for advanced tumors.Cytoreductive surgery with heated intraperitoneal chemotherapy may improve survival in a select few with metastatic peritoneal disease.These tumors have an unpredictable behavior even in early stages and local recurrence and delayed metastases may be seen.Lifelong surveillance is warranted. 展开更多
关键词 Goblet cell carcinoid of the appendix Notch-1 signaling Immunomarkers Math-1 signaling Intestinal stem cells Disease management
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Atresia of the appendix vermiformis:A rare case of developmental abnormality 认领 引用
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作者 Faik Yaylak Mustafa Cem Algin +1 位作者 Yesim Gungor Mehmet Korkmaz 《World Journal of Gastroenterology》 SCIE CAS 2013年第1期122-124,共3页
Acute appendicitis,which requires immediate surgical intervention,is an important diagnosis in patients with acute abdomen.However,developmental abnormalities may interfere with the preoperative diagnosis and surgical... Acute appendicitis,which requires immediate surgical intervention,is an important diagnosis in patients with acute abdomen.However,developmental abnormalities may interfere with the preoperative diagnosis and surgical treatment in some cases.Agenesis and atresia of the cecal vermiform appendix is an extremely rare clinical diagnosis.In addition,preoperative diagnosis may be difficult in some cases.Thus,diagnosis of the congenital absence of the vermiform appendix requires a thorough exploration of the retrocecal and ileocecal regions.A 59-year-old male was admitted from the emergency services with right lower abdominal pain.A celiotomy was performed with the suspicion of acute appendicitis.However,an atresia of the vermiform appendix was observed.The patient's appendix was thus removed.Pathological examination confirmed suppurative appendicitis.This case underlines the importance of the clinical entity for surgeons who may deal with a similar case. 展开更多
关键词 Appendix vermiformis Developmental abnormality Agenesis Atresia Acute abdomen
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Acute epiploic appendagitis at the tip of the appendix mimicking acute appendicitis: A rare case report with literature review 认领 引用
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作者 Kai Huang Abdul Waheed +3 位作者 William Juan Subhasis Misra Cristiano Alpendre Stephen Jones 《World Journal of Gastrointestinal Surgery》 SCIE 2019年第8期342-347,共6页
BACKGROUND Acute epiploic appendagitis of the appendix (AEAA) is a rare self-limiting inflammatory disorder of the epiploic appendages (EA) close to the vermiform appendix, which often times mimicking the presentation... BACKGROUND Acute epiploic appendagitis of the appendix (AEAA) is a rare self-limiting inflammatory disorder of the epiploic appendages (EA) close to the vermiform appendix, which often times mimicking the presentation of acute appendicitis (AA). To date, very few cases of AEAA have been reported. We report a case of a 52-year old man with the clinical suspicion of AA, but post-operative specimen examination confirmed AEAA as the final diagnosis. CASE SUMMARY A 52-year-old morbidly obese man presented to the emergency department with a 1-d history of the right lower quadrant (RLQ) abdominal pain. Physical examination revealed localized RLQ tenderness mimicking AA. The computed tomography abdomen was inconclusive, and a decision was made to perform laparoscopic appendectomy (LA). During the LA, an infarcted epiploic appendage at the tip of appendix and adherent to the abdominal wall was found, which was entirely excised. Final pathology showed congested and hemorrhagic epiploic appendage without any accompanied acute inflammatory changes in the wall of the appendix. Postoperative course was uneventful and he was doing well at seven months follow-up. CONCLUSION The possibility of AEAA should be considered in patients clinically suspected of having AA. Surgery is considered for those refractory to conservative management, with inconclusive diagnosis or develop complications at presentation. 展开更多
关键词 Acute epiploic appendagitis of the appendix Acute epiploic appendagitis Acute appendicitis Case report
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Primary colonic type adenocarcinoma of the cecal appendix presented as obstructive acute abdominal syndrome 认领 引用
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作者 Gabriel J.Arismendi-Morillo Rafael E.Aez-Moreno Mary C.Fernández-Abreu 《The Chinese-German Journal of Clinical Oncology》 2006年第6期458-459,共2页
We reported a case with an obstructive acute abdomen,and emergency exploratory laparotomy was performed.Ap-pendiceal neoplasm was observed adhered to the ileum,and an ileohemicolectomy was performed.From the histopath... We reported a case with an obstructive acute abdomen,and emergency exploratory laparotomy was performed.Ap-pendiceal neoplasm was observed adhered to the ileum,and an ileohemicolectomy was performed.From the histopathological point of view the neoplasm was an infiltrating colonic type adenocarcinoma of the appendix,with extension to the periapendicular adipose tissue and fixation of an adjacent ileal loop secondary to infiltration of the intestinal wall.The tumor produced a moderate luminal stenosis of the intestine,this explained the clinical manifestations of the patient.Post-operative evolution was satisfac-tory and there had been no signs of recurrence in the 5 years since the operation.Based upon the comparison of clinical char-acteristics,pathological behavior(in relation to the growth and dissemination),and therapeutic considerations,possibly colonic type adenocarcinoma of the appendix is a neoplasm similar to the carcinomas of ascending colon. 展开更多
关键词 appendix pdmary colonic type adenocarcinoma appendiceal adenocarcinoma
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Endometriosis of the duplex appendix: A case report and review of the literature 认领 引用 被引量：4
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作者 Ming-Yuan Zhu Fa-Ming Fei +3 位作者 Jing Chen Zhong-Cheng Zhou Bin Wu Yi-Yu Shen 《World Journal of Clinical Cases》 SCIE 2019年第15期2094-2102,共9页
BACKGROUND Duplication of the appendix is an infrequent congenital malformation with a complex classification.The horseshoe appendix is a subtype of the duplex appendix and is rarely reported in the literature.Endomet... BACKGROUND Duplication of the appendix is an infrequent congenital malformation with a complex classification.The horseshoe appendix is a subtype of the duplex appendix and is rarely reported in the literature.Endometriosis is a common gynecological disease that rarely occurs in the appendix.Moreover,horseshoe appendix combined with endometriosis has not been previously reported.CASE SUMMARY Here,we describe a 44-year-old woman who was admitted with a 1-d history of migratory lower right quadrant pain.Physical examination was consistent with the signs of acute appendicitis.The patient underwent an emergency exploratory laparotomy.The distal tip of the appendix was in contact with the cecum by another base,or“horseshoe appendix”.In addition,a small intestinal mass and an ovarian mass were identified.Subsequently,appendectomy,partial resection of the small intestine,and right oophorectomy were successively performed.The histopathology confirmed the diagnosis of acute inflammation of the duplex appendix with endometriosis,small intestine endometriosis,and ovarian endometriosis.CONCLUSION Surgeons need to be aware of the possibility of the duplex appendix when performing an appendectomy,and this study emphasizes the importance of exploring the entire abdomen. 展开更多
关键词 Duplex appendix Horseshoe appendix Endometriosis Appendectomy Case report
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The importance of visualization of appendix on abdominal ultrasound for the diagnosis of appendicitis in children: A quality assessment review 认领 引用 被引量：4
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作者 Muhammad Akhter Hamid Ruqiya Afroz +4 位作者 Uqba Nawaz Ahmed Aneela Bawani Dilnasheen Khan Rabia Shahab Asim Salim 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2020年第3期140-144,共5页
BACKGROUND:Ultrasound has the first line investigation role in the diagnosis of acute appendicitis in children.The purpose of this study was to perform a quality assessment review on the visualization rate of appendix... BACKGROUND:Ultrasound has the first line investigation role in the diagnosis of acute appendicitis in children.The purpose of this study was to perform a quality assessment review on the visualization rate of appendix on ultrasound in children in the community hospital setting.METHODS:A retrospective chart review of the abdominal ultrasound findings for the visualization of the appendix was performed on paediatric patients ranging from 5 to 18 years.Data were collected from the two community hospitals of Toronto by using hospital electronic medical record for the ultrasound findings in patients presented with abdominal pain.RESULTS:Data from two community hospitals indicated visualization rate of the appendix as 11.0%and 23.2%for site 1 and site 2 respectively.In cases where the ultrasound was repeated the visualization rate remains the same.A two-proportion z-test was performed to find whether the visualization of appendix increases the likelihood of diagnosing appendicitis.The results revealed that the visualization of an appendix(P=0.52),significantly improved the diagnosis of appendicitis(z=34,P<0.001).CONCLUSION:Visualization of an appendix on ultrasound increases the likelihood of correctly diagnosing appendicitis.In our study,we found low visualization rate of appendix on ultrasound that could be the result of many factors that contribute towards the low visualization rate of an appendix on ultrasound.Hence,the challenges in identifying appendix should be minimized to improve the visualization and diagnosis of appendicitis on ultrasound. 展开更多
关键词 Abdominal ultrasound Visualization Importance Appendix Abdominal pain Acute appendicitis Children Paediatric population
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Limited, local, extracolonic spread of mucinous appendiceal adenocarcinoma after perforation with formation of a malignant appendix-to-sigmoid fistula: Case report and literature review 认领 引用 被引量：5
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作者 Seifeldin Hakim Mitual Amin Mitchell S Cappell 《World Journal of Gastroenterology》 SCIE CAS 2016年第38期8624-8630,共7页
A 68-year-old man presented with progressive right lower quadrant abdominal pain and tenderness without rebound tenderness, and with constipation during the prior 9 mo. Abdomino-pelvic computed tomography and magnetic... A 68-year-old man presented with progressive right lower quadrant abdominal pain and tenderness without rebound tenderness, and with constipation during the prior 9 mo. Abdomino-pelvic computed tomography and magnetic resonance imaging demonstrated a dilated appendix forming a fistula to the sigmoid colon. Open laparotomy revealed a bulky abdominal tumor involving appendix, cecum, and sigmoid, and extending up to adjacent viscera, without ascites or peritoneal implants. The abdominal mass was removed en bloc, including resection of sigmoid colon, cecum(with preservation of ileocecal valve), appendix, right vas deferens, testicular vessels, and minimal amounts of anterior abdominal wall; and shaving off of small parts of the walls of the urinary bladder and small bowel. Gross and microscopic pathologic examination revealed an appendix-to-sigmoid malignant fistula secondary to perforation of mucinous adenocarcinoma of the appendix with minimal local spread(stage T4). However, the surgical margins were clear, all 13 resected lymph nodes were cancer-free, and pseudomyxoma peritonei or peritoneal implants were not present. The patient did well during 1 year of follow-up with no clinical or radiologic evidence of local recurrence, metastases, or pseudomyxoma peritonei despite presenting with extensive stage T4 cancer that was debulked without administering chemotherapy, and despite presenting with malignant appendiceal perforation. This case illustrates the non-aggressive biologic behavior of this low-grade malignancy. The fistula may have prevented free spillage of cancerous cells and consequent distant metastases by containing the appendiceal contents largely within the colon. 展开更多
关键词 Mucinous adenocarcinoma Appendicitis Appendix Malignant fistula Pseudomyxoma peritonei Colon cancer Metastases
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Gastrointestinal stromal tumor of appendix incidentally diagnosed by appendiceal hemorrhage 认领 引用 被引量：3
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作者 Kyu-Jong Kim Won Moon +3 位作者 Moo In Park Seun Ja Park Seung Hyun Lee Bong Kwon Chun 《World Journal of Gastroenterology》 SCIE CAS 2007年第23期3265-3267,共3页
Gastrointestinal stromal tumor is rare, which arises from the mesenchymal tissues in the gastrointestinal tract, and it is extremely rare in the appendix. Only a few cases have been found in this location to date. Alt... Gastrointestinal stromal tumor is rare, which arises from the mesenchymal tissues in the gastrointestinal tract, and it is extremely rare in the appendix. Only a few cases have been found in this location to date. Although the annual incidence of lower gastrointestinal bleeding has been increasing, bleeding related to the appendix is quite rare. We herein present a very rare case of gastrointestinal stromal tumor incidentally found by appendiceal hemorrhage. 展开更多
关键词 Gastrointestinal stromal tumor Gastrointestinal tract Appendix Lower gastrointestinal bleeding Appendiceal hemorrhage
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Combined goblet cell carcinoid and mucinous cystadenoma of the vermiform appendix 认领 引用 被引量：6
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作者 Khaled O Alsaad Stefano Serra Runjan Chetty 《World Journal of Gastroenterology》 SCIE CAS 2009年第27期3431-3433,共3页
Goblet cell carcinoid is an uncommon primary tumor of the vermiform appendix, characterized by dual endocrine and glandular differentiation. Whether goblet cell carcinoid represents a morphological variant of appendic... Goblet cell carcinoid is an uncommon primary tumor of the vermiform appendix, characterized by dual endocrine and glandular differentiation. Whether goblet cell carcinoid represents a morphological variant of appendiceal classical carcinoid or a mucin-producing adenocarcinoma is a matter of conjecture. Rare cases of goblet cell carcinoid with other concomitant appendiceal epithelial neoplasms have been documented. In this report, we describe a rare case of combined appendiceal goblet cell carcinoid and mucinous cystadenoma, and discuss the possible histopathogenesis of this combination. 展开更多
关键词 Goblet cell carcinoid Mucinous cystadenoma Vermiform appendix
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Somatostatin receptor scintigraphy in the follow up of neuroendocrine neoplasms of appendix 认领 引用 被引量：3
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作者 Jelena Saponjski Djuro Macut +4 位作者 Dragana Sobic-Saranovic Sanja Ognjanovic Ivana Bozic Antic Djordje Pavlovic Vera Artiko 《World Journal of Clinical Cases》 SCIE 2020年第17期3697-3707,共11页
BACKGROUND Neuroendocrine tumors of appendix(ANETs)known as carcinoids,are rare endocrine neoplasms originated from enterochromaffin cells of gastrointestinal tract.ANETs are the third most frequent(16.7%)gastrointest... BACKGROUND Neuroendocrine tumors of appendix(ANETs)known as carcinoids,are rare endocrine neoplasms originated from enterochromaffin cells of gastrointestinal tract.ANETs are the third most frequent(16.7%)gastrointestinal neuroendocrine tumors,with the incidence of 0.08-0.2 cases/100000 during one year.Incidental ANETs occur in 0.2%-0.7%of emergency surgical resections because of suspected appendicitis which is usually the first manifestation of ANET.Although there are a lot of papers about application of somatostatin receptor scintigraphy in gastrointestinal neuroendocrine tumors,there are very rare sporadic cases described about ANETs particularly.AIM To establish the role of somatostatin receptor scintigraphy(SRS)in the management of patients with neuroendocrine tumors of appendix(ANET).METHODS The total of 35 patients was investigated,23 females and 12 males,average age(43.7±17.3 years).All patients had histological diagnosis of ANET(34 carcinoids of appendix and one tubular carcinoid).Majority of tumors have been found incidentally during surgery of:Acute appendicitis(n=15),perforated appendicitis(n=2),ileus(n=3),hysterectomy(n=3),ruptured ovarian cyst(n=2),caecal volvulus(n=1),while 9 patients had diagnosis of appendiceal tumor before the surgery.Seventeen patients had tumor grade(G)G1,12 G2 and 6 G3.The right hemicolectomy was performed in 13,while the rest of the patients had appendectomy only.SRS was done early(2 h)and late(24 h)after i.v.application of 740 MBq technetium-99 m ethylenediamine-N,N’-diacetic acid Hydrazinonicotinyl-Tyr3-Octreotide(technetium-99 m-Tektrotyd,Polatom,Poland).SRS was performed for restaging in all the patients after surgery.RESULTS There were 12 true positive(TP),19 true negative,3 false positive and 1 false negative SRS result.Sensitivity of the method was 92.31%,specificity was 86.36%,positive predictive value was 80.00%,negative predictive value was 95.00%and accuracy 88.57%.Receiver operating characteristics analysis showed that SRS scintigraphy is a good test for detection TP cases[area under the curve of 0.850,95%confidence interval(CI):0.710-0.990,P<001].Single photon emission computed tomography contributed diagnosis in 7 TP findings.In 10 patients Krenning score was 4 and in 2 was 3.In 8 patients SRS significantly changed the management of the patients(in two surgery was repeated,in 4 somatostatin analogues and in two peptide receptor radionuclide therapy).Median progression-free survival in SRS positive patients was 52 months(95%CI:39.7-117.3 mo)while in SRS negative patients it was 60 months(95%CI:42.8-77.1 mo),without statistically significant difference between the two groups(P=0.434).CONCLUSION In conclusion,our results confirmed the value of SRS in the follow-up of the patients with ANET after surgery,if recurrences or metastases are suspected. 展开更多
关键词 Somatostatin receptor scintigraphy Carcinoid Appendix Follow up Nuclear medicine Radionuclide
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