背景:阑尾异物是一种罕见的,阑尾炎的病因描述不足。我们进行这项研究以确定异物阑尾炎的各种原因和后果。
方法:对七个机构的病理档案进行回顾性回顾,我们确定了56个含有异物的阑尾标本(定义为摄入,不可消化的材料)。我们记录了异物的类型,患者年龄和性别,和其他发现,如可用。
结果:患者平均年龄为7.7岁(范围:1天至18岁)。异物包括毛发,植物材料,磁铁,其他金属材料,BB颗粒,未另行规定的外来材料,和其他杂物。在48例有临床资料的病例中,31例患者出现腹痛,22例术前诊断为阑尾炎/阑尾炎症。7例阑尾穿孔(13%)。在34/47例有粗略描述的病例中,异物被大致识别。27例病例在显微镜下具有可识别的异物;10例与巨细胞反应有关。
结论:头发和植物材料是阑尾中最常见的异物;它们通常会引起粘膜损伤和巨细胞反应。金属物体不太常见。尽管儿童的阑尾异物很少见,有时无症状,它们可能导致穿孔。
BACKGROUND: Appendicular foreign bodies are a rare, under-described cause of appendicitis. We performed this study to determine the varied causes and consequences of foreign-body appendicitis.
METHODS: On retrospective review of the pathology archives of seven institutions, we identified 56 appendix specimens containing a foreign body (defined as ingested, non-digestible material). We recorded the type of foreign body, patient age and sex, and other findings, as available.
RESULTS: Mean patient age was 7.7 years (range: 1 day-18 years). The foreign bodies included hair, plant material, magnets, other metallic material, BB pellets, foreign material not otherwise specified, and other miscellaneous objects. Of 48 cases with available clinical information, 31 patients presented with abdominal pain, and 22 were preoperatively diagnosed as having appendicitis/appendicular inflammation. Seven patients had appendiceal perforation (13%). The foreign body was grossly identified in 34/47 cases with available gross descriptions. Twenty-seven cases had an identifiable foreign body microscopically; 10 were associated with giant cell reaction.
CONCLUSIONS: Hair and plant materials were the most common foreign objects found in the appendix; they often cause mucosal damage and giant cell reaction. Metallic objects were less common. Although appendicular foreign bodies in children are rare and sometimes asymptomatic, they may lead to perforation.