(Disclaimer: This article is for scientific use only, and the information in the following content has been processed to protect patient privacy)
Abstract: The initial symptoms of appendiceal adenocarcinoma are very similar to those of appendicitis, both presenting as pain in the right lower abdomen, which can worsen paroxysmally and often confuse the physician’s diagnosis. As in this case, the patient, a 68-year-old male, reported sudden onset of right lower abdominal pain at the time of consultation, and examination could reveal pressure and rebound pain in the right lower abdomen, CT and MRI were performed, and the diagnosis of appendiceal adenocarcinoma was confirmed, and radical right hemicolectomy was performed for treatment.
Basic information】Male, 68 years old
Disease Type】Appendiceal adenocarcinoma
Hospital】The First Affiliated Hospital of Kunming Medical University
Date of consultation】March 2021
Treatment plan】Surgical treatment (radical right hemicolectomy)
Treatment Period】7 days of hospitalization, 2 months of follow-up
Treatment results】Good postoperative recovery, no significant discomfort, no signs of metastasis within 2 months
I. Initial consultation
One morning in March 2021, Mr. Wang came to my clinic accompanied by his son Xiao Wang. Uncle Wang entered the room with a frown, pursed his lips, slightly bent over, with his right hand over his right lower abdomen, at a relatively slow pace, walking in small steps to the table and sitting down. Xiao Wang described: his father went out for a walk in the morning after dinner, and came back not long afterwards with a sudden stomach pain, thinking it was an upset stomach, but going to the The pain was always confined to the lower right side of the stomach. The patient’s communication with the patient revealed that he had often had a bloated stomach and indigestion a long time ago, but it was relieved after a while, and recently it always hurt a little. Immediately afterwards, the examination of Master Wang revealed that there was pressure pain and rebound pain in the right lower abdomen, which was very much like the typical manifestation of appendicitis, but considering the patient’s age, it was recommended that the patient be admitted to the hospital for examination and treatment to rule out whether it was appendiceal adenocarcinoma.
II. Treatment process
After the patient was admitted to the hospital, CT and MRI examinations were performed and the appendiceal wall was seen to be thickened. During the operation, we could see that the patient’s tumor was infiltrating the appendix and spreading to the cecum, and the tumor was locally infiltrating the whole layer of the cecum, but there was no obvious metastasis in other organs, so radical right hemicolectomy was performed.
III. Treatment effect
Through surgical treatment, it was found that the patient’s tumor originated from the appendix, and the tumor was locally infiltrated and spread in the direction of the cecum, but the cyst had not yet ruptured and caused intra-abdominal dissemination, so the tumor was relatively limited. During the 2-month follow-up period after surgery, there was no obvious abdominal distension, abdominal pain and other discomfort, and no tumor metastases were found in CT, MRI and other imaging examinations for the time being.
IV. Precautions
The surgery was successful, the patient’s discomfort disappeared and the condition was controlled. Since appendiceal adenocarcinoma is prone to recurrence, it is recommended that the patient should be reviewed every month after discharge from the hospital. If any abdominal discomfort occurs during the follow-up period, the patient should immediately seek medical examination to avoid delaying the diagnosis and treatment of the disease.
In daily life, attention should be paid to a reasonable diet. After surgery, we should first eat a liquid diet and slowly change to a semi-liquid diet, and then resume a normal diet after conditions allow. If abnormal hiccups and bloating occur after eating or in daily life, one should be alert and seek medical consultation in time to avoid confusing tumor recurrence with indigestion or gastroenteritis.
V. Personal insight
The symptoms of appendiceal adenocarcinoma are very similar to those of appendicitis in the early stage of the disease, which often confuse doctors’ diagnosis, so you should be more alert.
The symptoms of appendiceal adenocarcinoma in acute attack are basically the same as those of appendicitis in acute attack, both of them are pain in the right lower abdomen, which can be aggravated paroxysmally. Therefore, the diagnosis should not be made blindly, and patients should not take it lightly, but should seek medical consultation in time to clarify the diagnosis through imaging and pathological examination. In addition, the recurrence rate of appendiceal adenocarcinoma is relatively high, so radical surgery is recommended, and patients must be followed up regularly after surgery to avoid delaying the disease.