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Suture granuloma of the abdominal wall with intra-abdominal extension 12 years after open appendectomy

World Journal of Gastroenterology 2009年第32期15卷 4083-4086页

作者： Goran Augustin dragan korolija Mate Skegro Jasminka Jakic-Razumovic Department of Surgery Division of Abdominal SurgeryUniversity Hospital Center ZagrebKipatieva 1210000 ZagrebCroatia Department of Pathology University Hospital Center Zagreb Kipatieva 1210000 ZagrebCroatia

Most complications after appendectomy occur within ten days; however, we report the unusual case of a suture granuloma 12 years after open appendectomy. The afebrile 75-year-old woman presented with a slightly painful palpable mass in the right lower abdomen. There was no nausea or vomiting and bowel movements were normal. She lost 10 kg during the 3 mo before presentation. The patient had undergone an appendectomy 12 years previously. Physical examination revealed a tender mass, 10 cm in diameter, under the appendectomy scar. The preoperative laboratory findings, tumor markers and plain abdominal radiographs were normal. Multi-slice computed tomography scanning showed an inhomo-genous abdominal mass with minimal vascularization in the right lower abdomen 8.6cm×8cm×9 cm in size which communicated with the abdominal wall. The abdominal wall was thickened, weak and bulging. The abdominal wall mass did not communicate with the cecum or the ascending colon. Complete excision of the abdominal wall mass was performed via median laparotomy. Histopathological examination revealed a granuloma with a central abscess. This case report demonstrates that a preoperative diagnosis of abdominal wall mass after open appendectomy warrants the use of a wide spectrum of diagnostic modalities and consequently different treatment options.

关键词：肉芽肿缝合组织病理学检查腹腔诊断方法实验室检查肿瘤标志物身体检查

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