Emergency combined surgery for acute appendicitis and cystic lesions of small pelvis

Makhovsky V.Z.; Aksenenko V.A.; Makhovsky V.V.; Aksenenko D.V.; Kuyumcheva K.K.; Yurin S.V.

doi:https://doi.org/10.17116/hirurgia202202130

Makhovsky V.Z.

Stavropol State Medical University

Aksenenko V.A.

Stavropol State Medical University

Makhovsky V.V.

Polyclinic No. 1 of the Presidential Administration

Aksenenko D.V.

Stavropol State Medical University

Kuyumcheva K.K.

Stavropol State Medical University

Yurin S.V.

Stavropol Regional Clinical Hospital

Emergency combined surgery for acute appendicitis and cystic lesions of small pelvis

Authors:

Makhovsky V.Z., Aksenenko V.A., Makhovsky V.V., Aksenenko D.V., Kuyumcheva K.K., Yurin S.V.

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Journal: Pirogov Russian Journal of Surgery. 2022;(2): 30‑37

DOI: 10.17116/hirurgia202202130

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To cite this article:

Makhovsky VZ, Aksenenko VA, Makhovsky VV, Aksenenko DV, Kuyumcheva KK, Yurin SV. Emergency combined surgery for acute appendicitis and cystic lesions of small pelvis. Pirogov Russian Journal of Surgery. 2022;(2):30‑37. (In Russ.)
https://doi.org/10.17116/hirurgia202202130

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

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OBJECTIVE

To determine the optimal surgical approach for acute appendicitis and concomitant cystic lesions of small pelvis.

MATERIAL AND METHODS

The authors report the results of emergency combined surgery on abdominal and pelvic organs in 995 patients for the period from 1990 to 2020 (30 years). Acute appendicitis was diagnosed in 698 (70.15%) patients. Cystic lesions of small pelvis were observed in 286 (28.7%) patients: follicular cyst — 133 (46.5%), serous cyst — 91 (31.8%), corpus luteum cyst — 42 (46.4%), dermoid cyst — 20 (7.0%), endometrioid cyst — 3 (1.0%) cases. Catarrhal appendicitis was diagnosed in 10 (1.4%) patients, phlegmonous appendicitis — 685 (98.1%), gangrenous appendicitis — 3 (0.4%) patients. All patients with pyoinflammatory diseases of small pelvis had long-term history of gynecological diseases.

RESULTS

Cystic lesions of small pelvis can undergo malignant transformation. Therefore, surgical intervention is determined by surgeon together with gynecologist. Tree large endometrioid cysts (20—25 cm) were malignant. These patients also had adenocarcinoma of sigmoid colon. Malignant neoplasm resulted acute ileus, and the cysts were incorporated into pyogenic membrane. Extensive adhesive process was also observed. These aspects caused significant technical difficulties during resection of these cysts. Postoperative complications occurred in 2.31% of patients.

CONCLUSION

Prolonged therapy and follow-up of patients with urgent concomitant inflammatory diseases of abdominal cavity and small pelvis (chronic nonspecific salpingitis, diffuse pelvic endometriosis, ovarian cysts, etc.) can lead to development and growth of cystic lesions of small pelvis. These cysts may be complicated by subsequent malignant transformation.

Keywords:

acute appendicitis

purulent salpingitis

endometriosis and ovarian cysts

urgent simultaneous combined surgical and gynecological surgeries

Authors:

Makhovsky V.Z.

Stavropol State Medical University

Aksenenko V.A.

Stavropol State Medical University

Makhovsky V.V.

Polyclinic No. 1 of the Presidential Administration

Aksenenko D.V.

Stavropol State Medical University

Kuyumcheva K.K.

Stavropol State Medical University

Yurin S.V.

Stavropol Regional Clinical Hospital

Received:

08.04.2021

Accepted:

15.05.2021

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