Some time ago, a middle-aged woman was diagnosed as "acute appendicitis" in a local hospital because of pain in her right lower abdomen. She was treated with antibiotics, but she didn't get better. Later, she was transferred to Ganzhou Cancer Hospital for medical treatment. After further examination, she was diagnosed with ileocecal colon cancer and was surgically removed. His family went to the doctor and asked: This is because of the special anatomical structure of the appendix. Ileocecum is the junction of the end of ileum and the beginning of colon, where the appendix opens. The appendix is a atrophic intestine left over from ancestors' evolution, generally 4- 10cm long and 0.4-0.8cm straight. One end is blind and the other end leads to the cecum. Appendicitis is a common and frequently-occurring disease in surgery, accounting for about 30% of acute abdomen, with the highest incidence among acute abdomen. Colon cancer has the highest incidence in the whole digestive tract, and ileocecal colon cancer has the highest incidence in the whole colon. Because of the special anatomical structure of appendix, the characteristics of abdominal pain in appendicitis are very similar to those in colon cancer, which is difficult to distinguish clinically and easy to be misdiagnosed. Foreign literature reported that the early clinical manifestation of colon cancer was acute appendicitis, accounting for 1 1% ~ 15%. The misdiagnosis rate of colon cancer misdiagnosed as acute appendicitis in China is about 30%, and ileocecal tumors account for about 3 1% of colon tumors. Misdiagnosis of ileocecal tumor as acute appendicitis will inevitably delay early surgical treatment, and at the same time, without preoperative intestinal preparation, it will lead to an increase in surgical complications, which should be paid attention to. The ileocecal tumor has a slow onset and hidden symptoms. According to statistics, the main manifestations of right colon cancer are anemia and abdominal mass, while the symptoms of left colon cancer are intestinal obstruction, constipation, diarrhea and bloody stool. The author thinks that the reasons that are difficult to diagnose are: 1, X-ray examination, colon tumor can be easily diagnosed because of the function of closing ileocecal valve, and the ileocecal tumor is located at the ileocecal valve, and sometimes the tumor growth can not completely reach the ileocecal part when the intestinal cavity narrows, resulting in missed diagnosis. 2. When intestinal obstruction occurs, the intestinal cavity gasifies, and most ileocecal tumors grow in the cavity, which is not easy to find. 3. When intussusception occurs, it can not be clearly diagnosed as ileocecal lesions, especially when there are symptoms of peritonitis, it is easy to be misdiagnosed as appendiceal lesions. In fact, as long as clinicians pay attention to it ideologically, it is still easy to distinguish. Pay attention to the following points: 1, appendicitis has fever, right lower abdomen has tenderness and rebound pain, and ileocecal colon cancer does not; 2, ileocecal colon cancer usually has a mass in the right lower abdomen (painless mass), appendicitis is a painful mass; 3, colon cancer is often accompanied by other accompanying symptoms: such as irregular stool, loose stool, bloody stool, anemia, intestinal obstruction and so on. ; 4, do color Doppler ultrasound, CT, colonoscopy and other examinations can make a clear diagnosis. Especially for patients over 50 years old, they should not only ask about their medical history carefully, but also do routine rectal examination and fecal occult blood test, and do fiberoptic colonoscopy if necessary. For patients suspected of colon cancer before operation and patients over 50 years old, perioperative intestinal preparation should be made before surgical exploration. Surgical incision should be mainly right abdominal exploration incision, which is beneficial to intraoperative exploration. If the symptoms of appendix are not obvious during operation, the whole colon must be explored, and the lesions should be explored during operation and frozen pathological examination should be carried out. Once diagnosed, radical resection should be sought. [Expert introduction] Xie, male, deputy chief physician of surgery, Ganzhou Cancer Hospital. Engaged in clinical general surgery for 28 years, good at general surgery and diagnosis and treatment of anorectal diseases, especially good at radical resection of gastric cancer, colorectal cancer, resection of liver cancer, pancreaticoduodenectomy and interventional surgery of liver cancer. He went to PLA 175 Hospital, Cancer Hospital affiliated to Harbin Medical University and Guangdong Provincial People's Hospital for further study. He has written more than ten papers and won many municipal scientific research achievement awards.