1
|
Alfaraj AS, Almohamad AA, Alqabbani NS, Alghazwi MH, Alharbi AM, Ahmed AA, Aljumah MK, Aljumaah NY, Kadhem HE, Al Jalooud HH, AlMohsen ZS, Alharbi KM, Al Abbas HE, Al Khalifah FB, Al-Hawaj F. Colonic Angiolipoma: An Extremely Rare Tumor Clinically Masquerading as Acute Appendicitis. Cureus 2021; 13:e20659. [PMID: 35028238 PMCID: PMC8743046 DOI: 10.7759/cureus.20659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2021] [Indexed: 11/05/2022] Open
Abstract
The clinical presentation of right iliac fossa pain, anorexia, and vomiting are the classic clinical features of acute appendicitis. However, a broad spectrum of manifestations may result in a similar clinical picture, including gastrointestinal, genitourinary, and gynecologic pathologies. Imaging studies are crucial to establishing the diagnosis. Here, we report the case of a 58-year-old man who presented to the emergency department with a one-week history of right lower quadrant abdominal pain. The pain was associated with nausea, vomiting, and frequent bowel motions. There was no history of fever or weight loss. The examination of the abdomen showed localized tenderness and guarding in the right iliac fossa. The basic laboratory investigation was within the reference range. The computed tomography scan demonstrated a well-circumscribed intraluminal mass lesion in the ascending colon with no evidence of complete obstruction. The mass was slightly heterogeneous but had fat attenuation. There was no evidence of invasion. There was no stranding of the adjacent fat. The radiological findings were consistent with colonic lipoma. The patient underwent laparoscopic surgery and had a segmental resection of the tumor with primary anastomosis. The appendix was also resected. Histopathological examination showed mature adipose cells along with thin-walled, capillary-sized vessels representing a benign angiolipoma. Further, the resected appendix was completely normal and showed no evidence of acute inflammation. Colonic angiolipoma is an extremely rare tumor. This case demonstrated that a large angiolipoma of the ascending colon may show a presenting clinical picture similar to that of acute appendicitis. Complete resection of the tumor is associated with an excellent outcome.
Collapse
Affiliation(s)
| | - Asma A Almohamad
- College of Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | | | | | | | - Amina A Ahmed
- College of Medicine, Xi'an Jiaotong University, Xi'an, CHN
| | | | | | - Hawra E Kadhem
- College of Medicine, Xi'an Jiaotong University, Xi'an, CHN
| | | | | | - Kawkab M Alharbi
- College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, SAU
| | - Hassan E Al Abbas
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU
| | | | - Faisal Al-Hawaj
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU
| |
Collapse
|
2
|
Kokanalı MK, Cavkaytar S, Bozkurt S, Türker M, Aydın F, Doğanay M. Misdiagnosis of a Right Adnexal Mass: A Peculiar Case of Benign Appendiceal Mucocele. J Gynecol Surg 2016. [DOI: 10.1089/gyn.2014.0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Mahmut Kuntay Kokanalı
- Department of Gynecology, Dr. Zekai Tahir Burak Woman's Health Education and Research Hospital, Ankara, Turkey
| | - Sabri Cavkaytar
- Department of Gynecology, Dr. Zekai Tahir Burak Woman's Health Education and Research Hospital, Ankara, Turkey
| | - Sezen Bozkurt
- Department of Gynecology, Dr. Zekai Tahir Burak Woman's Health Education and Research Hospital, Ankara, Turkey
| | - Mengü Türker
- Department of Pathology, Dr. Zekai Tahir Burak Woman's Health Education and Research Hospital, Ankara, Turkey
| | - Feray Aydın
- Department of General Surgery, Dr. Zekai Tahir Burak Woman's Health Education and Research Hospital, Ankara, Turkey
| | - Melike Doğanay
- Department of Gynecology, Dr. Zekai Tahir Burak Woman's Health Education and Research Hospital, Ankara, Turkey
| |
Collapse
|
3
|
Acute right lower quadrant pain beyond acute appendicitis: MDCT in evaluation of benign and malignant gastrointestinal causes. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2014. [DOI: 10.1016/j.ejrnm.2014.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
4
|
M S, Chetty Y V N, Saheb B. Peculiar case of mucocele of appendiceal tip. J Clin Diagn Res 2013; 7:2017-8. [PMID: 24179929 DOI: 10.7860/jcdr/2013/6573.3391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 07/21/2013] [Indexed: 11/24/2022]
Abstract
Mucocele of Appendix is a gross or clinical descriptive term for dilatation of the appendiceal lumen by mucus.It is a rare pathology with an overall incidence of 0.2 to 0.3% of all appendectomies. Majority of these cases present with mucocele involved whole length of the appendix. On extensive literature search,exact incidence of mucocele confined only to the tip of appendix is not known, though there are very few case reports. Here we report a peculiar case of large mucocele of appendix confined only to the tip, sparing significant length of proximal appendix and causing diagnostic dilemma pre-operatively in a 43 -years -old lady.
Collapse
Affiliation(s)
- Sridhar M
- Assistant Professor, Department of Surgery, M.S. Ramaiah Medical College , Karnataka, India
| | | | | |
Collapse
|
5
|
Debnath J, Kumar R, Gupta R, Mathur A, Gulati SK, Shukla A. Endometriosis with salpingitis simulating acute appendicitis. Med J Armed Forces India 2011; 67:179-81. [PMID: 27365797 DOI: 10.1016/s0377-1237(11)60030-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2010] [Accepted: 09/07/2010] [Indexed: 10/18/2022] Open
Affiliation(s)
| | - Rajesh Kumar
- Senior Advisor, Subharti Medical College, Meerut
| | - Ritu Gupta
- Graded Specialist (Surgery), 167 Military Hospital C/o 56 APO, Meerut
| | - Ankit Mathur
- Graded Specialist (Surgery), 167 Military Hospital C/o 56 APO, Meerut
| | - S K Gulati
- Associate Professor (Obstetrics & Gynaecology), Subharti Medical College, Meerut
| | | |
Collapse
|
6
|
Abstract
Acute appendicitis is a common surgical emergency and the diagnosis can often be made clinically; however, many patients present with atypical findings. For these patients, there are multiple imaging modalities available to aid in the diagnosis of suspected appendicitis in an effort to avoid a negative appendectomy. Computed tomography is the test of choice in most patients in whom the diagnosis is not certain. Ultrasonography is particularly useful in children and pregnant women. Magnetic resonance imaging is recommended when ultrasonography is inconclusive. Appropriate use of these imaging studies avoids delays in treatment, prolonged hospitalization, and unnecessary surgery.
Collapse
Affiliation(s)
- Nancy A Parks
- Department of Surgery, University of Tennessee Health Science Center, 910 Madison Avenue, Suite 220, Memphis, TN 38163, USA
| | | |
Collapse
|
7
|
Solomkin JS, Mazuski JE, Bradley JS, Rodvold KA, Goldstein EJC, Baron EJ, O'Neill PJ, Chow AW, Dellinger EP, Eachempati SR, Gorbach S, Hilfiker M, May AK, Nathens AB, Sawyer RG, Bartlett JG. Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Surg Infect (Larchmt) 2010; 11:79-109. [PMID: 20163262 DOI: 10.1089/sur.2009.9930] [Citation(s) in RCA: 310] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Evidence-based guidelines for managing patients with intra-abdominal infection were prepared by an Expert Panel of the Surgical Infection Society and the Infectious Diseases Society of America. These updated guidelines replace those previously published in 2002 and 2003. The guidelines are intended for treating patients who either have these infections or may be at risk for them. New information, based on publications from the period 2003-2008, is incorporated into this guideline document. The panel has also added recommendations for managing intra-abdominal infection in children, particularly where such management differs from that of adults; for appendicitis in patients of all ages; and for necrotizing enterocolitis in neonates.
Collapse
Affiliation(s)
- Joseph S Solomkin
- Department of Surgery, the University of Cincinnati College of Medicine, 231 Albert B. Sabin Way, Cincinnati, OH 45267-0558, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
van Randen A, Laméris W, van Es HW, ten Hove W, Bouma WH, van Leeuwen MS, van Keulen EM, van der Hulst VPM, Henneman OD, Bossuyt PM, Boermeester MA, Stoker J. Profiles of US and CT imaging features with a high probability of appendicitis. Eur Radiol 2010; 20:1657-66. [PMID: 20119730 PMCID: PMC2882051 DOI: 10.1007/s00330-009-1706-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2009] [Revised: 11/24/2009] [Accepted: 11/25/2009] [Indexed: 01/07/2023]
Abstract
Objectives To identify and evaluate profiles of US and CT features associated with acute appendicitis. Methods Consecutive patients presenting with acute abdominal pain at the emergency department were invited to participate in this study. All patients underwent US and CT. Imaging features known to be associated with appendicitis, and an imaging diagnosis were prospectively recorded by two independent radiologists. A final diagnosis was assigned after 6 months. Associations between appendiceal imaging features and a final diagnosis of appendicitis were evaluated with logistic regression analysis. Results Appendicitis was assigned to 284 of 942 evaluated patients (30%). All evaluated features were associated with appendicitis. Imaging profiles were created after multivariable logistic regression analysis. Of 147 patients with a thickened appendix, local transducer tenderness and peri-appendiceal fat infiltration on US, 139 (95%) had appendicitis. On CT, 119 patients in whom the appendix was completely visualised, thickened, with peri-appendiceal fat infiltration and appendiceal enhancement, 114 had a final diagnosis of appendicitis (96%). When at least two of these essential features were present on US or CT, sensitivity was 92% (95% CI 89–96%) and 96% (95% CI 93–98%), respectively. Conclusion Most patients with appendicitis can be categorised within a few imaging profiles on US and CT. When two of the essential features are present the diagnosis of appendicitis can be made accurately.
Collapse
Affiliation(s)
- A van Randen
- Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Solomkin JS, Mazuski JE, Bradley JS, Rodvold KA, Goldstein EJ, Baron EJ, O'Neill PJ, Chow AW, Dellinger EP, Eachempati SR, Gorbach S, Hilfiker M, May AK, Nathens AB, Sawyer RG, Bartlett JG. Diagnosis and Management of Complicated Intra-abdominal Infection in Adults and Children: Guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Clin Infect Dis 2010; 50:133-64. [PMID: 20034345 DOI: 10.1086/649554] [Citation(s) in RCA: 974] [Impact Index Per Article: 69.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Abstract
Evidence-based guidelines for managing patients with intra-abdominal infection were prepared by an Expert Panel of the Surgical Infection Society and the Infectious Diseases Society of America. These updated guidelines replace those previously published in 2002 and 2003. The guidelines are intended for treating patients who either have these infections or may be at risk for them. New information, based on publications from the period 2003–2008, is incorporated into this guideline document. The panel has also added recommendations for managing intra-abdominal infection in children, particularly where such management differs from that of adults; for appendicitis in patients of all ages; and for necrotizing enterocolitis in neonates.
Collapse
Affiliation(s)
- Joseph S. Solomkin
- Department of Surgery, the University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - John E. Mazuski
- Department of Surgery, Washington University School of Medicine, Saint Louis, Missouri
| | | | - Keith A Rodvold
- Department of Pharmacy Practice, Chicago
- Department of Medicine, University of Illinois at Chicago, Chicago
| | - Ellie J.C. Goldstein
- R. M. Alden Research Laboratory, David Geffen School of Medicine at UCLA, Los Angeles
| | - Ellen J. Baron
- Department of Pathology, Stanford University School of Medicine, Palo Alto, California
| | - Patrick J. O'Neill
- Department of Surgery, The Trauma Center at Maricopa Medical Center, Phoenix, Arizona
| | - Anthony W. Chow
- Department of Medicine, University of British Columbia, Vancouver, British Columbia
| | | | | | - Sherwood Gorbach
- Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts
| | - Mary Hilfiker
- Department of Surgery, Rady Children's Hospital of San Diego, San Diego
| | - Addison K. May
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | | | - John G. Bartlett
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| |
Collapse
|
10
|
Optimized protocol for diagnosis of acute ileitis. Clin Gastroenterol Hepatol 2009; 7:1183-8. [PMID: 19631291 DOI: 10.1016/j.cgh.2009.07.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2009] [Revised: 07/06/2009] [Accepted: 07/11/2009] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Suspected acute ileitis (AI) is a poorly defined clinical condition with multiple causes; its diagnostic protocol has not been standardized properly. We performed a prospective evaluation of the incidence and causes of AI to create a standard protocol for diagnosis. METHODS The definition of AI included abdominal pain, diarrhea, fever, and at least 1 confirmatory imaging method (abdominal computed tomography scan or ultrasound) showing pathologic changes in the terminal ileum that indicated ileal inflammation. We studied all patients with a presumptive diagnosis of AI seen in the Emergency Room at the Ramón y Cajal Hospital in Madrid, from March 2005 to May 2007, according to a pre-established protocol. Sixty-six patients with primary AI were followed up for at least 6 months. RESULTS An infectious cause was found in 33.3% of cases; the most frequently detected microorganism was Yersinia spp. A gynecologic condition was identified in 9.1% of cases initially diagnosed as AI, representing 13.95% of the cases among female patients. Crohn's disease was identified in 12.1% of patients. The diagnostic protocol led to negative results in 33.4% of the patients; 6.1% of patients did not complete the study. The initial diagnosis did not change among any of the patients during the follow-up period. CONCLUSIONS This protocol led to a definitive diagnosis of AI in more than 60% of potential cases. The most common cause was acute infection. About 10% of cases were of gynecologic origin and about 12% of patients presented with Crohn's disease.
Collapse
|
11
|
Appendicular mass mimicking as suprapubic mass: a case report. CASES JOURNAL 2009; 2:7815. [PMID: 19918486 PMCID: PMC2769376 DOI: 10.4076/1757-1626-2-7815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2009] [Accepted: 07/18/2009] [Indexed: 12/03/2022]
Abstract
Introduction We are writing about an unusual case of appendicular mass presenting as painful suprapubic mass in a female patient admitted to gynaecology ward. There has been no recent discussion in the gynaecologic literature of appendicular mass in a young woman presenting as gynaecologic case like this one. Case presentation A 39-year-old lady was admitted to gynaecological ward with the complaint of painful suprapubic mass with no bowel symptoms. Subsequent investigations raised the suspicion of tubo-ovarian abscess. The laparotomy revealed burst appendicular mass with involvement of ovaries and part of inflamed bowels. Hence right salpingo-oophorectomy, appendicectomy and right hemicolectomy were performed. The patient made un-remarkable recovery. Conclusion Our case presentation highlights the fact that pelvic mass presentation can be misleading, not always of gynaecologic origin therefore clinicians should think broadly as multidisciplinary input may be inevitable.
Collapse
|
12
|
Kitagawa M, Kotani T, Miyamoto Y, Kuriu Y, Tsurudome H, Nishi H, Yabe M, Otsuji E. Noncontrast and contrast enhanced computed tomography for diagnosing acute appendicitis: A retrospective study for the usefulness. J Radiol Case Rep 2009; 3:26-33. [PMID: 22470667 DOI: 10.3941/jrcr.v3i6.101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Abdominal computed tomography (CT) provides great benefits for the differential diagnosis in patients complaining of acute abdominal pain. However, the use of diagnostic X-rays is associated with the cumulative risk of cancer development. In order to determine the relative usefulness of noncontrast and enhanced CT with intravenous contrast material for diagnosing acute appendicitis, the retrospective analysis was performed using 247 patients (46 children and 201 adults) with clinically suspected appendicitis, who were admitted to our hospital from 2002 to 2006 and underwent noncontrast or combined noncontrast and enhanced CT examination. Of 185 patients who were diagnosed to have acute appendicitis with appendiceal thickening (167 cases) or normal-sized appendix (18 cases), 73 cases underwent noncontrast CT alone and these 73 cases could be retrospectively diagnosed to have appendicitis on noncontrast CT. On the other hand, 112 cases of these 185 patients underwent noncontrast CT followed by enhanced CT, and vermiform appendix was detected in 86 cases of them (86/112, 76.8%) on noncontrast CT. These 86 cases could be retrospectively diagnosed to have acute appendicitis on noncontrast CT, whereas enhanced CT was required to detect vermiform appendix and to obtain the final diagnosis of appendicitis in the remaining 26 cases (26/112, 23.2%). Enhanced CT was superior to noncontrast CT in diagnosing appendicitis in all age and any gender groups. We suggest that enhanced, but not noncontrast, CT should be primarily performed for diagnosing acute appendicitis in all patients to minimize the radiation exposure unless intravenous administration of contrast material is contraindicated.
Collapse
Affiliation(s)
- Maki Kitagawa
- Department of Surgery, Saiseikai Kyoto Hospital, Kyoto, Japan
| | | | | | | | | | | | | | | |
Collapse
|
13
|
Maxfield CM, Bayindir P. Fat-containing lesions revealed by CT in children with right lower quadrant pain. Pediatr Radiol 2009; 39:371-6. [PMID: 19142630 DOI: 10.1007/s00247-008-1110-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2008] [Revised: 11/18/2008] [Accepted: 12/05/2008] [Indexed: 10/21/2022]
Abstract
Suspected appendicitis is the most common indication for emergent abdominal surgery in children. The clinical diagnosis of appendicitis can be challenging, and CT is playing an increasing role in the evaluation of right lower quadrant pain. Occasionally, alternative diagnoses to appendicitis can be suggested on CT. The appreciation of a fat-containing lesion in the right lower quadrant will often allow a specific diagnosis. Importantly, many of these lesions are self-limited and treated nonoperatively. The purpose of this pictorial essay is to illustrate the spectrum of fat-containing lesions that can present as alternative diagnoses to appendicitis on CT scans performed for the evaluation of right lower quadrant pain in children.
Collapse
Affiliation(s)
- Charles M Maxfield
- Department of Radiology, Duke University Medical Center, Durham, NC, USA
| | | |
Collapse
|
14
|
Temesi R, Bezsilla J, Botos A, Sikorszki L, Berecz J, Pap T, Ludvig Z, Bende S. [Laparoscopic treatment of appendiceal mucocele]. Magy Seb 2008; 61:24-8. [PMID: 18296281 DOI: 10.1556/maseb.61.2008.1.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Mucocele is a mucin-filled cavity, which can be multi-loculated as well. Mucocele is relatively rarely found in the appendix. The disease does not cause any symptoms in most cases, and it is usually an accidental finding. A thorough investigation should be carried out to exclude malignancy. Depending on the operative findings and the full histological report, the spectrum of surgery extends from appendectomy to right hemicolectomy. In this paper, we discuss the presentation, diagnostical options, and the possible surgical treatment--based on our experience with five cases. In three cases a non-tender mass was palpable in the right lower quadrant of the abdomen, while another patient presented with right lower quadrant abdominal pain and one with abdominal pain and diarrhoea. Abdominal and pelvic ultrasound and CT scans raised the possibility of mucocele, however colonoscopy was negative. After laparoscopic exploration, laparoscopy assisted partial caecum resection was carried out in two cases, in further two cases laparoscopic appendectomy, and in one case laparoscopic partial caecum resection was done. The hystological examinations showed appendiceal mucocele with no malignancy demonstrated. All patients recovered without complications, they were discharged from hospital on postoperative day five. The patients have been disease free after a 6-30 month follow-up period. We concluded that laparoscopy is a recommended method for the surgery of appendiceal mucocele.
Collapse
Affiliation(s)
- Rita Temesi
- Borsod-Abaúj-Zemplén Megyei Kórház és Egyetemi Oktató Kórház, Altalános Sebészeti Osztály, 3532 Miskolc, Szent Imre tér 9/b.
| | | | | | | | | | | | | | | |
Collapse
|
15
|
Acute Abdominal Pain: Diagnostic Strategies. Emerg Radiol 2007. [DOI: 10.1007/978-3-540-68908-9_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
16
|
Hoeffel C, Crema MD, Belkacem A, Azizi L, Lewin M, Arrivé L, Tubiana JM. Multi-detector row CT: spectrum of diseases involving the ileocecal area. Radiographics 2006; 26:1373-90. [PMID: 16973770 DOI: 10.1148/rg.265045191] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The ileocecal area is a relatively short segment of the gastrointestinal tract but may be affected by pathologic conditions that are either common throughout the gastrointestinal system or exclusive to this area. These conditions include benign and malignant tumors, inflammatory processes (appendicitis, diverticulitis, epiploic appendagitis, Crohn disease), infectious diseases, and miscellaneous conditions (cecal ischemia, typhlitis, cecal volvulus, duplication cyst). The various components of the ileocecal area (cecum, appendix, ileocecal valve, terminal ileum) are close to one another, so that these conditions may involve more than one anatomic structure, thereby creating a diagnostic dilemma. The evaluation of various parameters (eg, stratified enhancement pattern of the thickened bowel wall, degree of thickening, extent and location of bowel wall involvement, degree of fat stranding relative to the degree of wall thickening) and associated findings (lymph nodes, mesenteric stranding, abscess and sinus tracts, fatty proliferation, solid organ abnormalities) will help narrow the differential diagnosis. Multi-detector row computed tomography (CT) is considered the best imaging examination for the evaluation of the ileocecal area. Consequently, the radiologist should be familiar with the multi-detector row CT features of the spectrum of diseases affecting this area to help ensure correct diagnosis and appropriate treatment.
Collapse
Affiliation(s)
- Christine Hoeffel
- Department of Radiology, Hôpital Saint-Antoine, 184 rue du Faubourg Saint-Antoine, 75571 Paris Cedex 12, France.
| | | | | | | | | | | | | |
Collapse
|
17
|
Imaging Evaluation of Right Lower Quadrant Pain: Self-Assessment Module. AJR Am J Roentgenol 2006. [DOI: 10.2214/ajr.06.0797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|