An ileal hyperplastic polyp comorbidity in the case of acute appendicitis

Abstract

Introduction: We aimed to underline the importance of the covert comorbidities like ileal intestinal polyps in pediatric abdominal operations for appendicitis. Case: A 10-year-old girl was referred to us from the emergency ward with the complaints of abdominal pain and vomiting. After detailed examination, we decided to conduct an abdominal exploration in suspicion of potential acute appendicitis. During the laparotomy, an acute simple appendicitis was found and appendectomy was performed. We further explored the abdomen to rule out a possible Meckel diverticulitis, during which an ileal intraluminal mass was palpated about 10 cm proximal to the intestinal ileocecal valve. We performed enterotomy and resected the polypoid mass completely. The histopathological reports were lymphoid hyperplasia for the appendicitis and intestinal hyperplastic polyp for the polypoid mass. Follow up of the patient after 6 months was eventless. Conclusions: Comorbidities like intestinal polyps should be part of the considerations during the abdominal explorations for acute appendicitis. Missing an ileal polyp may lead to a second operation.

Long, Pedunculated, Large Hyperplastic Polyp of the Terminal Ileum Protruding Through the Ileocecal Valve: A Case Report

“…Therefore, we believe that ileal hyperplastic polyps are extremely rare. In addition, Irsi and Karacay [ 9 ] reported a case of an ileal hyperplastic polyp associated with acute appendicitis found accidentally during exploration to rule out Meckel diverticulitis. We incidentally identified the polyp during colonoscopy in the present case, while these other authors found it in a surgical patient [ 3 , 9 ].…”

“…Unfortunately, we did not obtain an abdominal radiograph or a computed tomography scan to confirm this assumption before colonoscopy. In the etiology of intussusception, polyps have an important role, acting as a trigger or leading point [ 9 ].…”