Cecal Fecalith Mimicking Intussusception

Gohary, Amin; Shepherd, D. F. C.; Freeman, N.V.

doi:10.1055/s-2008-1063146

Cited by 4 publications

(6 citation statements)

References 2 publications

(5 reference statements)

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“…In 1981, we reported a case of severe abdominal pain diagnosed clinically and radiologically as intussusception, but it proved during exploration to be a case of impacted caecal faecalith. 5 This has prompted us to think twice before labelling patients with severe abdominal colic as intussusception before excluding faecal impaction at the caecum and terminal ileum. The pathognomonic clinical presentation in this group of patients is severe abdominal colic with screaming and contorting.…”

Section: Discussionmentioning

confidence: 99%

Severe colic mimicking intussusception: a new phenomenon

El-Gohary¹

2015

BMJ Open Gastroenterol

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ObjectiveTo highlight a new phenomenon that we have encountered in children during the past 5 years. Children in this group have a pathognomonic clinical picture of sudden acute severe abdominal colic during which the child is continuously screaming for 1–2 min. All these patients were initially diagnosed on clinical and ultrasonographic grounds as acute intussusception. Careful interpretation of the radiological findings revealed faecal impaction of the terminal ileum and caecum.DesignThis is a retrospective study looking at children presenting between 2009 and 2014 with acute severe abdominal colic pain. These were 11 patients aged 9 months to 5 years. We reviewed our experience in the management and diagnosis of these patients.ResultAll patients were diagnosed initially as intussusception, which was confirmed by ultrasonography (US). US revealed an appearance mimicking intussusception, 3 cases of which were intermittent. This US appearance proved to be a hard stool filling the terminal ileum. In all patients, abdominal X-ray revealed stool at the right side of the colon filling the caecum. Diagnostic gastrografin enemas that were performed in four patients excluded intussusception and confirmed stool at the caecum and ascending colon. In none of those patients had contrast passed into the terminal ileum. There was dramatic response to fleet and/or gastrografin enemas. Five patients required a second dose of enema and two patients required three doses.ConclusionsWe highlight a new phenomenon of severe abdominal pain caused by faecal impaction of the terminal ileum and caecum. Increased awareness of this condition helps to avoid unnecessary investigations and/or surgical exploration.

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Section: Discussionmentioning

confidence: 99%

Severe colic mimicking intussusception: a new phenomenon

El-Gohary¹

2015

BMJ Open Gastroenterol

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“…Other diseases mimicking intussusception include small bowel abscess, enterolith, Ascaris lumbricoides , cecal fecalith, complicated Rapunzel syndrome, appendicitis in duplex appendix, tuberculosis and eosinophilic gastroenteritis with perforation …”

Section: Discussionmentioning

confidence: 99%

Diseases mimicking intussusception: Diagnostic dilemma

Karakuş

Özokutan

Ceylan

2014

Pediatrics International

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“…The two reported children presented with signs and symptoms of intussusception (2). One adult case (3) and two pediatric cases (2) had pre-operative diagnoses of caecal tumours.…”

Section: Discussionmentioning

confidence: 99%

“…In nine others caecal masses were demonstrated. If operation does not immediately follow a barium enema, delayed films could demonstrate a typical pattern of permeation of barium into the periphery of caecal faecolith, making a specific diagnosis possible (2).…”

Section: Radiologic Findingsmentioning

confidence: 99%

Caecal faecolith: ultrasonic – radiologic diagnosis

Khaleghian

Travis

1993

Australasian Radiology

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The entity of caecal faecoliths is not well known to most radiologists. It presents as a hard tender palpable mass in the right iliac fossa. It usually occurs in older women with chronic constipation. On ultrasound it appears as an intracaecal, highly echogenic, shadowing mass. Plain radiographs may show lamellated calcifications. Barium enema shows a well defined intracaecal mass. Using a combination of ultrasound and plain films or barium enema, a preoperative diagnosis should be possible.

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Cecal Fecalith Mimicking Intussusception

Abstract: The rare finding of a cecal fecalith in an 8-year-old child is described together with a review of similar cases. These indicate not only the difficulty of diagnosis, but the dilemma faced by the surgeon at the operation.

Cited by 4 publications

References 2 publications

Severe colic mimicking intussusception: a new phenomenon

Severe colic mimicking intussusception: a new phenomenon

Diseases mimicking intussusception: Diagnostic dilemma

Caecal faecolith: ultrasonic – radiologic diagnosis

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