Intussusception of the appendix

Abstract

Two cases of intussusception of the appendix are reported--one caused by adenocarcinoma and adenomatous polyp and the other by an endometrioma. Appendiceal intussusception and adenocarcinoma are both uncommon entities and this is the first report of the two occurring concomitantly. Due to variable symptoms, the correct diagnosis of appendiceal intussusception has rarely been made preoperatively. Classification, symptoms, radiographic appearance, and differential diagnosis are discussed, and the authors suggest a new classification for intussusception of the appendix.

Two Unusual Cases of Adult Intussusception

“…Our case is an example of type IV. While intussusception of the normal appendix has been reported, appendiceal lesions such as endometriosis, and carcinoids more commonly result in intussusception [12, 13, 14]. In our case, the pathophysiologic predisposing factor to intussusception was acute appendicitis.…”

Appendicular intussusception into a polyp

“…polyps, mucocele, carcinoid, endometriosis). Appendicular intussusception has been classified into four anatomical variants by Moschocowitz [6] and McSwain [7], and further simplified by Langsam et al [8] into: -Type 1. The tip is inverted into the proximal portion of the appendix.…”

“…There is complete inversion of the appendix, with accompanying ileocaecal intussusception. Types 1 and 2 can also result in complete inversion of the appendix into the caecum; this is called the "inside out appendix" [8].…”

Intussusception of the Appendix Secondary to Mucinous Cystadenoma

“…This classification was simplified by Langsam et al [19]: type 1, the intussusception begins at the end of the appendix, the tip of the appendix is the intussusceptum and its more proximal portion is the intussuscipiens; type 2, the intussusception begins at the base of the appendix, the base is the intussusceptum and the cecum is the intussuscipiens; type 3, the proximal portion of the appendix forms the intussusceptum and is received by the distal portion of the cecum, and type 4, this is the complete inversion of the appendix accompanied with ileocecal intussusception.…”