Sonographic diagnosis of intussusception of the appendix vermiformis

Pumberger, W.; Hörmann, Marcus; Pomberger, Gerhard; Hallwirth, Ulrike

doi:10.1002/1097-0096(200011/12)28:9<492::aid-jcu8>3.0.co;2-l

Cited by 21 publications

(6 citation statements)

References 20 publications

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“…4 The most significant concern with appendiceal intussusception in the setting of endometriosis is the risk of intestinal intussusception. 5 Although rarely reported, treatment of the condition involves either appendectomy or, in our case, laparoscopic partial cecectomy with appendectomy. This removes the risk of leaving an appendiceal stump and also provides a margin of resection for any lesion within the appendix.…”

Section: Discussionmentioning

confidence: 99%

Appendiceal intussusception from endometriosis: endoscopic and laparoscopic approach

Birriel

Smith

Eyvazzadeh

2017

annals

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Appendiceal intussusception is an rare diagnosis that may be found on imaging or at the time of surgery, as seen in this case of a 33-year-old female presenting with gastrointestinal symptoms. Images are presented with differential diagnosis as well as treatment options. Case reportA 33-year-old white female presented with a several months' history of left lower-quadrant pain most notable after menstrual cycles. This was associated with episodes of intermittent loose stools alternating with constipation. Past medical history was significant for hypertension, anxiety and asthma. Previous surgical history includes a tubal ligation approximately 5 years earlier. On physical examination, her general condition was good and her abdomen was soft, although some tenderness was exhibited in the right lower quadrant. Laboratory tests and a urinalysis were grossly normal with a white cell count of of 9,990/mm 3 .The patient underwent a colonoscopy as part of the workup for her abdominal pain, at which time a lesion was discovered in the lumen of the appendix (Fig 1). The lesion was suspicious for a polyp or mucocele, which was benign on superficial cold biopsy. A follow-up abdominal computed tomography (CT) scan showed dilated, thickened appendix impinging on the cecum (Fig 2). After discussion with the patient regarding the possibility of mucocele, among other diagnoses, she agreed to proceed with a laparoscopic resection. A shortened, thickened appendix and cecum were dissected free from surrounding structures and lateral attachments to the abdominal wall were freed. A laparoscopic partial cecectomy with appendectomy was performed. The specimen consisted of an appendix measuring approximately 5cm in length by 1.7cm in diameter. Final pathology was read as benign appendix with intussusception in the setting of intramural endometriosis. This was negative for dysplasia and malignancy. The patient did well postoperatively and was discharged on hospital day two, tolerating a regular diet. DiscussionAppendiceal intussusception is an uncommon diagnosis, with an estimated incidence reported by Collins as 0.01%. 1 Clinical presentation of appendiceal intussusception can vary from crampy lower abdominal pain to acute appendicitis. 2 In this case, the patient had symptoms suggestive of a

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Section: Discussionmentioning

confidence: 99%

Appendiceal intussusception from endometriosis: endoscopic and laparoscopic approach

Birriel

Smith

Eyvazzadeh

2017

annals

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“…'Coiled spring' sign of cecum or filling defect of appendix on double-contrast barium enema could be helpful for the diagnosis 11. On abdominal ultrasonography, cecum might appearing as concentric loop pattern or the appendix invaginated into the cecum 12. Cecum appearing as a bulls-eye shape, sausage shape, or kidney shape are the characteristic findings of appendiceal intussusception on abdomen-pelvis computed tomography 13.…”

Section: Discussionmentioning

confidence: 99%

Adult Intussusception Caused by an Appendiceal Mucocele and Reduced by Colonoscopy

et al. 2011

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Appendiceal intussusception is a very rare disease that is found in only 0.01% of patients who have undergone an appendectomy. Clinical symptoms vary but include acute appendicitis symptoms such as right lower quadrant abdominal pain or repetitive right lower quadrant crampy pain. Some patients are asymptomatic. Operative treatment is necessary to reduce an appendiceal intussusception in adults, but there is a debate about how to perform the reduction. Successful colonoscopic reductions have been recently reported for some cases. We report a case of appendiceal intussusception that was diagnosed, reduced by colonoscopy, and histologically confirmed as a mucinous cystadenoma after the operation.

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“…The condition assumes a greater importance in the differential diagnosis of right lower quadrant abnormalities, particularly if the symptoms are subacute or recurring (11). Casteels et al (12) described five possible clinical features: 1) acute appendicitis, 2) intussusception, 3) recurrent right iliac fossa pain, 4) intermittent painless rectal bleeding, and 5) asymptomatic findings at laparotomy, barium enema, or colonoscopy.…”

Section: Discussionmentioning

confidence: 99%

“…Sonogram has a proven sensitivity for the diagnosis of intussusception, and the typical sonographic appearances are well documented (6, 11). It enables a physician to identify a lead point within a complex target sign, but there are few publications about the sonographic pattern of intussusception of the appendix (6, 18).…”

Section: Discussionmentioning

confidence: 99%

Colonoscopic Diagnosis of Appendiceal Intussusception : A Case Report

et al. 2005

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Intussusception of the appendix is an uncommon condition and the diagnosis is rarely made preoperatively. Intussusception of the appendix may mimic a neoplastic lesion. Colonoscopy is a valuable tool for diagnosis of the appendiceal intussusception. A 17-yr-old female admitted with repeated abdominal pain, nausea, vomiting and febrile sensation. We diagnosed as appendiceal intussusception by colonoscopy, which showed a polypoid tumor (about 1.5 cm) in the cecum. This sessile polypoid mass looks like foreskin or glans. We present colonoscopic finding of appendiceal intussusception and review the literature.

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Sonographic diagnosis of intussusception of the appendix vermiformis

Cited by 21 publications

References 20 publications

Appendiceal intussusception from endometriosis: endoscopic and laparoscopic approach

Appendiceal intussusception from endometriosis: endoscopic and laparoscopic approach

Adult Intussusception Caused by an Appendiceal Mucocele and Reduced by Colonoscopy

Colonoscopic Diagnosis of Appendiceal Intussusception : A Case Report

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