The “Inside-out” Appendix

Hill, B. Jay; Schmidt, Kenneth D.; Economou, Steven G.

doi:10.1148/95.3.613

Cited by 16 publications

(3 citation statements)

References 15 publications

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“…Appendiceal intussusception, when complete, may produce a linear or finger-like intraluminal filling defect with nonfilling of the appendix, the pathognomic of appendiceal intussusception, as in our case (9). A completely inverted or inside-out appendix is, howevere, extremely unusual (10). In instances of partial appendiceal intussusception without visualization of appendiceal lumen, differentiation from the cecal mass is also difficult.…”

Section: Discussionmentioning

confidence: 99%

Complete Invagination of Vermiform Appendix with Adenocarcinoma

Seo

Choi

Kim

et al. 2000

J Korean Radiol Soc

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Primary adenocarcinoma of the appendix is a rare neoplasm (1 8) and intussusception of the appendix is also rare (1). The most common presentation of appendiceal adenocarcinoma is that of acute appendicitis (2). It has seldom been diagnosed preoperatively, however, and is frequently an incidental finding at the time of surgery for unrelated conditions (3). We report a case of adenocarcinoma in a 39-year-old man whose initial complaint was right lower abdominal pain, and which involved intussusception of the appendix with the leading point. Case ReportA 39-year-old man was admitted to our hospital complaining of right lower abdominal pain, first noted one month earlier. He had a five-month history of epigastric pain and during that time his body weight had decreased by 8 kg. Physical examination revealed equivocal tenderness in the right lower quadrant without palpable mass. The white blood cell count was within normal range and the hemoglobin level was 9.5g/dl, and other laboratory findings were non-specific. Initial differential diagnoses were appendicitis, diverticulitis, or malignancy originating in the bowel.Barium enema showed a fungating filling defect in the medial wall of the cecum and this was thought to be the result of extrinsic compression by a periappendiceal abscess or a submucosal mass such as lymphoma (Fig.1A).Retrospective review of the findings of barium enema revealed a movable finger-like filling defect at the top of the cecal mass (Figs. 1A, B). Abdominal CT demonstrat-Appendiceal intussusception is a very rare pathological condition, an incidence, as revealed by appendectomy specimens, of only 0.01 percent. There are various types among which complete invagination of the appendix is very rare. We encountered a case of intussusception of the appendix with complete invagination induced by appendiceal adenocarcinoma. A preoperative diagnosis of appendiceal adenocarcinoma and intussusception was not possible, but a final pathological report confirmed these conditions and retrospective analysis of a barium enema showed a finger-like filling defect of the cecum, a relatively specific finding in such cases. We describe a case involving a 39-year old man who one month earlier had noted the onset of pain in the right lower abdomen.

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Section: Discussionmentioning

confidence: 99%

Complete Invagination of Vermiform Appendix with Adenocarcinoma

Seo

Choi

Kim

et al. 2000

J Korean Radiol Soc

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“…In our patient the position of the cecal filling defect in relation to the ileocecal valve was not noted at fluoroscopy. The etiology of appendiceal intussusception may be partly due to anatomic factors such as a mobile mesoappendix or a wide proximal appendicular lumen (3,5). Intrinsic abnormalities of the appendix noted in thi s condition include polyps, mucoceles, parasites.…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis of appendiceal intussusception is difficult to make, particularly in those patients with intermittent symptoms. Moreover, roentgenographic examination has rarely established the diagnosis (4,5). We present a child with recurrent abdominal pain in whom the diagnosis of intussusception of the appendix was made colonoscopically after a filling defect of the cecum was found on barium enema examination.…”

mentioning

confidence: 95%

Cecal Polyp and Appendiceal Intussusception in a Child with Recurrent Abdominal Pain

Bailey,

Courington,

Andres

et al. 1987

J. pediatr. gastroenterol. nutr.

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SummaryA 7‐year‐old boy developed recurrent abdominal pain. He was eventually discovered to have an inverted appendix via colonoscopy. At surgery, a polyploid intracecal mass was palpated at the base of the partially invaginated appendix. Resection of the cecal mass (histologically, a juvenile polyp) and appendix was easily accomplished. The types of clinical presentation and treatment of children with appendiceal intussusception are discussed.

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Endometriosis of the appendix

Langman

Rowland

Vernon‐Roberts

1981

Journal of British Surgery

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The clinical and pathological features of 6 cases of appendiceal endometriosis are reported. The appendix alone was involved in 3. Thefindings have been compared with previously reported cases. One of the largest deposits caused intussusception but otherwise the microscopic size of deposits did not correlate with symptomatology. The diagnosis may be suspected when the abdominalpain does not shvt from theperi-umbilical region to the right iliac fossa in the manner of classic appendicitis and when the symptoms begin during or are exacerbated by menstruation.

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The “Inside-out” Appendix

Cited by 16 publications

References 15 publications

Complete Invagination of Vermiform Appendix with Adenocarcinoma

Complete Invagination of Vermiform Appendix with Adenocarcinoma

Cecal Polyp and Appendiceal Intussusception in a Child with Recurrent Abdominal Pain

Endometriosis of the appendix

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