Two Cases of Appendiceal Intussusception: A Rare Diagnostic Pitfall in Colonoscopy

Seddik, H.; Rabhi, M.

doi:10.1155/2011/198984

Cited by 13 publications

(21 citation statements)

References 6 publications

(6 reference statements)

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“…The most frequent histopathological finding which comes along with appendiceal intussusception is an inflammation, while the second most common diagnosis is endometrial implants in the intussuscepted appendix [4]. It is important to mention that intussusception of the appendix may occur without any underlying abnormality [9,10]. In our case, histopathological examination of surgical material has shown chronic active ulcerative inflammation, hyperplastic/regenerative mucous membrane lesions, and low-grade intraepithelial neoplasia.…”

Section: Discussionmentioning

confidence: 80%

Intussusception of the Appendix and Ileum Endometriosis: A Case Report

et al. 2016

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Background: Intussusception of the appendix is a very rare condition. It may clinically mimic acute or chronic abdominal diseases or can be asymptomatic. Case Report: This paper describes our experience with intussusception of the appendix. We report a case of a female with appendiceal intussusception and ileum endometriosis. Conclusion: It is important to know about such a rare condition in order to avoid mistaking it with other abdominal diseases. However, diagnosis is rarely made preoperatively.

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Section: Discussionmentioning

confidence: 80%

Intussusception of the Appendix and Ileum Endometriosis: A Case Report

et al. 2016

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“…3 Regarding our case, the involvement of the cecal appendix as a cause of intussusception was first described in 1858. 19,20 It's an uncommon condition with an incidence rate of 0.01% in an autopsy series. 21 Several etiologies have been noted: ana- tomic variations of the appendix, or pathologic conditions such as tumors [polyps, mucinous cystoadenoma or cystoadenocarcinoma, carcinoid tumor, and gastrointestinal stromal tumors (GIST)], endometriosis, parasitism, cystic fibrosis, abnormal appendicular peristaltism, fecaliths, and foreign bodies.…”

Section: 10mentioning

confidence: 99%

“…21 Several etiologies have been noted: ana- tomic variations of the appendix, or pathologic conditions such as tumors [polyps, mucinous cystoadenoma or cystoadenocarcinoma, carcinoid tumor, and gastrointestinal stromal tumors (GIST)], endometriosis, parasitism, cystic fibrosis, abnormal appendicular peristaltism, fecaliths, and foreign bodies. 20,[22][23][24][25] Intussusception of the resultant appendiceal stump after inversion-ligation appendectomy has even been described. 22 Nevertheless, appendiceal intussusception may develop without any underlying abnormality.…”

Section: 10mentioning

confidence: 99%

“…In all these cases in which the cecal appendix is involved as the lead point of intussusception, the clinical presentation may mimic an acute appendicitis. 20,22,23 There are differences neither in symptomatology nor in clinical features between intussusception caused by malignant or benign lesions. In most of cases, the clinical findings are unspecific but, when there is high suspicion of appendiceal mucinous tumor, prompt surgical intervention is advocated not only to solve the intestinal occlusion itself but also to prevent development of pseudomyxoma peritonei.…”

Section: 10mentioning

confidence: 99%

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Adult Intussusception of Appendicular Mucinous Cystoadenoma

Feliú

Rueda

Escuder

et al. 2013

International Surgery

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Intussusception is a rare cause of adult intestinal obstruction. Clinical manifestations are not specific, which makes a preoperative diagnosis difficult to establish and often causes delay. We report a case of acute intestinal obstruction due to ileocolic intussusception. An emergency laparoscopy was performed revealing an obstructive mass at the ileocecal region resulting from an appendicular tumor. A right hemicolectomy was conducted. The pathologic examination of the resected sample concluded the mass comprised an appendicular mucinous cystoadenoma. We discuss the clinical features, preoperative diagnosis, and surgical strategies of adult intussusception, as well as the uncommon finding of an appendicular mucinous tumor as its causative lesion, with a review of the available literature.Key words: Adult intussusception -Appendiceal mucocele -Intestinal obstruction I ntussusception is the invagination of a proximal segment of bowel (intussusceptum) into the lumen of the adjacent distal segment (intussuscipiens). Pediatric patients account for 95% of all cases of intussusception, in whom it is usually idiopathic or the result of a viral process; whereas adult patients account for only 1% to 5%, and an organic lesion is found in up to 90% of the adult cases. 1,2Acute bowel obstruction due to intussusception is rare in adults and accounts for 0.003% to 0.02% of hospital admissions and for only 1% of all intestinal obstructions.1 Preoperative diagnosis is a real challenge for physicians because of its unspecific and extremely variable presentation and requires a high index of suspicion. Therefore, the initial diagnosis is usually missed or delayed and may only be established during surgery. [3][4][5] We present a very uncommon case of acute intestinal obstruction resulting from an ileocolic intussusception secondary to a mucinous tumor of the appendix and review the literature about this finding as a lead point. Case ReportA 57-year-old female presented to the emergency department with a 2-to 3-month history of intermittent and worsening abdominal pain, great- est in the right lower quadrant, which had increased gradually over the past 3 days. It was associated with dizziness and diarrhea but she denied any history of fever, nausea, vomiting, bloody stools, or weight loss. The patient's medical history included a groin hernia surgery and gastroesophageal reflux on oral treatment.Initial vital signs were within normal limits. Abdominal examination revealed diffuse tenderness on palpation, above all in the right lower quadrant, but without rebound or voluntary guarding. There was no palpable mass, and the auscultation found struggle bowel sounds. Blood tests were normal as was urine analysis.Abdominal X-ray exam was not demonstrative of intestinal obstruction. Computed tomography (CT) of the abdomen and pelvis showed a pathologic mass at the ileocolic region, of cystic appearance with parietal calcifications, with edematous pericolonic fat stranding suggesting of ileocolic intussusception causing an intestinal obstr...

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“…In addition, systemic bacterial infection with fever and shivering has also been described in the literature, after simple endoscopic biopsies taken from an intussuscepted appendix. Symptoms retreated with broad spectrum antibiotherapy (Seddik & Rabhi, 2011). Special care should be taken in cases of simple appendectomy after reduction of the appendiceal intussusception, when the appendiceal stump is inverted with a purse-string suture into the caecal wall.…”

Section: Complicationsmentioning

confidence: 99%