RESUMEN
PURPOSE: We report four cases of unusual presentation of colonic cancer revealed by an abscess of the abdominal wall. MATERIALS AND METHODS: Our study included 3 men and 1 women ranging in age from 33 to 66 years presenting with abdominal wall abscess (in the left anterior abdominal wall in 2 patients and in the quadratus lumborum muscle in the other 2 patients). Our cases were listed from the departments of radiology and abdominal surgery of Sahloul hospital from 1995 through 2000. Ultrasonography (US) and computed tomography (CT) were performed in all cases; barium enema in three. RESULTS: US and CT revealed segmental colonic wall thickening (left colon in three patients and right colon in one patient). The diagnosis of colonic cancer was reached by colonoscopy with biopsy in all 4 cases. All of our patients underwent surgical treatment. CONCLUSION: In this era of newer diagnostic imaging modalities, US and CT must frequently be used in the evaluation of patients with abdominal wall abscess, to depict intra-abdominal infection and especially malignant lesion causing abdominal wall abscess.
Asunto(s)
Absceso Abdominal/diagnóstico , Carcinoma/diagnóstico , Neoplasias del Colon/diagnóstico , Diagnóstico por Imagen , Absceso Abdominal/diagnóstico por imagen , Músculos Abdominales/patología , Adulto , Sulfato de Bario , Biopsia , Carcinoma/diagnóstico por imagen , Neoplasias del Colon/diagnóstico por imagen , Colonoscopía , Medios de Contraste , Diagnóstico Diferencial , Enema , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
PURPOSE: The purpose of our work was to assess the value of abdominal sonography (US) and computed tomography (CT) in the preoperative diagnosis of appendiceal mucocele. MATERIAL: and methods. We retrospectively reviewed 10 cases of mucocele of the appendix, 7 cases without pseudomyxoma peritonei, and 3 cases with pseudomyxoma peritonei. All cases were investigated radiologically by plain film and US, barium enema was performed in 3 cases and CT in 5 cases. RESULTS: Mucoceles of the appendix are rare and their clinical presentation is not specific. US confirms the appendicular involvement, but often poses the differential diagnosis with acute inflammation, abscess or localized appendicular peritonitis. CT appears as a mandatory examination since it allows accurate preoperative diagnosis period. In this series, the diagnosis was made preoperatively in the 5 cases where CT had been performed. CONCLUSION: US is useful to confirm the abnormal pattern of the appendix but does not allow accurate diagnosis of mucocele. CT is more specific and accurate for diagnosis of mucocele of the appendix.