RESUMO
Chronic idiopathic ulcers of the colon pose diagnostic challenges due to their elusive etiology and potential resemblance to other intestinal pathologies, such as cecal carcinoma. This case report outlines the clinical course of a 68-year-old female patient who presented to the emergency department (ED) with persistent right lower quadrant pain. Despite multiple hospital visits yielding varied diagnoses, a definitive diagnosis was only made following a laparoscopic partial colectomy, which revealed chronic idiopathic ulcers with transmural scarring and adhesions to adjacent small intestine loops. Histological examination demonstrated a substantial ulcer bed populated by inflammatory cells, including large stellate and spindled stromal cells within the granulation tissue, alongside lymphoid hyperplasia and scar tissue extending into the muscularis propria. The initial presentation of this case could easily be mistaken for appendicitis, diverticulitis, carcinoma, or irritable bowel syndrome, highlighting the significance of considering chronic idiopathic ulcers in the differential diagnosis of patients presenting with cecal masses.
RESUMO
During a routine dissection of the abdominal region in our department of anatomy's dissection laboratory, we found two variations of the vasculature of the gastrointestinal tract within the greater peritoneal and retroperitoneal compartments: an aberrant left colic artery (LCA) and an accessory right colic artery (RCA). The aberrant LCA originates from a common trunk (CT) that arises from the superior mesenteric artery instead of the inferior mesenteric artery. The CT continues for a short distance and terminates by dividing into a middle colic artery and an accessory RCA. The aberrant LCA and accessory RCA had abnormal courses; therefore, they are vulnerable to injury during surgical procedures of the region. Hence, a thorough knowledge of vascular variations is required to avoid potential complications.
