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1.
Ghana Med J ; 58(1): 109-114, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38957279

RESUMO

Introduction: Mucocoele of the appendix occurs in 0.2-0.7% of people in the world without any well-defined clinical symptoms. It occurs when there is an accumulation of mucous in the lumen of the appendix. Case Presentation: We present three cases: a 48-year-old male admitted to the emergency room with a one-day history of right iliac fossa pain. Abdominal examination was suggestive of acute appendicitis. The initial abdominal computerised tomography scan was reported as being unremarkable. At surgery, a firm tumour of the appendix was found, and a limited right hemicolectomy was done. Histopathology confirmed a mucocoele of the appendix with borderline mucinous histology.The second case is a 63-year-old man who presented with a one-year history of abdominal distension and weight loss. Previous abdominal ultrasound was suggestive of liver cirrhosis with significant ascitic fluid. Abdominal magnetic resonance imaging found an appendix mucocoele with infiltration of the omentum and scalloping of the liver surface suggestive of pseudomyxoma peritonei. A percutaneous biopsy of the omental mass confirmed metastatic mucinous adenocarcinoma of the appendix.The third case is a 68-year-old man who, during an annual medical check-up, had an incidental finding of a cystic right iliac fossa mass on ultrasound, confirmed on abdominopelvic computerised tomography scan to be an appendix mucocele. He had laparoscopic appendicectomy. The histopathological diagnosis confirmed a mucinous cystadenoma of the appendix. Conclusion: Preoperative diagnosis of appendiceal mucocoele is difficult and commonly discovered intraoperatively. The prognosis is good for the histologically benign type, but it is poor when malignant or peritoneal lesions are present. Funding: None declared.


Assuntos
Apêndice , Mucocele , Humanos , Masculino , Pessoa de Meia-Idade , Mucocele/cirurgia , Mucocele/diagnóstico por imagem , Mucocele/patologia , Apêndice/patologia , Apêndice/diagnóstico por imagem , Apêndice/cirurgia , Idoso , Tomografia Computadorizada por Raios X , Neoplasias do Apêndice/cirurgia , Neoplasias do Apêndice/patologia , Neoplasias do Apêndice/diagnóstico por imagem , Adenocarcinoma Mucinoso/cirurgia , Adenocarcinoma Mucinoso/patologia , Adenocarcinoma Mucinoso/diagnóstico por imagem , Apendicite/cirurgia , Apendicite/diagnóstico por imagem , Apendicectomia , Imageamento por Ressonância Magnética , Doenças do Ceco/cirurgia , Doenças do Ceco/patologia , Pseudomixoma Peritoneal/patologia , Pseudomixoma Peritoneal/cirurgia
2.
Rozhl Chir ; 103(6): 232-235, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38991788

RESUMO

In this article, we present case reports of two patients admitted to the University Hospital in Pilsen for acute abdomen due to a disorder of the passage through the gastrointestinal tract (GIT). Both were indicated for surgery. The patients were diagnosed intraoperatively with rarely occurring cecal volvulus (CV). The findings required an ileocecal resection; nevertheless, both patients fully recovered despite the need the resection.


Assuntos
Abdome Agudo , Doenças do Ceco , Volvo Intestinal , Humanos , Volvo Intestinal/cirurgia , Volvo Intestinal/diagnóstico por imagem , Volvo Intestinal/complicações , Abdome Agudo/etiologia , Doenças do Ceco/cirurgia , Doenças do Ceco/complicações , Doenças do Ceco/diagnóstico por imagem , Doenças do Ceco/diagnóstico , Masculino , Íleus/cirurgia , Íleus/etiologia , Íleus/diagnóstico por imagem , Feminino , Pessoa de Meia-Idade , Idoso
4.
J Med Case Rep ; 18(1): 297, 2024 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-38943209

RESUMO

INTRODUCTION: Colon volvulus is the twisting of a segment of colon on its mesenteric axis, which can lead to the obstruction of the lumen and the blood supply. Colon volvulus is common in "volvulus belt" countries and can involve the sigmoid (60-70%) and cecum (25-40%). CASE PRESENTATION: We report a case of a 47-year-old male, Alawites, who presented with bowel obstruction and dilated abdomen without any specific abdominal pain. Abdominal laparotomy showed both sigmoid and cecum volvulus with no signs of perforation or ischemia. DISCUSSION AND CONCLUSION: One of the possible risk factors of sigmoid colon volvulus is the length of the rectum and sigmoid, while mobile cecum is considered as a possible reason for cecum volvulus. The management remains controversial and is specific for every case, depending mainly on the vitality of the colonic walls and the general condition of the patient.


Assuntos
Colo Sigmoide , Volvo Intestinal , Humanos , Volvo Intestinal/cirurgia , Volvo Intestinal/diagnóstico por imagem , Volvo Intestinal/complicações , Masculino , Pessoa de Meia-Idade , Colo Sigmoide/diagnóstico por imagem , Colo Sigmoide/cirurgia , Colo Sigmoide/patologia , Doenças do Ceco/cirurgia , Doenças do Ceco/diagnóstico por imagem , Doenças do Colo Sigmoide/diagnóstico por imagem , Doenças do Colo Sigmoide/cirurgia , Obstrução Intestinal/cirurgia , Obstrução Intestinal/etiologia , Obstrução Intestinal/diagnóstico por imagem , Ceco/diagnóstico por imagem , Ceco/patologia , Laparotomia , Resultado do Tratamento
6.
Artigo em Inglês | MEDLINE | ID: mdl-38765516

RESUMO

Objective: To evaluate the association between clinical and imaging with surgical and pathological findings in patients with suspected neuroendocrine tumor of appendix and/or appendix endometriosis. Methods: Retrospective descriptive study conducted at the Teaching and Research Institute of Hospital Israelita Albert Einstein, in which medical records and databases of patients with suspected neuroendocrine tumor of appendix and/or endometriosis of appendix were analyzed by imaging. Results: Twenty-eight patients were included, all of which had some type of appendix alteration on the ultrasound examination. The pathological outcome of the appendix found 25 (89.3%) lesions compatible with endometriosis and three (10.7%) neuroendocrine tumors. The clinical findings of imaging and surgery were compared with the result of pathological anatomy by means of relative frequency. Conclusion: It was possible to observe a higher prevalence of appendix endometriosis when the patient presented more intense pain symptoms. The image observed on ultrasound obtained a high positive predictive value for appendicular endometriosis.


Assuntos
Apêndice , Endometriose , Tumores Neuroendócrinos , Ultrassonografia , Humanos , Feminino , Endometriose/diagnóstico por imagem , Estudos Retrospectivos , Adulto , Tumores Neuroendócrinos/diagnóstico por imagem , Apêndice/diagnóstico por imagem , Apêndice/patologia , Pessoa de Meia-Idade , Diagnóstico Diferencial , Adulto Jovem , Neoplasias do Apêndice/diagnóstico por imagem , Neoplasias do Apêndice/patologia , Doenças do Ceco/diagnóstico por imagem
8.
Med Clin (Barc) ; 162(10): 500-504, 2024 05 31.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38570296

RESUMO

OBJECTIVE: This study aims to assess the clinical, radiological, and histological characteristics of Actinomyces infection identified in appendectomy specimens. MATERIAL AND METHODS: Between January 2013 and November 2023, 5834 patients underwent appendectomy in our clinic, and their pathology reports were retrospectively reviewed. RESULTS: Actinomyces appendicites were reported in 14 specimens (0.23%). It was determined that appendectomy was performed in only 10 patients (71.4%), ileocecal resection was performed in two patients (14.2%) and right hemicolectomy in two patients (14.2%). The operations on five patients were performed by laparoscopy, and the operations on the other nine patients were performed by open surgery. Laparoscopy was started in three patients and converted to open surgery due to suspicion of an ileocecal mass and cecal perforation. It was found that the white blood cell count of three patients was within the normal range of reference (8-9.77mg/dL); leukocytosis was detected in other patients (10.2-18.7mg/dL). C-reactive protein was normal in one patient and high in the rest of the patients. While the first-hour erythrocyte sedimentation rate was normal in five patients, it was found to be high in the other patients. Findings on radiological imaging were reported as acute appendicitis, appendicular plastron, and ileocecal mass. As a result of the pathology findings, the patients were given oral penicillin or semi-synthetic penicillin derivatives during one month. CONCLUSION: Ileocecal and appendecular actinomycosis are rare, and preoperative diagnosis is difficult. A definitive diagnosis is usually made after a histopathological examination. After surgery, long-term antimicrobial treatment of the patient is possible with penicillin.


Assuntos
Actinomicose , Apendicectomia , Humanos , Actinomicose/diagnóstico , Masculino , Feminino , Estudos Retrospectivos , Pessoa de Meia-Idade , Adulto , Idoso , Apendicite/diagnóstico , Apendicite/cirurgia , Adulto Jovem , Doenças do Ceco/diagnóstico , Doenças do Ceco/cirurgia , Doenças do Ceco/microbiologia , Laparoscopia , Actinomyces/isolamento & purificação , Adolescente
9.
J Visc Surg ; 161(3): 226-227, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38453591

RESUMO

Common mesentery is an abnormal rotation of the primary umbilical loop characterized by inverted positioning of the mesenteric vessels; the mesenteric vein is displaced to the left of the artery. The inversion can be complete or incomplete. If it is incomplete, the mesenteric root is very short, with an empty right iliac fossa and the caecum in high median or subhepatic position. If it is complete, the entire small intestine is on the right, the entire large intestine is on the left; there is no third duodenum, and the second duodenum is anastomosed in the jejunum to the right of the superior mesenteric vessels. Cecal volvulus is a rarely encountered cause of acute intestinal occlusion and should be considered as a surgical emergency. There exist two main types of volvulus: by twisting of the large intestine around its axis, which remains in place; or by tilt and to rotation of the colon, which changes position.


Assuntos
Doenças do Ceco , Volvo Intestinal , Mesentério , Volvo Intestinal/cirurgia , Volvo Intestinal/diagnóstico por imagem , Volvo Intestinal/complicações , Humanos , Doenças do Ceco/cirurgia , Doenças do Ceco/diagnóstico por imagem , Mesentério/cirurgia , Masculino , Feminino , Tomografia Computadorizada por Raios X
10.
Vet Radiol Ultrasound ; 65(3): 275-278, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38459956

RESUMO

An 8-year-old cat was presented for an acute history of anorexia, marked abdominal pain, and hyperthermia. Ultrasonography showed a cecal perforation with focal steatitis and adjacent free gas bubbles, consistent with focal peritonitis. Surgery confirmed the imaging findings. An enterectomy was performed with the removal of the cecum and ileocolic valve, and anastomosis between the ileum and colon was performed. Histology revealed transmural enteritis and chronic severe pyogranulomatous peritonitis with intralesional plant fragments.


Assuntos
Doenças do Gato , Doenças do Ceco , Perfuração Intestinal , Ultrassonografia , Animais , Gatos , Doenças do Gato/diagnóstico por imagem , Doenças do Gato/cirurgia , Doenças do Gato/diagnóstico , Doenças do Ceco/veterinária , Doenças do Ceco/diagnóstico por imagem , Doenças do Ceco/cirurgia , Ceco/diagnóstico por imagem , Ceco/cirurgia , Ceco/lesões , Perfuração Intestinal/veterinária , Perfuração Intestinal/cirurgia , Perfuração Intestinal/diagnóstico por imagem , Peritonite/veterinária , Peritonite/diagnóstico por imagem , Peritonite/etiologia , Ultrassonografia/veterinária
11.
Prensa méd. argent ; 110(1): 37-42, 20240000. fig
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1552733

RESUMO

El vólvulo cecal es una causa rara de abdomen oclusivo agudo. Cada año, aproximadamente 2,8-7,1 personas por millón se ven afectadas por esta patología. Se estima que el vólvulo cecal representa el 25-40% de todo el vólvulo del colon. Causa alrededor del 1-1,5% de las oclusiones intestinales en adultos. La mayoría de los pacientes presentan síntomas de hinchazón, estreñimiento, náuseas y vómitos. Hasta el 50% puede tener síntomas intermitentes antes de la torsión. Su baja prevalencia dificulta su diagnóstico preoperatorio, siendo diagnosticado frecuentemente durante la cirugía. Presentamos el caso de un hombre de 66 años que ingresa por dolor abdominal, cuyos métodos de imagen complementarios iniciales fueron diagnósticos de abdomen agudo oclusivo y finalmente durante la cirugía se observó un vólvulo cecal


The cecal volvulus is a rare cause of an acute occlusive abdomen. Each year, approximately 2.8-7.1 people per million are affected by this pathology. It is estimated that the cecal volvulus represents 25-40% of all the colon volvulus. Causing about 1-1.5% of intestinal occlusions in adults. Most patients have symptoms of bloating, constipation, nausea, and vomiting. Up to 50% may have intermittent symptoms before torsion. Its low prevalence hinders its preoperative diagnosis, being frequently diagnosed during surgery. We present a case of a 66-year-old man admitted for abdominal pain, whose initial complementary imaging methods were diagnostic of acute occlusive abdomen and finally a cecal volvulus was observed during surgery


Assuntos
Humanos , Masculino , Idoso , Doenças do Ceco/patologia , Volvo Intestinal/patologia , Abdome Agudo/cirurgia
12.
Arab J Gastroenterol ; 25(2): 234-236, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38378356

RESUMO

Mucormycosis is a life-threatening fungal infection mostly involving the ocular region, sinuses and brain. It is mostly seen in the immunocompromised host. Gastrointestinal (GI) mucormycosis is rare and mostly present as hematemesis, abdominal pain and melena. Here, we present a case of intestinal mucormycosis who presented as cecal perforation. Surgical resection was done, and the diagnosis was made by histopathology. Our case is unique in the way that GI mucormycosis is itself a rare entity and even rarer in an immunocompetent host.


Assuntos
Perfuração Intestinal , Mucormicose , Humanos , Mucormicose/diagnóstico , Mucormicose/complicações , Perfuração Intestinal/etiologia , Perfuração Intestinal/diagnóstico , Perfuração Intestinal/microbiologia , Masculino , Doenças do Ceco/diagnóstico , Doenças do Ceco/microbiologia , Pessoa de Meia-Idade
15.
Am Surg ; 90(6): 1734-1735, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38213128

RESUMO

Gastrointestinal tuberculosis (TB) is a rare manifestation of extra-pulmonary TB that is known to mimic many different gastrointestinal diseases. We present a case of an 85-year-old male patient with delayed diagnosis of gastrointestinal TB who underwent colonic resection for a cecal mass that was initially suspected to be malignant. Acid-fast staining of the surgical specimen later revealed acid-fast bacilli and multiple lymph nodes with necrotizing granulomas. The purpose of this study is to stress the importance of including gastrointestinal TB as a differential diagnosis for patients with suspected colorectal malignancy, especially when initial biopsy results do not reveal malignant features.


Assuntos
Colectomia , Tuberculose Gastrointestinal , Humanos , Masculino , Colectomia/métodos , Tuberculose Gastrointestinal/diagnóstico , Tuberculose Gastrointestinal/cirurgia , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Doenças do Ceco/cirurgia , Doenças do Ceco/diagnóstico , Doenças do Ceco/microbiologia
16.
Am J Clin Pathol ; 161(5): 418-429, 2024 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-38217538

RESUMO

OBJECTIVES: The appendix, although considered a vestigial organ, is of considerable clinical importance because acute appendicitis is a common medical problem. There are also other disease processes involving the appendix. The appendix is among the first specimens that the pathologist (and surgeon) cuts one's teeth on. Thus, there may be a tendency to underestimate the clinically and prognostically significant appendiceal pathologies. METHODS: We provide a vade mecum of the pathologic features of a wide range of nonneoplastic appendiceal pathologies, with an emphasis on developing a practical approach to grossing, microscopy, and reporting-all with clinical and therapeutic implications. Much of this is based on literature on MEDLINE with reference to years 2008 to 2023, as well as on personal experiences and interpretations. RESULTS: The appendix can harbor a myriad of nonneoplastic pathologies, including infections, inflammations of varying etiologies (including interval appendectomy), endometriosis, diverticulosis, and so on. Chronic appendicitis, Crohn disease, and clinical audit are recurring themes while COVID-19 is a new entity. CONCLUSIONS: Most importantly, all pathologists should appreciate that the appendix is not as "routine" a specimen as one would want to believe.


Assuntos
Apêndice , COVID-19 , Humanos , Apêndice/patologia , COVID-19/patologia , Apendicite/patologia , Doenças do Ceco/patologia , Doenças do Ceco/diagnóstico , SARS-CoV-2
17.
Ann R Coll Surg Engl ; 106(1): 93-95, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36622245

RESUMO

Tumours of the appendix are very rare tumours that can and often present with a mucocele. This is a case report highlighting the associated pathology of appendix tumours and the management of a large mucocele. Specifically, how a right hemicolectomy is very rarely needed in these cases regardless of size and local anatomical relationships and some important considerations for the practicing surgeon in the non-tertiary centre that encounters a case like this.


Assuntos
Cavidade Abdominal , Neoplasias do Apêndice , Apêndice , Doenças do Ceco , Anormalidades do Sistema Digestório , Mucocele , Humanos , Mucocele/diagnóstico , Mucocele/diagnóstico por imagem , Doenças do Ceco/diagnóstico , Doenças do Ceco/cirurgia , Apêndice/diagnóstico por imagem , Apêndice/cirurgia , Apêndice/patologia , Neoplasias do Apêndice/complicações , Neoplasias do Apêndice/diagnóstico , Neoplasias do Apêndice/cirurgia
19.
Abdom Radiol (NY) ; 49(2): 357-364, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37989898

RESUMO

PURPOSE: To assess the diagnostic performance and reliability of 18 CT signs to diagnose cecal volvulus, a surgical emergency, versus a group of non-volvulus mimickers. MATERIALS AND METHODS: Four radiologists retrospectively and independently assessed 18 CT signs in 191 patients with cecal volvulus (n = 63) or a non-volvulus control group ((n = 128), including cecal bascule (n = 19), mobile cecum (n = 95), and colonic pseudo-obstruction (n = 14)) at a single institution from 2013 to 2021. Fleiss' kappa coefficient was used to assess inter-reader agreement. For diagnostic performance metrics, we assessed sensitivity, specificity, and positive and negative predictive values. For predictive performance, all 18 signs were included in bivariate and stepwise lasso multivariate logistic regression models to diagnose cecal volvulus. Performance was assessed by ROC curves. RESULTS: 191 patients (mean age: 63 years +/- 15.5 [SD]; 135 women) were included in the study. Nine of the 18 CT signs of cecal volvulus demonstrated good or better (> 0.6) inter-reader agreement. Individual CT signs with sensitivity, specificity, positive and negative predictive values all above 70% for diagnosing cecal volvulus were transition point, bird beak, and X-marks-the-spot. A lasso regression model determined four CT features: transition point, bird beak, coffee bean, and whirl had excellent prediction (AUC = .979) for cecal volvulus if all present. CONCLUSION: CT signs for cecal volvulus that have high sensitivity and specificity include: transition point, bird beak, and X-marks-the-spot and were reliable in distinguishing non-volvulus mimickers. If the following four features were present: transition point, bird beak, coffee bean, and whirl, there was excellent prediction (AUC = .979) for cecal volvulus.


Assuntos
Doenças do Ceco , Volvo Intestinal , Humanos , Feminino , Pessoa de Meia-Idade , Volvo Intestinal/diagnóstico por imagem , Estudos Retrospectivos , Reprodutibilidade dos Testes , Tomografia Computadorizada por Raios X , Valor Preditivo dos Testes , Doenças do Ceco/diagnóstico por imagem
20.
BMJ Case Rep ; 16(11)2023 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-37940197

RESUMO

An internal hernia through the foramen of Winslow represents a rare surgical pathology. This report describes a case with incipient caecal ischaemia and discusses current diagnostic and therapeutic approaches. A patient in his early 60s presented at the emergency department with abdominal pain and last bowel movement three days prior. A CT scan of the abdomen suggested an internal hernia into the lesser sac. Intraoperatively, the suspected diagnosis could be confirmed laparoscopically with a twisted mobile caecum herniating through the foramen of Winslow. Due to a suspected ischaemia and laparoscopic frustrated reduction, a right open hemicolectomy was performed. The hernia gap was closed. The postoperative course was uneventful. Despite the rarity of internal hernias in patients without prior abdominal surgery, surgeons should be aware of this entity. The diagnosis can be difficult and sometimes only established intraoperatively. Open surgery is usually required. If the gap is clearly identified, the recommendations tend towards its closure.


Assuntos
Doenças do Ceco , Hérnia Abdominal , Obstrução Intestinal , Humanos , Hérnia Abdominal/complicações , Hérnia Abdominal/diagnóstico por imagem , Hérnia Abdominal/cirurgia , Hérnia/complicações , Hérnia/diagnóstico por imagem , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Ceco/diagnóstico por imagem , Ceco/cirurgia , Doenças do Ceco/complicações , Doenças do Ceco/diagnóstico por imagem , Doenças do Ceco/cirurgia , Hérnia Interna
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