MyMedR

Fulltext Caecal diverticulitis--a review of eight cases in Taiping, Malaysia

Lim KG

Med J Malaysia, 1999 Jun;54(2):230-4.

PMID: 10972034

Most patients presenting with acute right sided peritonitic pain are diagnosed and managed as acute appendicitis. In a series of 336 patients, eight were found to have caecal diverticulitis. The occurrence of such diverticula appears to be more frequent in Asian populations. The diagnosis can be established at operation on the basis of surgical findings. The aim of this retrospective review is to discuss the management of such patients when acute diverticulitis is found at the time of appendicectomy. It is advocated that management be conservative where possible, with appendicectomy and antibiotics. Where the possibility of a carcinoma remains, investigation after surgery by colonoscopy may be undertaken.

Matched MeSH terms: Cecal Diseases/diagnosis; Cecal Diseases/etiology; Cecal Diseases/surgery*

Torsion of the vermiform appendix

STIRK DI

Med J Malaya, 1958 Mar;12(3):555-8.

PMID: 13565028

Matched MeSH terms: Cecal Diseases*

Appendiceal intussusception presenting as a caecal mass

Alhamar M, Ahsan B, Hogan K, Raoufi M

Malays J Pathol, 2020 Dec;42(3):483-486.

PMID: 33361733

INTRODUCTION: The differential diagnosis of caecal mass is broad and the inclusion of appendiceal pathologies is an important element.

CASE REPORT: We report a 37-year-old woman with recurrent right iliac fossa pain. Computed tomography scan revealed a caecal mass suggesting complete inversion or intussusception of the appendix, which was confirmed by pathologic microscopic examination. This case report discusses appendiceal intussusception with emphasis on diagnosis and treatment options.

DISCUSSION: Appendiceal intussusception is a rare entity and the complete type typically presents as a polypoid lesion located at the appendiceal orifice in the caecum. It is imperative to include this entity in the differential diagnosis of caecal mass, especially during colonoscopy, as the removal of this polypoid lesion can result in a devastating caecal perforation or haemorrhage.

Matched MeSH terms: Cecal Diseases/pathology*

Fulltext Large bowel cancer in a young adult presenting as an acute intussusception--a case report

Jasmi AY, Zain AR, Hayati AR

Med J Malaysia, 1992 Dec;47(4):316-9.

PMID: 1338918

A 14 year old Malay boy with an adenocarcinoma of the transverse colon is reported. A lesion was discovered early when he presented with an uncommon complication in the form of a bowel intussusception. Emergency segmental colonic resection was performed, followed later by an extended left hemicolectomy following histological confirmation of the disease. Benign adenomatous polyp is believed to be the predisposing condition. Both ralities, colorectal cancer in young adults and adult intussusception, are discussed.

Matched MeSH terms: Cecal Diseases/etiology*

Diverticular disease of the large bowel in Singapore. An autopsy survey

Lee YS

Dis Colon Rectum, 1986 May;29(5):330-5.

PMID: 3084185

One thousand fourteen consecutive large intestines were removed at autopsy from persons over the age of 14 years and examined for diverticular disease. Diverticulosis was encountered in 194 patients (19 percent). The lesion appeared early in life, after the second decade. Men were affected more frequently than women before the age of 60 years. Chinese men had significantly more diverticular disease than Malayan men (P less than 0.01) and Indian men (P less than 0.02). Chinese men also had significantly more diverticular disease than Chinese women. There was a predominance of right colon involvement, with the disease affecting especially the ascending colon and cecum. This pattern was observed in all three major ethnic groups, and in both the Singapore-born and foreign-born Singaporeans. The cause of right-sided diverticulosis is unknown. It appears that, while adoption of the western diet may influence the prevalence of diverticular disease, the site of predilection is determined more by racial or genetic predisposition. All diverticula examined histologically were false, including 39 (20 percent) solitary diverticula. The distribution of solitary diverticula was similar to that of multiple diverticulosis. It is suggested that solitary and multiple diverticulosis are part of the spectrum of the same disease.

Matched MeSH terms: Cecal Diseases/epidemiology; Cecal Diseases/pathology

Fulltext Acute appendicitis: pathology of 1,000 cases

Thanaletchimy N

Med J Malaysia, 1986 Dec;41(4):336-42.

PMID: 3670157

A retrospective study of the pathology seen in 1,000 consecutive appendicectomy specimens with a pre-operative diagnosis of acute appendicitis, was made in an attempt to find common factors which might throw light on the aetiology of the disease. Acute inflammation was seen in 775 cases. In 225 cases where no inflammation was seen, 168 appendices were associated with other pathology, i.e., lymphoid hyperplasia, fibrosis and tumour. In 57 cases the appendix was not inflamed. Acute inflammation was seen more in males and in patients aged below 30 years, while normal appendices were more commonly seen in females of reproductive age.

Matched MeSH terms: Cecal Diseases/complications

Fulltext Neuroendocrine tumour masquerading as intussusception: A case report

Wong L, Kanthasamy SV, Durairaj G, Thangaratnam RR

Int J Surg Case Rep, 2020;77:48-52.

PMID: 33137672 DOI: 10.1016/j.ijscr.2020.10.091

INTRODUCTION: Intussusception usually occurs in the paediatric population. When it occurs in the adult population, it is normally caused by a malignant intraluminal pathology.

PRESENTATION OF CASE: A 72-year-old female presented to us with right-sided abdominal pain for 3 weeks, associated with vomiting and diarrhoea. She had an appendectomy done 30 years ago and a recent myocardial infarction. Abdominal examination revealed a previous appendectomy scar and tenderness over the right lumbar region. Computed tomography showed ileocaecal intussusception. Right hemicolectomy with a double barrel stoma was performed as she was unstable intraoperatively. Histopathological examination of the tumour showed a well-differentiated neuroendocrine tumour. Subsequent PET scan showed no systemic disease and a reversal of the stoma was done. She remained disease free for a year.

DISCUSSION: Our patient had undergone a right hemicolectomy despite the high risk of mortality, as there is a high chance of malignancy. Double barrel stoma was done, as she was unstable intraoperatively. Fortunately, she recovered well and had her stoma reversed without any further recurrence of her disease.

CONCLUSION: Adult patients who present with intussusception should be managed with resection, as there is a high possibility of a malignancy. Early resection should be planned to prevent further spread of the tumour.

Matched MeSH terms: Cecal Diseases

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