Presentation
Diarrhea with intermittent cramping abdominal pain ?overflow.
Patient Data
Cystic lesion noted closely related to the posterior aspect of the cecum, and extending into the right paracolic gutter. No adjacent fat stranding. No mural nodularity. No normal appendix seen.
There is prominent redundant loop of sigmoid colon dilated up to 8 cm with a fluid level. There is a focal segment of luminal narrowing in the distal sigmoid, and another in the proximal sigmoid, which may represent adhesive narrowing but is felt more likely to represent focal peristalsis.
The more proximal loops of colon are normal in caliber. Small bowel loops are also normal in caliber.
Solid organs are unremarkable. Gallbladder calculus noted. No free fluid, focal collection or free gas.
Conclusion
- Incidental cystic lesion related to the posterior aspect of the cecum. Given that no normal appendix is seen, this could represent a mucocoele of the appendix. Enteric duplication cyst is another possibility. Suggest correlation with any history of previous appendectomy.
- There is a short segment of luminal narrowing in the distal sigmoid which may represent a stricture. Correlate clinically, and with sigmoidoscopy if appropriate.
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