Presentation
Acutely worsening right lower abdominal pain and nausea. Pain has been ongoing for several months.
Patient Data
The stomach is collapsed/empty. There is oral contrast in normal caliber small bowel loops and reaching the colon. The appendix is questionably seen. There is a lobulated solid mass involving the cecum centered around the ileocecal valve. There is oral contrast with a moderate amount of stool throughout the remainder of the colon.
The considerable abnormality in the right lower quadrant. The large mass in the cecum now appears to be an intussusception above this into the ascending colon. There is some mixed air or fluid in the colon around this. Distal small bowel loops are mildly prominent. Proximal small bowel not particularly distended.
Case Discussion
Recently diagnosed patient with lymphoma of the cecum. Intussusception is the invagination of a distal portion of bowel into a proximal portion. Intussusception most commonly occurs in children under 5 years of age; however, it can occur in adult patients due to pathologic lead points. Nearby abdominal masses including polyps, Peyer's patches, intestinal wall thickening, or lymphomas can lead to invagination. When a pathological lead point is suspected, as in the case of this patient, treatment is with surgical resection of the affected bowel segment.
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