Isolated submucosal lipomatosis of the appendix
Right abdominal pain, elevated CRP.
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Retrocecal appendix thickened up to a diameter of 9 mm, with long segment of submucosal lipomatosis. Minimal periappendiceal fat stranding.
The patient was taken to the ER, where an inflamed vermiform appendix was removed laparoscopically.
Isolated appendiceal lipomatosis is a rare entity that can visually mimic appendicitis 1 because of its thickened, hypodense submucosa. One should note the submucosa exhibits fat density, not "water" density. In this specific case, there were appropriate clinical signs, elevated C-reactive protein, and mild fat stranding, all concerning for appendicitis.
Long retrocecal appendix with signs of acute inflammation, stuck to the abdominal wall.
Appendix 7 cm long and up to 10 mm in diameter. The serosa is gray and displays vascular markings.
- 1. Şanlı Ş, Sasani H, Darıcı E, Bakır B. Isolated submucosal lipomatosis of appendix mimicking acute appendicitis: computed tomography findings. Acta Medica Anatolia 2(X-X), March 2014. doi:10.15824/actamedica.35025
- 2. ANTOCI B. [Submucous lipomatosis of the appendix]. (1956) Rivista di anatomia patologica e di oncologia. 11 (9): cxxvii-cxxxiii. Pubmed