Small bowel obstruction due to caecal carcinoma
92 years old female presented to the emergency department with features of acute small bowel obstruction and an inferior right quadrant pain. The patient had a history of previous appendicectomy.
CT Abdomen and pelvis (selected images)
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Bilateral pleural effusion, a small amount of free fluid in the peritoneal cavity and inflammatory area adjacent to the caecum, which has markedly thickened and irregular walls.
Caecal carcinoma can clinically mimic acute appendicitis, either by presenting as a painful mass or secondary to perforation.
In this case, we can see an inflammatory process with free fluid around the caecum region. Although these may suggest possible acute appendicitis, the history of previous appendicectomy and the markedly thickened and irregular caecal walls make a colorectal tumour most likely.
Colorectal carcinoma is the most common cancer of the gastrointestinal tract and the second most frequently diagnosed malignancy in adults.
Check also for other causes of small bowel obstruction.