Small bowel obstruction due to caecal carcinoma

Case contributed by Dr Bruno Di Muzio

Presentation

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.

Patient Data

Age: 92 years
Gender: Female
CT

CT Abdomen and pelvis (selected images)

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.

Case Discussion

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.

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Case information

rID: 13035
Published: 20th Feb 2011
Last edited: 16th Apr 2018
Inclusion in quiz mode: Excluded

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