Small bowel obstruction due to cecal carcinoma

Case contributed by Bruno Di Muzio
Diagnosis almost certain


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 appendectomy.

Patient Data

Age: 90 years
Gender: Female

Bilateral pleural effusion, a small amount of free fluid in the peritoneal cavity and inflammatory area adjacent to the cecum, which has markedly thickened and irregular walls.

Case Discussion

Cecal 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 cecum region.  Although these may suggest possible acute appendicitis, the history of previous appendectomy and the markedly thickened and irregular cecal walls make a colorectal tumor 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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