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BMMR. 2014; 17(3): 105-107


Caecal Polyp as a Rare Cause of Acute Abdomen: Case Report

Zafer Kilbas, Yasar Subutay Peker, Ali Harlak, Nail Ersoz, Gokhan Yagci.

Abstract
Radiologic imaging is getting used more commonly in the evaluation of acute abdomen in our daily practice. Ultrasonography and computed tomography are worthwhile when clinical presentation is not concordant with appendicites. In this study, we aimed to present a rare case of caecal polyp causing acute appendicitis.
36-years-old male patient presented with right lower quadrant pain and nausea. On physical examination, rebound tenderness was obtained but there was no muscular rigidity. All blood tests including biochemistry and hemogram were within normal limits. Ultrasonography showed an enlarged, non-compressible appendix with 2-cm diameter and caecal edema. When a CT was performed to exclude a probable appendix tumor, a-25 mm diameter mass was obtained at posterior wall of caecum. As colonoscopy was applied, 2x3cm of sessile polyp located at caecum encircling appendical orifis was observed. Diagnostc biopsy was performed without polypectomy, due to its wide base. Histopathological diagnosis resulted adenomatous polyp with no malignancy. Appendectomy + partial caecal resection involving the polyp was performed. Histopathology confirmed the preoperative diagnosis ''mucinous neoplasm with tumor free margin''. Patient was discharged on postoperative fourth day without any complication
Radiological imaging methods are beneficial for evaluating and confirming the diagnosis of acute abdomen. Negative laparatomies or second-step surgeries may be decreased by advanced radiological imaging, especially when there is discordance between clinical and laboratory findings.

Key words: acute appendicitis, cecal polyp, mucocele, imaging methods



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