Abstract
Acute appendicitis represents a rare presentation of carcinoma of cecum. Neoplastic lesion of cecum may cause appendicitis by mechanical obstruction at the orifice of the vermiform appendix. The dilatation and perforation of appendix may produce a peri-appendicular abscess. A radical surgical approach of cecal masses, with intra-operative abscess drainage and resection should be performed in elderly patients, fit for surgery, to avoid the risk of unrecognising malignant lesion as well as to achieve a safe and adequate treatment. We describe a case of right iliac fossa abscess initially diagnosed with acute appendicitis that, at surgical exploration, resulted from a cecal tumour causing appendicitis for an obstructive mechanism.
Highlights
Peri-appendicular abscess is usually due to primary appendicitis or it may be caused by various pathological conditions: inflammatory, infective, neoplastic, immunological, ischemic, occlusive
We present a case of right iliac fossa abscess, initially diagnosed as a complication of acute appendicitis that, at surgical exploration, was proven to be produced by a cecal tumour causing appendicitis for an obstructive mechanism
Appendicitis and perforation originated from chronic obstruction of the base of appendix caused by the cecal neoplasm
Summary
Peri-appendicular abscess is usually due to primary appendicitis or it may be caused by various pathological conditions: inflammatory, infective, neoplastic, immunological, ischemic, occlusive (table 1).We present a case of right iliac fossa abscess, initially diagnosed as a complication of acute appendicitis that, at surgical exploration, was proven to be produced by a cecal tumour causing appendicitis for an obstructive mechanism.complex, predominantly cystic, mass of large size (6 × 8 cm) with heterogeneous, mainly peripheral enhancement (figure 1). Peri-appendicular abscess is usually due to primary appendicitis or it may be caused by various pathological conditions: inflammatory, infective, neoplastic, immunological, ischemic, occlusive (table 1). We present a case of right iliac fossa abscess, initially diagnosed as a complication of acute appendicitis that, at surgical exploration, was proven to be produced by a cecal tumour causing appendicitis for an obstructive mechanism. Complex, predominantly cystic, mass of large size (6 × 8 cm) with heterogeneous, mainly peripheral enhancement (figure 1). The adjacent cecum had its wall thickened and it was not possible to differentiate the appendix separately from the mass. The patient failed to respond to the initial conservative management, which consisted of intravenous fluids and triple antibiotic therapy with cefotaxime, gentamicin and metronidazole, without any improvement of pain and fever. At a further ultrasound examination, the mass appeared not modified
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