Presentation
Abdominal pain.
Patient Data
The appendix is dilated measuring 11 mm with wall stratification due to submucosal edema (target-like sign) with minimal fat stranding. It shows appendico-cecal invagination (appendiceal intussusception) of proximal part of the appendix with dilated intra-cecal part measuring 22 mm surrounded by encysted intracecal fluid. No suspicious cecal wall thickening or masses.
Bilateral inguinal hernias transmitting omental fat, larger on right side.
Basal lung zones show multiple calcific foci at both lower lobes.
Chest radiograph shows diffuse centrilobular emphysema, predominately affecting both upper lobes and multiple calcific foci at both lower lobes, mostly representing calcified granuloma.
Classification system for appendiceal intussusception by Forshall et al. 2.
appendectomy is sufficient in types 1.a, 1.c, and 1.d as the lesion does not include appendiceal base
ileocecectomy may be required in types 1.b and 1.e
Author: Ahmed K. Ali et al
Original files: https://www.sciencedirect.com/science/article/pii/S2213576622003621#bib14
Modifications: none
License: This file is licensed under Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)
Case Discussion
CT features of appendico-cecal invagination of proximal part of the appendix, suggestive of appendiceal intussusception. It's a very rare diagnosis accounting for 0.01% of appendectomies. It is considered as type 1.b according to Forshall et al. classification system.
Unable to process the form. Check for errors and try again.