Forty-two patients with abdominal masses caused by appendicitis underwent immediate surgery. A clear separation between a phlegmon and abscess could not be made before operation. In most patients, it was possible to perform an appendectomy and, thus, obviate the need for appendectomy at a subsequent admission. There were no deaths in this series of patients. The complication rate of 35.7% could have been reduced by leaving the skin wounds open.
A case report describes a postmenopausal woman who presented with vaginal bleeding and a pelvic mass. She was found to have a colon cancer with a large metastasis in the right ovary. A review of the literature suggests that ovarian metastasis from a primary colon carcinoma is not rare. Frequently, the ovarian tumors causes symptoms sooner than the primary carcinoma. The presence of ovarian metastasis is associated with a poor prognosis. Consideration should be given to the performance of prophylactic oophorectomy during colon resections for carcinoma.
Recently a patient with ulcerative colitis developed abdominal pain and a left upper quadrant mass. A 67Ga-citrate scintiscan showed increased activity over the mass. A barium enema demonstrated retrograde obstruction at the splenic flexure and intraluminal multilobulated tissue masses. The total abdominal colectomy specimen showed localized giant pseudopolyposis at the splenic flexure. This condition is a rare local complication of both ulcerative and granulomatous colitis. It resembles a villous adenoma on barium enema and, although inflammatory, may simulate a colonic carcinoma. When symptomatic, local resection may be sufficient treatment.
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