Appendiceal and appendiceal-ileocolic intussusception: sonographic and radiographic evaluation

Koumanidou, C.; Vakaki, Marina; Theofanopoulou, Maria; Nikas, John; Pitsoulakis, George; Kakavakis, Konstantinos

doi:10.1007/s002470000395

Cited by 27 publications

(32 citation statements)

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“…1 Clinical presentation of appendiceal intussusception can vary from crampy lower abdominal pain to acute appendicitis. 2 In this case, the patient had symptoms suggestive of a Figure 1 Mass at the appendiceal orifice on colonoscopy after cold forceps biopsy chronic presentation, with waxing and waning symptoms. Contributing factors to intussusception of the appendix have been classified into anatomical and pathological causes.…”

Section: Discussionmentioning

confidence: 81%

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Appendiceal intussusception from endometriosis: endoscopic and laparoscopic approach

Birriel

Smith

Eyvazzadeh

2017

annals

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Appendiceal intussusception is an rare diagnosis that may be found on imaging or at the time of surgery, as seen in this case of a 33-year-old female presenting with gastrointestinal symptoms. Images are presented with differential diagnosis as well as treatment options. Case reportA 33-year-old white female presented with a several months' history of left lower-quadrant pain most notable after menstrual cycles. This was associated with episodes of intermittent loose stools alternating with constipation. Past medical history was significant for hypertension, anxiety and asthma. Previous surgical history includes a tubal ligation approximately 5 years earlier. On physical examination, her general condition was good and her abdomen was soft, although some tenderness was exhibited in the right lower quadrant. Laboratory tests and a urinalysis were grossly normal with a white cell count of of 9,990/mm 3 .The patient underwent a colonoscopy as part of the workup for her abdominal pain, at which time a lesion was discovered in the lumen of the appendix (Fig 1). The lesion was suspicious for a polyp or mucocele, which was benign on superficial cold biopsy. A follow-up abdominal computed tomography (CT) scan showed dilated, thickened appendix impinging on the cecum (Fig 2). After discussion with the patient regarding the possibility of mucocele, among other diagnoses, she agreed to proceed with a laparoscopic resection. A shortened, thickened appendix and cecum were dissected free from surrounding structures and lateral attachments to the abdominal wall were freed. A laparoscopic partial cecectomy with appendectomy was performed. The specimen consisted of an appendix measuring approximately 5cm in length by 1.7cm in diameter. Final pathology was read as benign appendix with intussusception in the setting of intramural endometriosis. This was negative for dysplasia and malignancy. The patient did well postoperatively and was discharged on hospital day two, tolerating a regular diet. DiscussionAppendiceal intussusception is an uncommon diagnosis, with an estimated incidence reported by Collins as 0.01%. 1 Clinical presentation of appendiceal intussusception can vary from crampy lower abdominal pain to acute appendicitis. 2 In this case, the patient had symptoms suggestive of a

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Section: Discussionmentioning

confidence: 81%

“…1 Clinical presentation of appendiceal intussusception can vary from crampy lower abdominal pain to acute appendicitis. 2 In this case, the patient had symptoms suggestive of a …”

mentioning

confidence: 86%

Appendiceal intussusception from endometriosis: endoscopic and laparoscopic approach

Birriel

Smith

Eyvazzadeh

2017

annals

View full text Add to dashboard Cite

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“…In most cases of appendiceal intussusception, radiographical findings were normal, unless a small-bowel obstruction co-existed. "Air-fluid" levels of the small intestine could then be present in plain abdominal X-Ray films (Koumanidou et al, 2001;Varsamis et al, 2010). Cases of appendiceal invagination were diagnosed during double-contrast barium enema examination, sometimes at asymptomatic patients.…”

Section: Laboratory Radiological and Colonoscopical Investigationmentioning

confidence: 99%

“…Appendiceal intussusception may appear as the "multiconcentric ring" sign on transverse scans, while longitudinal sonograms may show the inverted appendix protruding into the caecal lumen (Pumberger et al, 2000). Koumanidou et al in 2001 argued that the sonograhic appearance of multiple concecntric hypoechoic and hyperechoic rings is not characteristic of appendiceal intussusception but intussusception in general. She also claimed that visualization of the appendix within the head of the intussusception may be considered characteristic only when a small cyst or a "target-like" mass is demonstrated, having an outer diameter which should not exceed 6mm (Koumanidou et al, 2001).…”

Section: Laboratory Radiological and Colonoscopical Investigationmentioning

confidence: 99%

“…Koumanidou et al in 2001 argued that the sonograhic appearance of multiple concecntric hypoechoic and hyperechoic rings is not characteristic of appendiceal intussusception but intussusception in general. She also claimed that visualization of the appendix within the head of the intussusception may be considered characteristic only when a small cyst or a "target-like" mass is demonstrated, having an outer diameter which should not exceed 6mm (Koumanidou et al, 2001). Tseng et al in 2006 reported a case of preoperative appendiceal intussusception diagnosis with endoscopic sonography, which revealed a multiconcentric ring structure in the region of the caecal base (Tseng et al, 2006).…”

Section: Laboratory Radiological and Colonoscopical Investigationmentioning

confidence: 99%

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Appendiceal Intussusception

Varsamis¹,

Pouggouras²,

Salveridis³

et al. 2012

Current Concepts in Colonic Disorders

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Preoperative sonographic diagnosis of appendiceal intussusception: A case report

Alehossein

Alizadeh

Nahvi

et al. 2009

J of Clinical Ultrasound

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Appendiceal and appendiceal-ileocolic intussusception: sonographic and radiographic evaluation

Abstract: The sonographic appearances of two children with appendiceal intussusception and two others with appendiceal-intestinal intussusception are described. All the cases were documented by barium enema and surgically confirmed.

Cited by 27 publications

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Appendiceal intussusception from endometriosis: endoscopic and laparoscopic approach

Appendiceal intussusception from endometriosis: endoscopic and laparoscopic approach

Appendiceal Intussusception

Preoperative sonographic diagnosis of appendiceal intussusception: A case report

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