Bleeding caecal mass: a rare finding

Beck, Matthew; He, Mike

doi:10.1093/jscr/rjv116

Cited by 3 publications

(3 citation statements)

References 5 publications

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“…This case expands the differential of massive lower GI bleeding to include cecal mucosal bleeding: a likely intermittent cause that is amenable to endoscopic management with epinephrine and electrocautery. While there have been reported cases of cecal Dieulafoy lesions 4 and other submucosal masses, 5 this endoscopic evaluation did not identify any visible, gross lesion as the cause for bleeding other than the mucosa. The patient's mucosal bleeding was identified in the setting of uremic platelet dysfunction 3 and therapeutic anticoagulation (apixaban).…”

Section: Discussioncontrasting

confidence: 55%

Case report: An unusual case of cecal mucosal bleeding

Kamara

Sugawa

2022

JGH Open

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Cecal mucosal bleeding is an undocumented and rare cause of lower gastrointestinal (GI) bleeding. We present a case of a 73-year-old woman with end-stage renal disease and paroxysmal atrial fibrillation on apixaban who presented with lower gastrointestinal bleed. She was found to have symptomatic, acute chronic anemia requiring multiple packed red blood cell transfusions. Colonoscopy revealed a localized area of active, cecal mucosal bleeding without evidence of Dieulafoy lesion, ulcer, mass, arteriovenous malformation, or diverticula. Hemostasis was achieved with epinephrine injection and the use of bipolar electrocautery. She was later resumed on her therapeutic anticoagulation without recurrence of bleeding. Therapeutic anticoagulation in our patient with ESRD increased her risk for gastrointestinal bleeding. Had this transient, mucosal-limited bleeding not been active during endoscopic evaluation, the etiology of her massive gastrointestinal bleeding would have been missed. This case expands the differential of acute, lower GI bleeding to include cecal mucosal bleeding, which is a rare, intermittent, cause of bleeding that is amenable to endoscopic management.

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Section: Discussioncontrasting

confidence: 55%

Case report: An unusual case of cecal mucosal bleeding

Kamara

Sugawa

2022

JGH Open

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“…[ 1 ] Matthew described an intestinal hemorrhage induced by a cecal fecalith, which was managed by cecal resection; the fecalith was located proximal to the ileocecal valve and was extruded from the cecalcavity. [ 2 ]…”

Section: Discussionmentioning

confidence: 99%

“…Enteroscopy shows a bulging mass on the cecal cavity wall without a mucosal ulcer, which could be misdiagnosed as a submucosal neoplasm. As reported, a cecal submucosal fecalithis a symptomatic or presents as intestinal hemorrhage [ 1 , 2 ] ; however, a cecal submucosal fecalith leading to recurrent right lower quadrant abdominal pain, similar to the clinical symptoms of appendicitis, has not been reported. Herein, we report a female patient presenting with recurrent right lower quadrant abdominal pain, which was first misdiagnosed as appendicitis.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic surgery assisted by colonoscopy for a submucosal cecal fecalith presenting as acute appendicitis

Ruan

Zheng

et al. 2017

Medicine

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Rationale:A cecal submucosal fecalith is extremely rare and is likely to be misdiagnosed as appendicitis with an incarcerated fecalith.Patient concerns:This review presents the case of a female patient complaining of recurrent abdominal pain in the right lower quadrant, similar to the clinical symptoms of appendicitis. Physical examination revealed an abdominal tenderness in the right lower quadrant without rebound tenderness or muscular tension. An ultrasound examination found a mass located in the right lower abdomen. Computed tomography showed a high-density shadow in the cecal cavity.Diagnoses:A fecalith was detected in the submucosal cecal wall. The postoperative pathologic examination showed that the fecalith was located in the submucosa.Interventions:A partial cecal excision was performed under laparoscopic surgery assisted by colonoscopy.Outcomes:The patient was discharged 1 week after surgery without postoperative complications.Lessons:Fecaliths should be considered in the differential diagnosis of submucosal occupying lesions of the cecum.

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