Caecal appendix lipomatosis in a pregnant patient mimicking acute appendicitis

Sanches, Laura Pereira; Júnior, Antônio Rahal; Falsarella, Priscila Mina; Carvalho, Vithor de Oliveira; Valle, Leonardo Guedes Moreira; Neto, Miguel José Francisco; Garcia, Rodrigo Gobbo; Funari, Marcelo Buarque de Gusmão

doi:10.31744/einstein_journal/2020rc5415

Cited by 2 publications

(3 citation statements)

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“…Appendix localization is rare for this entity. 'Submucosal lipomatosis of the appendix' was described histopathologically by Antonci in 1956 at first (6,8). Afterward, it has been reported as rare case reports.…”

Section: Introductionmentioning

confidence: 99%

“…In 36% of the patients operated with a prediagnosis of AA, lymphoid hyperplasia, fecalitis, enterobius vermicularis, carcinoid tumor, or adenoma were determined without transmural inflammation in microscopic examination of the appendix (4). 'Submucosal lipomatosis' is another entity that has been rarely reported in patients who were followed up or operated with prediagnosis of AA (6)(7)(8)(9). The histological layers of the gastrointestinal segments are mucosa, submucosa, muscularis propria, and serosa from inside to outside.…”

Section: Introductionmentioning

confidence: 99%

“…On radiological imaging techniques, thickening of the appendiceal wall which is in favor of fatty tissue without periappendiceal inflammation, fluid accumulation, or lymphadenopathy is suspicious for the diagnosis (6). Hypodense homogeneous thickening (7,8) between -80 to -120 HU on CT, high intensity in T1 and T2 weighted sequences on MRI and decreasing intensity in fat suppression sequence support fatty tissue infiltration (8). Preoperative diagnosis is important as it prevents unnecessary surgery and reduces morbidity.…”

Section: Introductionmentioning

confidence: 99%

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Is Submucosal Lipomatosis of the Appendix Vermiformis Really a Rare Entity?

Ay Haldız

2024

Harran Üniversitesi Tıp Fakültesi Dergisi

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Background: Acute appendicitis (AA) is the most common surgical emergency in patients who visit the emergency department with abdominal pain. In some of the patients who were operated with a prediagnosis of AA, lymphoid hyperplasia, fecalitis, enterobius vermicularis, carcinoid tumor, or adenoma are determined without transmural inflammation in microscopic examination of the appendix. 'Submucosal lipomatosis' is also another entity that has been rarely reported in appendix localization. In this study, we aimed to determine the frequency and severity of submucosal fatty tissue (SFT) in appendectomy specimens and identify risk factors. Materials and Methods: 293 appendectomy specimens were evaluated retrospectively. The amounts of SFT (A0: None, A1: Isolated adipocytes (Mild), A2: Small adipocyte groups (Moderate), A3: Prominent adipocyte groups (Marked), A4: Severe adipocyte groups that narrow the lumen (Severe)) and the groups that were created according to the amounts of SFT (Group 1: Cases with A1,2,3,4, group 2: Cases with A2,3,4, group 3: Cases with A3,4) were determined in hematoxylin-eosin sections. Results: 91.47% of the cases had any amount of SFT. Amounts of SFT were mild in 23.89%, moderate in 46.76%, marked in 18.09%, and severe in 2.73%. All of the cases without SFT were in pediatric age. When the amount of SFT increased, the mean age and adult rate increased regularly (p<0.05). As 68% of the cases without SFT were female, male predominance was observed in cases with SFT. When the amount of SFT increased, male rate increased regularly (p<0.05). AA wasn’t determined in 26,28% of the cases. The AA rate in the group without SFT (20%) was marked lower than group 1 (78,73%), group 2 (82,32%), and group 3 (83,87%) (p<0.05). The most prominent increase in AA rate was between the group without SFT and group 1 which was the most sensitive group to the amount of SFT. When group 1,2,3 were compared, no significant increase in the AA ratio was found. Conclusions: The presence of SFT in the appendix is a common condition. Age increase and male gender are risk factors for the accumulation of SFT. Due to SFT accumulation increases the risk of AA, it would be logical to classify it as mild/moderate/marked/severe, and accept it as 'Submucosal lipomatosis'.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Is Submucosal Lipomatosis of the Appendix Vermiformis Really a Rare Entity?

Ay Haldız

2024

Harran Üniversitesi Tıp Fakültesi Dergisi

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A Focal Submucosal Lipomatosis

Chandanwale

Patel

Verma

et al. 2023

Indian Journal of Medical Specialities

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Gastrointestinal lipomatosis is less frequent condition and it differs from lipoma due to the lack of capsule. The most common location of gastrointestinal lipomatosis is colon, followed by the ileum and jejunum. Isolated lipomatosis of the appendix is rare. It can be diffuse, asymmetric, or focal. In the localized form, only few patients present with symptoms. Obstruction of the lumen of the appendix is thought to be the primary pathology of appendicitis. Various pathologies such as hard fecal mass, stones, lymphoid hyperplasia, and neoplasia have been implicated. Obstruction of the appendiceal lumen due to isolated submucosal lipomatosis of the appendix is extremely rare. It can be one of the causes of appendicitis. Although radiological modalities such as ultrasonography, computed tomography scan, and magnetic resonance imaging are used for diagnostic workups, definitive diagnosis requires histopathological examination.

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Caecal appendix lipomatosis in a pregnant patient mimicking acute appendicitis

Cited by 2 publications

References 10 publications

Is Submucosal Lipomatosis of the Appendix Vermiformis Really a Rare Entity?

Is Submucosal Lipomatosis of the Appendix Vermiformis Really a Rare Entity?

A Focal Submucosal Lipomatosis

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