A Case of Appendiceal Intussusception

Abstract

A case of appendiceal intussusception was reported. A 69-year-old female was admitted to our hospital complaining of right lower quadrant pain. A hard mass with tenderness was palpated in the right lower abdomen. Initial ultrasonographic examination of the abdomen revealed a dilated large intestine with multiple layer sign and the 5cm-sized mass in the lead. Computed tomography of the abdomen showed the lamellar structure of the large intestine and the mass with calcification. By enema study using gastrografin, the patient was diagnosed as having intussusception of the transverse colon. Subsequently, colonofiberscopy revealed a giant ulcer of the transverse colon and a protruding mass at the base of the cecum. Ultrasonography of the cecum also demonstrated a dilated appendix with multiple concentric ring sign. On laparotomy, the mass of the cecum was diag-nosed as intussusception of the vermiform appendix. This was reduced and an appendec-tomy was performed. The pathological diagnosis of the specimen was carcinoma in ade-noma of the appendix. Such a case of appendiceal intussusception with adenocarcinoma of the appendix is extremely rare. Retrospectively, preoperative ultrasonography showed the characteristic appearance of appendiceal intussusception. Although preoperative diagnosis of appendiceal intussusception is very difficult, it was emphasized that ultrasonographic examination may be valuable for diagnosis thereof.