Abstract
A 38-year-old man was admitted to our hospital with a cecal submucosal tumor. One year ago, he had undergone an appendectomy for acute appendicitis at another hospital. Colonoscopy revealed a cecal submucosal tumor at an orifice of the appendix. Endoscopic ultra sonography showed that tumor was hypoechic and developed from a muscularis propria. Enhanced computed tomography (CT) revealed that the regional lymph nodes were swelling. He underwent laparoscopic-assisted ileocecal resection because of a possibility of malignancy. Pathological diagnosis revealed that a foreign-body granuloma was formed around a silk braid. The patient was discharged on postoperative day 9 without complication. According to the operation record of his appendectomy, the appendix was ligated with a silk braid.
Some cases have been reported of cecum granuloma formed around sutures which were used during appendectomy. A foreign-body granuloma should be considered in cases of cecal submucosal tumors. This case suggests that a silk braid used in an appendectomy can lead to the formation of granuloma ; therefore, thread made from monofilament or absorbable suture material should be used to prevent foreign-body granuloma formation.
