Abstract
A 61-year-old woman was admitted to a local hospital with a few days' history of persistent lower right abdominal pain. She was diagnosed as having acute appendicitis and treated conservatively with antibiotics, however, her symptoms did not improve. Then, based on the findings of abdominal ultrasonography, she was suspected as having an ileocecal abscess and was referred to our hospital. Physical examination revealed local signs of peritoneal irritation in the right iliac fossa and a hard, fist-sized mass, which was tender to palpation, was palpable. The white blood cell count and serum C-reactive protein levels were elevated. Abdominal CT showed an ileocecal abscess. Appendicitis with abscess formation was suspected based on detailed examination, and emergency surgery was scheduled. During the surgery, we observed a mass in the ileocecal region, and mucus with pus was present when the mass was removed.
Since a malignant lesion was suspected, ileocecal resection with D2 lymph node dissection was performed. The resected specimen showed an abscess in the ileocecum on the serosal side, with the appendix identified along the abscess wall. However, the mucosal surface was intact. The lesion was finally diagnosed by histopathology as a sessile serrated adenoma/polyp of the appendix. We report a rare case of appendiceal SSA/P.
