Perforated acute appendicitis resulting from appendiceal villous adenoma presenting with small bowel obstruction: a case report

BMC Gastroenterology

Case Report

Yu-Guang Chen¹  Yen-Lin Chen²  Chin-Hui Hsu³  Yi-Chiao Cheng⁴  Hao-Ming Chang⁴ 

[1] Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taiwan;Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taiwan;Division of gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taiwan;Division of general surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taiwan;

关键词: Appendicitis;    Intestinal Obstruction;    Acute Appendicitis;    Small Bowel Obstruction;    Perforated Appendicitis;   

DOI  :  10.1186/1471-230X-11-35

 received in 2010-11-18, accepted in 2011-04-09,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundA villous adenoma is an extremely rare benign tumour in the appendix, in contrast to other benign appendiceal lesions. The clinical features are usually asymptomatic. Acute appendicitis is the most common complication with the lesion obstructing the orifice of the appendiceal lumen. Thus, a villous adenoma is usually found during surgical intervention for acute appendicitis. Mechanical obstruction induced by acute perforated appendicitis has been previously reported. Acute appendicitis caused by a villous adenoma presenting with acute intestinal obstruction has not been previously reported.Case presentationA 78-year-old woman presented to our Emergency Department with diffuse abdominal pain and tenderness. The abdominal plain film and computed tomography revealed an intestinal obstruction. After surgical intervention, the ruptured appendix was shown to be associated with intestinal obstruction. The post-operative pathologic diagnosis was an appendiceal villous adenoma.ConclusionsThis is the first report describing an appendiceal villous adenoma, which is an occasional cause of perforated acute appendicitis, presenting as a complete intestinal obstruction. We emphasize that in elderly patients without a surgical history, the occult cause of complete intestinal obstruction must be determined. If an appendiceal tumour is diagnosed, an intra-operative frozen section is suggested prior to selecting a suitable method of surgical intervention.

【 授权许可】

Unknown   
© Chen et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.