Open AccessLaparoscopic surgery assisted by colonoscopy for a submucosal cecal fecalith presenting as acute appendicitis
Author(s) -
Xiuhang Ruan,
Bailiang Ye,
Zhenlin Zheng,
Huixing Zhou,
Xiaochun Zheng,
Zhenxu Zhou
Publication year - 2017
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000008872
Subject(s) - medicine , colonoscopy , acute appendicitis , appendicitis , general surgery , appendix , surgery , colorectal cancer , cancer , paleontology , biology
Abstract Rationale: A cecal submucosal fecalith is extremely rare and is likely to be misdiagnosed as appendicitis with an incarcerated fecalith. Patient concerns: This review presents the case of a female patient complaining of recurrent abdominal pain in the right lower quadrant, similar to the clinical symptoms of appendicitis. Physical examination revealed an abdominal tenderness in the right lower quadrant without rebound tenderness or muscular tension. An ultrasound examination found a mass located in the right lower abdomen. Computed tomography showed a high-density shadow in the cecal cavity. Diagnoses: A fecalith was detected in the submucosal cecal wall. The postoperative pathologic examination showed that the fecalith was located in the submucosa. Interventions: A partial cecal excision was performed under laparoscopic surgery assisted by colonoscopy. Outcomes: The patient was discharged 1 week after surgery without postoperative complications. Lessons: Fecaliths should be considered in the differential diagnosis of submucosal occupying lesions of the cecum.