Erişkin bir hastada çekumda polipoid kitle olarak prezente olan şaşırtıcı bir olgu: apendiks intussusepsiyonu

Öz

Apendiks intussusepsiyonu yetişkin bir hastada nadir görülen bir durumdur ve başlangıçta klinik veya radyolojik olarak ayırıcı tanıda düşünülmeyebilir. Organik bir nedene bağlı olarak veya idiyopatik olarak ortaya çıkar. Bu yazıda, kolonoskopide çekumda polipoid lezyon saptanan ve radyolojik görüntüleme yapılmayan, sonuçta gross ve histopatolojik olarak apendiks intussusepsiyonu tanısı konulan 74 yaşında bir hasta sunulmuştur. Sonuç olarak, hekimlere çekumda kitle şüphesi ile başvuran tüm hastalarda apendiks intussusepsiyonunu alternatif bir tanı olarak düşünmeleri önerilmektedir.

Anahtar Kelimeler

• Appendiks vermiformis
• çekum
• intussusepsiyon
• apendiksin inversiyonu

A puzzling case presenting as a polypoid mass in the cecum in an adult patient: appendiceal intussusception

Öz

Appendiceal intussusception is a rare condition in an adult patient and may not be initially considered in the differential diagnosis clinically or radiologically. It occurs due to an organic cause or idiopathically. We report a 74-year-old patient who had a polypoid lesion in the cecum on colonoscopy with no radiologic imaging and was ultimately diagnosed grossly and histopathologically as appendiceal intussusception. In conclusion, physicians are advised to consider appendiceal intussusception as an alternative diagnosis in all patients presenting with a suspected cecal mass.

Anahtar Kelimeler

• Appendix vermiformis
• intussusception
• cecum
• inverted appendix

Kaynakça

1. 1. Birkness J, Lam Himlin D, Byrness K, Wood L, Voltaggio L. The inverted appendix – a potentially problematic diagnosis: clinicopathologic analysis of 21 cases. Histopathology 2019;74:853-860. https://doi. org/10.1111/his.13824
2. 2. Kimura N, Hiraki M, Sato H, Koga H, Mori D, Tanaka T, Kitahara K. Intussusception of the cecum due to the acute appendicitis: a case report. Int J Surg Case Rep 2022;100:107727. https://doi.org/10.1016/j. ijscr.2022.107727
3. 3. Salehzadeh A, Scala A, Simson JN. Appendiceal intussusception mistaken for a polyp at colonoscopy: case report and review of literature. Ann R Coll Surg Engl 2010;92:46-48. https://doi.org/10.1308/14787081 0X12699662981591
4. 4. Zenger S, Bilgiç Ç, Buğra D. Laparoscopic partial cecum resection in appendiceal intussusception. Turk J Surg 2018;35:74-77. https://doi.org/10.5578/turkjsurg.3633
5. 5. Chaar CI, Wexelman B, Zuckerman K, Longo W. Intussusception of the appendix: comprehensive review of the literature. Am J Surg 2009;198:122-128. https:// doi.org/10.1016/j.amjsurg.2008.08.023
6. 6. Adhikari AB, Acharya K, Kathayat K, Bhatta NC, Koirala DP, Dahal GR. Forshal type IE appendiceal intussusception: A case report. Int J Surg Case Rep 2021;84:106151. https://doi.org/10.1016/j. ijscr.2021.106151
7. 7. Grama F, Onica M, Chitul A, Bezede C, Burcoş T, Cristian D. Appendix intussusception: a challenging differential diagnosis. ANZ J Surg 2020:90;2090-2091. https://doi.org/10.1111/ans.15727
8. 8. Petracic I, Pajic A, Visnjic S, Gliha A, Car A, Petracic AO. Appendiceal intussusception in pediatric patient - cse report. J Surg Curr Trend Innov 2020;4:026. https:// doi.org/10.24966/SCTI-7284/100026