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Autoamputation of the Appendix Presenting as a Calcified Abdominal Mass Following Necrotizing Enterocolitis
Brent R Weil1, Alyaa Al-Ibraheemi2, Sara O Vargas2
11 Department of Surgery, Boston Children's Hospital, Boston, Massachusetts, USA.
Abstract:
Autoamputation of the appendix has previously been reported in the literature, but it is likely an unusual event. We report a 2-year-old male child who had previously undergone laparotomy and bowel resection for necrotizing enterocolitis. Two years later a calcified intra-abdominal mass was identified on abdominal radiography and ultrasonography. Eventual laparotomy revealed a densely calcified mass within the transverse mesocolon. The mass was uneventfully resected. Pathologic evaluation showed appendiceal tissue, consistent with prior autoamputation of the vermiform appendix. Autoamputation of the appendix has not to our knowledge previously been associated with a calcified mass nor been associated with a history of necrotizing enterocolitis, and these factors distinguish this case as noteworthy.
Insights
A rare case of autoamputation of the appendix occurred in a child with a history of necrotizing enterocolitis, presenting as a calcified intra-abdominal mass. This unique presentation highlights unusual appendiceal pathology and its potential sequelae.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Pathology
Background:
- Autoamputation of the vermiform appendix is a rare event.
- Necrotizing enterocolitis can necessitate abdominal surgery in infants.
Observation:
- A 2-year-old male, with prior laparotomy for necrotizing enterocolitis, presented with a calcified intra-abdominal mass.
- Radiography and ultrasonography identified the mass within the transverse mesocolon.
Findings:
- Laparotomy revealed and resected a densely calcified mass.
- Pathologic evaluation confirmed the mass to be appendiceal tissue, indicative of autoamputation.
Implications:
- This case represents the first reported instance of autoamputation of the appendix associated with a calcified mass.
- The history of necrotizing enterocolitis is a novel factor in this unusual presentation of appendiceal autoamputation.
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