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Submucosal mucoid as a late complication after appendectomy-A case report
Kristýna Bajcurová1, Petr Novák2, Eva Korčáková1
1Department of Imaging Methods, Charles University Medical School and Teaching Hospital in Pilsen, Alej Svobody 923/80, 304 60, Pilsen, Czech Republic; Biomedical Centre, Charles University Medical School in Pilsen, Alej Svobody 1655/76, 323 00, Pilsen, Czech Republic.
Introduction:
Shortly after an operation infection, intraabdominal abscess, seroma, haemorrhage or development of paralytic ileus may occur. Postoperative adhesions, nonspecific abdominal pain without signs of obstruction, incisional hernia and appendicitis or mucocele in appendiceal stump present common late complications. We present a unique case of a late complication after appendectomy.
Presentation Of Case:
The case report describes a unique expansion in the ascending colon of a young athlete with long-lasting abdominal pain in the lower right quadrant. Colonoscopy showed a lesion in a wall of the ascending colon. Computed tomography (CT) confirmed a cystoid formation of high content density in a wall of the caecum. A right hemicolectomy was performed. Histology showed a lesion located in the submucosa with intestinal lining and stroma rich in lymphoid cells. These are the typical attributes of the wall of the appendix. Other parts of the wall were not demonstrated, and there was no communication with the lumen of the native bowel.
Conclusion:
A submucosal cavity filled with acellular matter, which were probably disintegrated epithelioid structures, and calcifications were found in the ascending colon, while no intestinal cell atypia or dysplasia was found. The case cannot be classified under any previously presented diagnosis.
Insights
A rare late complication following appendectomy presented as an ascending colon lesion in a young athlete. This unique case involved a submucosal cavity, likely of appendiceal origin, not fitting any established diagnosis.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Appendectomy complications include infections, abscesses, and hernias.
- Late complications can manifest as chronic pain or stump issues.
Purpose of the Study:
- To report a unique late complication after appendectomy.
- To describe a rare ascending colon lesion with appendiceal features.
Main Methods:
- Case report of a young athlete with chronic right lower quadrant pain.
- Diagnostic workup included colonoscopy and computed tomography (CT).
- Surgical intervention involved a right hemicolectomy with subsequent histological analysis.
Main Results:
- A submucosal lesion in the ascending colon/cecum was identified.
- Histology revealed features consistent with appendiceal wall tissue.
- The lesion contained acellular matter and calcifications, with no atypia or dysplasia.
Conclusions:
- The described lesion represents an unclassified, unique late complication post-appendectomy.
- Appendiceal remnants can present atypically in distant colonic locations.
- This case highlights the importance of considering unusual presentations of post-surgical complications.
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