Appendicitis Secondary to Obstructing Ascending Colon Malignancy.

Area of Science:

• Gastroenterology
• Surgical Oncology
• Abdominal Imaging

Background:

• Appendicitis typically presents with right lower quadrant pain due to appendiceal orifice obstruction.
• Common causes include lymphoid hyperplasia, fecaliths, or infection, leading to inflammation and potential perforation.
• Neoplastic obstruction, though rare, can also cause appendicitis, particularly in older individuals.

Observation:

• A 68-year-old male presented with atypical symptoms suggestive of perforated appendicitis.
• The patient's presentation deviated from the classic periumbilical pain localizing to the right lower quadrant.
• Imaging and subsequent surgical findings revealed an underlying colonic adenocarcinoma as the cause.

Findings:

• The colonic adenocarcinoma obstructed the appendiceal orifice, leading to perforated appendicitis.
• This case underscores that appendicitis in older populations may present atypically.
• Neoplastic etiology should be considered in elderly patients with appendicitis, especially with unusual symptoms.

Implications:

• Highlights the importance of considering colonic adenocarcinoma in the differential diagnosis of appendicitis in older patients.
• Emphasizes the need for thorough investigation in atypical appendicitis presentations, regardless of age.
• Suggests potential for earlier cancer detection through evaluation of unusual appendicitis cases.