GI Radiography
Case 6 :
 
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A 60-year-old male presented with acute abdominal pain on the right and vomiting since 2 days. CT scan of abdomen was performed. What is the diagnosis?

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Imaging Findings

CT examination shows circumferential thickening of the large bowel (caecum / ascending colon), with an eccentrically placed enhancing polypoidal lesion within. Fuzziness of fat planes is seen around this lesion, suggestive of inflammation, with a small amount of loculated fluid.

Operative findings revealed a polypoidal mass lesion at the base of caecum, which had intussuscepted. No adjacent lymphadenopathy was found on table. A right hemicolectomy was performed. Histopathology revealed a benign adenoma.

Diagnosis

Polypoidal caecal mass lesion causing intussusception

Discussion

Adenomatous polyps are divided into the tubular adenoma, intermediate type (tubulovillous adenoma) and villous adenoma, according to the histological arrangement of stroma and epithelium. Tubular adenomas are commoner, while villous adenomas have the greatest malignant potential. Tubular adenomas may be single or multiple, and sessile or pedunculated, they occur in familial polyposis of the colon and in Gardener’s syndrome.

Contribution

Dr. Ian D’Souza, Dr. Sanjeev Mani, Mumbai