INVERTEDAPPFNDICAL STUMP SIMULATING CANCER OF THE CECUM

Roentgenographic diagnosis of abnormality in the cecum can often be misleading. It is not always possible to differentiate neoplastic changes from benign conditions that distort the cecum, even with air contrast studies. The commonest conditions causing difficulty in roentgenographic differential diagnosis in the cecal region are fecal scyballa, distortion secondary to an appendical abscess, regional ileitis, tuberculosis, cecal diverticulitis, amebic involvement of the cecum, ulcerative colitis, adhesions following an appendectomy, and an inverted appendical stump. The case we are reporting is that of patient who had had an appendectomy. An irregular filling defect of the cecum, suggestive of a neoplasm on examination, was found at surgery to be an inverted appendical stump. Gottlieb and associates emphasized the ever-present danger of misinterpreting feces for an intraluminal defect. Adequate preparation plus air contrast enemas are important. An appendical abscess will give an extraluminal smooth mass but may give enough distortion to make