33 Filling Defects in the Cecum

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

• Fig GI 33-1 Periappendiceal abscess. There is fixation and a mass effect at the base of the cecum with no filling of the appendix.

• Fig GI 33-2 Periappendiceal abscess. Severe inflammatory mucosal changes and a mass effect on the lateral aspect of the ascending colon (arrows) in a patient with a ruptured retrocecal appendix.

• Fig GI 33-3 Inverted appendiceal stump. In this example, the mass (arrows) is large and irregular, simulating a neoplasm at the base of the cecum.

• Fig GI 33-4 Mucocele of the appendix. Smooth, broad-based filling defect (arrow) indents the lower medial part of the cecum. There is no filling of the appendix with barium.

• Fig GI 33-5 Intussusception of the appendix (arrow). After reduction, the cecum and appendix appeared normal on another barium enema examination.

• Fig GI 33-6 Adenocarcinoma of the appendix. The extensive tumor produces a large mass (arrows) that mimics an intraluminal cecal neoplasm.

• Fig GI 33-7 Carcinoma of the pancreas metastatic to the cecum. There is a localized extrinsic pressure defect (arrows) on the medial and inferior aspects of the cecum and no filling of the appendix.

• Fig GI 33-8 Solitary benign ulcer of the cecum. Lobular soft-tissue mass centered at the ileocecal valve (arrows) with a central irregular barium collection representing ulceration.42

• Fig GI 33-9 Adherent fecalith (arrows) in cystic fibrosis.

• Fig GI 33-10 Burkitt's lymphoma. A huge mass fills essentially the entire cecum.10