Ruan Xiao-Jiao, Ye Bai-Liang, Zheng Zhi-Hai, Zhou Huan-Hao, Zheng Xiao-Feng, Zhou Zhen-Xu
Department of General Surgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, China.
Medicine (Baltimore). 2017 Nov;96(47):e8872. doi: 10.1097/MD.0000000000008872.
A cecal submucosal fecalith is extremely rare and is likely to be misdiagnosed as appendicitis with an incarcerated fecalith.
This review presents the case of a female patient complaining of recurrent abdominal pain in the right lower quadrant, similar to the clinical symptoms of appendicitis. Physical examination revealed an abdominal tenderness in the right lower quadrant without rebound tenderness or muscular tension. An ultrasound examination found a mass located in the right lower abdomen. Computed tomography showed a high-density shadow in the cecal cavity.
A fecalith was detected in the submucosal cecal wall. The postoperative pathologic examination showed that the fecalith was located in the submucosa.
A partial cecal excision was performed under laparoscopic surgery assisted by colonoscopy.
The patient was discharged 1 week after surgery without postoperative complications.
Fecaliths should be considered in the differential diagnosis of submucosal occupying lesions of the cecum.
盲肠黏膜下粪石极为罕见，很可能被误诊为伴有嵌顿粪石的阑尾炎。
本病例报告了一名女性患者，主诉右下腹反复疼痛，与阑尾炎临床症状相似。体格检查发现右下腹压痛，无反跳痛或肌紧张。超声检查发现右下腹有一肿块。计算机断层扫描显示盲肠腔内有高密度影。
在盲肠壁黏膜下检测到粪石。术后病理检查显示粪石位于黏膜下层。
在结肠镜辅助下行腹腔镜下部分盲肠切除术。
患者术后1周出院，无术后并发症。
在鉴别诊断盲肠黏膜下占位性病变时应考虑粪石。
