Chebbo Houssein, Yazbak Amer, Saleh Sarah, Karam Karam, Azizi Lamia, Fiani Elias
Faculty of Medicine, University of Balamand, Dekweneh-Beirut, Lebanon.
Department of Gastroenterology, Faculty of Medicine, University of Balamand, Dekweneh-Beirut, Lebanon.
Eur J Case Rep Intern Med. 2024 Aug 14;11(9):004783. doi: 10.12890/2024_004783. eCollection 2024.
Cystica profunda is a rare benign finding of mucous-filled cysts in the submucosa of the gastrointestinal tract, more commonly found in the rectum and colon. Risk factors include rectal prolapse, inflammatory bowel diseases, pelvic radiation and being post-appendectomy. We present a case of a female patient presenting with rectorrhagia, found to have sigmoidal colitis cystica profunda (CCP) six months post-appendectomy. This case is one of the few in medical literature to highlight the direct association between laparoscopic appendectomy and CCP, previously discussed in the literature as a complication post-appendectomy in the American Journal of Gastroenterology.
Physicians should have a high index of suspicion to rule out colitis cystica profunda (CCP) when approaching a patient with rectorrhagia following laparoscopic appendectomy.It is pivotal to make a prompt diagnosis for CCP in the context of rectorrhagia and initiate timely management.It is important to differentiate CCP from other aetiologies of lower gastrointestinal tract bleed as it is coined 'the great imitator'.
深部囊肿是胃肠道黏膜下层充满黏液的囊肿的一种罕见良性表现，更常见于直肠和结肠。危险因素包括直肠脱垂、炎症性肠病、盆腔放疗和阑尾切除术后。我们报告一例女性患者，阑尾切除术后6个月出现直肠出血，被发现患有乙状结肠深部囊肿（CCP）。该病例是医学文献中少数强调腹腔镜阑尾切除术与CCP之间直接关联的病例之一，此前《美国胃肠病学杂志》曾将其作为阑尾切除术后的一种并发症进行过讨论。
对于腹腔镜阑尾切除术后出现直肠出血的患者，医生应高度怀疑以排除深部囊肿性结肠炎（CCP）。在直肠出血的情况下，及时诊断CCP并启动及时治疗至关重要。将CCP与下消化道出血的其他病因区分开来很重要，因为它被称为“伟大的模仿者”。
