Submucosal Lipomatosis of Caecum with Concomitant Acute Appendicitis: A Diagnostic Dilemma

Abstract

Colonic lipomatosis is relatively a rare tumour of mesenchymal origin, composed of welldifferentiated adipocytes interlaced by fibrous tissues. A 59-year-old lady presented with right iliac fossa pain with positive rebound tenderness, Rovsing’s and obturator signs. Investigation revealed marked leucocytosis suggestive of an acute appendicitis. Diagnostic laparoscopy revealed an inflamed appendix with concomitant caecal mass suspecting of a malignancy. Laparoscopic right hemicolectomy was proceeded following oncologic resection. However, final histopathologic examination was consistent with caecal colonic lipomatosis with concomitant acute appendicitis. Hereby, dual pathologies can be elicited in an acute abdomen.

Keywords: acute abdomen, acute appendicitis, colonic lipomatosis.