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Q. CT scan and colonoscopy reports show appendiceal orifice. Kindly explain.

Answered by
Dr. Vivek Chail
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Dec 02, 2020

Hello doctor,

I had an abdominal CT scan with oral and IV contrast. However, the radiologist did not find my appendix on the scan. The CT scan was done, and my colonoscopy revealed that appendiceal orifice. Please help.

#

Hi,

Welcome to icliniq.com.

I have thoroughly reviewed the CT abdomen scan images (attachment removed to protect patient identity). It is true that a typical appendix-like structure is not visualized in the given images. It can mean that your appendix is small and compressed by the adjacent bowel in the ileocaecal junction area.

The details of colonoscopy on the appendiceal orifice is not complete to provide more details of the findings of colonoscopy with reference to the appendix.

Thank you doctor,

I have attached the colonoscopy report. My surgeon and gastro recommended removing the appendix. Please let me know what you think.

#

Hi,

Welcome back to icliniq.com.

The colonoscopy report (attachment removed to protect patient identity), shows a tumor-like area in the appendiceal orifice and is in the caecum. This might have been partially obscured in the CT scan images or might be compressed and therefore not clearly visualized in the images.

A routine CT abdomen gives a general idea of the abdominal structures, and it is possible that small lesions are not well visualized. Other factors can be that the lesion is soft and has compressed into the bowel wall adjacent to the appendiceal orifice and not seen.

The above are possible reasons when a CT abdomen might not show lesions documented on colonoscopy. A virtual colonoscopy may be scheduled if you still desire to have the best imaging techniques to visualize the appendiceal orifice tumor.

Whether to proceed with surgery to remove the appendix, it will help to know any biopsy results provided to you. The appendix is a non-important organ but can develop small collections that we call mucoceles and rarely show malignancy. I have come across a few cases of cancer of the appendix in my clinical practice.

Keeping in mind your good health in the future, and after analyzing biopsy results, appendix removal might be one of the recommended treatments, even if the biopsy results do not confirm a malignancy.


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