Malignant Appendeceal Carcinoid Tumour with Intestinal Obstruction and Caecal Perforation: A Case Report in Northern Ghana
Research Reports in Gastroenterology has recently launched a case report which is related to Appendeceal Carcinoid Tumour with Intestinal Obstruction and Caecal Perforation.
A 43-year-old man presented to the Medical/Surgical Emergency Unit of the Tamale Teaching Hospital (TTH) with a day’s history of vomiting associated with severe abdominal pain and distension.
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Carcinoid tumours are the most common neoplasms of the appendix. These tumours are generally asymptomatic; however, symptomatic patients may clinically mimic acute appendicitis and or intestinal obstruction. There are a few publications in Ghana which mention carcinoid tumours. However, these publications do not give much attention to the clinico-pathological features of this tumour as an entity, or highlight the possible complications of the disease. Presented in this case report is a 43-year-old man who was seen with signs and symptoms of acute intestinal obstruction at the Medical/Surgical Emergency Department of the Tamale Teaching Hospital (TTH). He had an emergency exploratory laparotomy and right hemicolectomy. Subsequent histopathological examination of the specimen revealed a metastatic carcinoid tumour to the intestines with caecal obstruction and perforation. The origin of the carcinoid tumour was the appendix. Clinicians should exhibit a high index of suspicion concerning right-sided large bowel obstruction and thoroughly investigate the cause of the obstruction and attempt to exclude neoplasm of the appendix, which though rare, can be the cause of the obstruction as demonstrated in this case. The final diagnosis is made after an extensive histopathological examination.
Type of surgery
Exploratory laparotomy with right hemicolectomy and end-to-end ileo-colic anastomosis, and a repair of the right inguinal hernia were carried out. Findings at surgery Complex solid appendiceal mass Distended caecum with perforation at the base. Solid nodules palpable within the walls of the caecum, ileum and jejunum. Empty hernia sac. Pus in the pelvic cavity.
Preoperative diagnosis of carcinoid of the appendix, a very rare condition, is very diÙ¹cult to make. Ðe condition can lead to complications such as perforations of the bowel and intestinal obstruction. Clinicians should have a high index of suspicion when dealing with conditions of the appendix to be able to investigate the patients appropriately, including imaging, and to have a diÙˆÙ´erentiDl diagnosis of tumours of the appendix in mind, even though they are rare. All resected appendices should be examined histopathologically even when they appear normal.
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Research Reports in Gastroenterology