An inverted appendix found on routine colonoscopy: A case report with discussion of imaging findings

Abstract

Appendiceal inversion is an uncommon incidental finding on colonoscopy that can mimic pathologic processes such as colon polyps and neoplasms due to its mass-like appearance. Endoscopic removal of these lesions has been associated with a higher risk of peritonitis and bleeding. Awareness of appendiceal inversion may potentially decrease unwarranted interventions as well as its associated risks. Although there are many reported cases of iatrogenic appendiceal inversion due to the traditional inversion-ligation technique performed during open appendectomy, there are few reported cases of asymptomatic appendiceal inversion without a known history of iatrogenic inversion. Here, we present a case of an asymptomatic patient with appendiceal inversion and no prior history of appendectomy. Furthermore, we discuss management and characteristic imaging findings of appendiceal inversion that may help to distinguish it from similarly appearing pathologic conditions.

Keywords: Appendiceal inversion; Colonoscopy; Inverted appendix.

Fig. 1

Images obtained during colonoscopy demonstrating a tubular lesion in the ascending colon.

Fig. 2

CT demonstrating an intraluminal tubular structure in the cecum.

Fig. 3

Contrast CT 4 years prior demonstrating similar intraluminal tubular structure in the cecum.