Acute appendicitis associated with carcinoma of the colon

Abstract

Summary Carcinoma of the colon, besides causing acute appendicitis, may cause symptoms resembling appendicitis. A diagnosis of appendicitis was made when carcinomatous symptoms were already present in 44 (7%) of the 603 patients with colonic carcinoma comprising this study. In 12 patients, the appendix was distinctly involved by inflammation. However, in the other patients, the symptoms of carcinoma only resembled those of appendicitis. We must remember that carcinoma of the right colon was responsible for definite appendicitis and symptoms of appendicitis. The diagnosis of appendicitis was established by symptoms, before detection of the carcinoma, in 17 per cent of patients with carcinoma of the cecum and in 14 per cent of those with carcinoma of the ascending colon. Carcinoma often escapes detection during appendectomy and leads to delays that can be serious. A correct diagnosis could be made in the majority of cases by exploring the cecum and ascending colon. Therefore, it is advisable to utilize a large incision when performing an appendectomy. To make added provision against mistakes, roentgenologic examination should be performed on patients of carcinoma age who complain of symptoms of appendicitis.