A DIAGNOSTIC TWIST: CAVERNOUS HEMANGIOMA PRESENTING AS ACUTE APPENDICITIS paolomerino@hotmail.com

 

A DIAGNOSTIC TWIST: CAVERNOUS HEMANGIOMA PRESENTING AS ACUTE APPENDICITIS

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Spain

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Cavernous hemangiomas are benign vascular tumors relatively frequent in organs such as the skin, central nervous system and bones and exceptionally rare in the gastrointestinal tract. These lesions typically show up as intermittent stomach pain, chronic iron deficiency anemia, or lower gastrointestinal hemorrhage.

A 16 year-old male presented with 24 hours of severe right iliac fossa pain radiating to the left ,asociated with vomiting , fever and anorexia. Physical exam revelaed positive Mc Burney , Rovsing and Blumberg signs. Laboratory tests showed leukocytosis with neutrophilia. Clinical suspicion of acute appendicitis led to exploratory laparotomy.

Intraoperatively, a coralliform mass approximately 8 × 10 cm in size was discovered, involving the cecum and the proximal third of the ascending colon. The mass had an ecchymotic appearance.The patient recovered uneventfully, passing stool on postoperative day six, and was discharged in stable condition with a soft diet and scheduled outpatient follow-up. Histopathological analysis confirmed the diagnosis of a cavernous hemangioma.

Although the initial clinical suspicion pointed toward acute appendicitis, intraoperative findings revealed a cavernous hemangioma of the colon, an exceptionally rare vascular lesion in this age group and location. Timely surgical management and appropriate postoperative care contributed to a favorable outcome, reinforcing the critical role of early intervention and vigilant clinical follow-up in rare gastrointestinal vascular pathologies.