Radiologic analysis of cecal filling defects and local wall displacement

It has long been accepted that cecum and ileocecal valve are prime important area in GI roentgenology because of variety and frequency of primary and secondary disease involvement. However, precise preoperative diagnosis is still debatable roentrenologically. It is necessary to use the more descriptive terms and systemic approach for roentgenologic diagnosis in this area. Authors analyzed pathologically verified 54 cases of cecal lesion by double contrast colon examination at Yonsei University Medical College Severance Hospital from January 1975 to September 1980. Of the distribution of diseases, pericecal abscess (16/54; 29.6%) was most common, and followed by intestinal tuberculosis (9/54; 16.6%), and carcinoma (9/54; 16.6%) etc. The ratio of male and female was 2.18 : 1 and peak incidence was above 4th decade. The majority of cases show right lower quadrant pain and palpable mass as clinical manifest ion. Of the radiologic findings, abnormality in appendix such as nonfilling or irregular filling of barium suggest pericecal abscess, mucocele and less frequently adenocarcinoma of cecum, and characteristically pericecal abscess show rather smooth displacement of medical wall of cecum, but abrupt transition of lesion is shown in adenocarcinoma. Irritability and shortening of cecum, and flxation and spiculation of terminal ileum were frequently found in inflammatory conditions such as pericecal abscess, intestinal tuberculosis and chronic nonspecific inflammation. Cecal lesion associated with involvement of ileocecal value were noted in intestinal tuberculosis, lymphoma and adenocarcinoma