盲腸炎の鑑別

Coned Cecum
A. INFLAMMATION
1. Crohn disease
√ involvement of ascending colon + terminal ileum
2. Ulcerative colitis
√ backwash ileitis (in 10%)
√ gaping ileocecal valve
3. Appendicitis
4. Typhlitis
5. Perforated cecal diverticulum

B. INFECTION
1. Tuberculosis
√ colonic involvement more prominent than that of terminal ileum
2. Amebiasis
√ involvement of cecum in 90% of amebiasis
√ thickened ileocecal valve fixed in open position
√ reflux into normal terminal ileum
√ skip lesions in colon
3. Actinomycosis
• palpable abdominal mass
• indolent sinus tracts in abdominal wall
4. Blastomycosis
5. Anisakiasis
6. Typhoid, Yersinia

C. TUMOR
1. Adenocarcinoma of the cecum
Frequency: 25% of colon cancers; 95% of malignant cecal masses are
adenocarcinomas
√ large polypoid bulky mass causing asymmetric wall thickening
√ mild pericolic fat infiltration
√ rarely obstructing
√ may act as lead point for intussusception
2. Metastasis to cecum