title: A rare congenital anomaly, bridge-like appendiceal fistula to the terminal ileum, demonstrated by MDCT.
abstract: Although appendiceal anatomical anomalies are very rare, understanding of the anatomical details of these anomalies is important for surgery. In this case report, we present images from multi-detector row computed tomography (MDCT) and histological findings of a rare anatomical appendiceal anomaly originating from the cecum and opening into the terminal ileum like a bridge. These anatomical details were clearly depicted on MDCT with multi-planar reconstruction. MDCT demonstrated a communication between the appendix and terminal ileum. Histological analysis revealed that a normal mucosal layer was maintained from the appendix to the connected ileum, without any evidence of inflammatory or neoplastic changes, and only thickening of the muscular layer of the appendix was identified. Based on these histological findings, the appendix was considered to represent an anatomical anomaly rather than secondary fistula caused by inflammation or neoplasm, which has not yet been reported.
authors.affiliation: Department of Radiology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji, Fukui 910-1193, Japan.
authors.forename: Kayo
authors.initials: K
authors.lastname: Takeuchi
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Kosaka
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Kinoshita
authors.forename: Toyohiko
authors.initials: T
authors.lastname: Sakai
authors.forename: Katsuji
authors.initials: K
authors.lastname: Sawai
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Imamura
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Kimura
mesh_terms: D001062:Appendectomy / Q000379:methods; D001065:Appendix / Q000002:abnormalities* / Q000000981:diagnostic imaging; D001707:Biopsy, Needle; D003287:Contrast Media; D003937:Diagnosis, Differential; D004065:Digestive System Abnormalities / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007082:Ileum / Q000002:abnormalities / Q000000981:diagnostic imaging*; D007150:Immunohistochemistry; D033162:Incidental Findings; D007412:Intestinal Fistula / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D011856:Radiographic Image Enhancement / Q000379:methods*; D035583:Rare Diseases
chemical_list: D003287:Contrast Media