PMC3745926_01
Right colon mass on colonoscopy.
CRIM.SURGERY2013-525081.001.jpg
PMC3745926_01_CRIM.SURGERY2013-525081.001.jpg
fig1
During a difficult colonoscopy at a charity clinic, a large tumor was found in his right colon that precluded passage of the scope to the cecum (see Figure 1).
Right colon and mesenteric masses on CT.
CRIM.SURGERY2013-525081.002.jpg
PMC3745926_01_CRIM.SURGERY2013-525081.002.jpg
fig2
The imaging demonstrated a 5 x 5 cm mass in the mesentery with spiculated calcifications, as well as an additional mass near the ileocecal valve that had the appearance of an intussusception (see Figure 2).
CT showing SMA dorsal to SMV.
CRIM.SURGERY2013-525081.003.jpg
PMC3745926_01_CRIM.SURGERY2013-525081.003.jpg
fig3
Malrotation was not suspected, although later review of the imaging with a specialized CT radiologist demonstrated inversion of the normal SMA to SMV configuration (see Figure 3).
Depiction of intraoperative findings of malrotation and right colon and mesenteric masses.
CRIM.SURGERY2013-525081.004.jpg
PMC3745926_01_CRIM.SURGERY2013-525081.004.jpg
fig4
The cecum and appendix were found to occupy the left upper quadrant (see Figures 4 and 5).
Intraoperative finding of right colon mass in setting of malrotation.
CRIM.SURGERY2013-525081.005.jpg
PMC3745926_01_CRIM.SURGERY2013-525081.005.jpg
fig5
The cecum and appendix were found to occupy the left upper quadrant (see Figures 4 and 5).