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The authors present the case of a very rare pseudomyxoma peritonei as a late complication of appendectomy. The definite diagnosis was established 11 years after appendectomy for appendiceal mucocele. In the paper the authors emphasize the need for correct retrospective evaluation of all data in patients with unusual diagnoses.

Abdominal tuberculosis is a rare disease. Therapy usually consists in drug treatment while surgery is only performed in complicated cases. We report on a 75 year-old man who presented with clinical and radiologic signs of bowel obstruction. The patient complained of weight loss and B-symptoms. There was a history of drug treatment for tuberculosis of the neck and throat in the medical department four weeks prior to admission. Intraoperatively a coecum stenosis was found due to a large tumor that macroscopically appeared with a diffuse carcinomatosis of the peritoneum. A right hemicolectomy was performed. Histopathology findings revealed a granulomatous inflammation with epithelioid cells. Signs of peritoneal carcinomatosis were not seen. The patient recovered well after an additional tuberculostatic treatment and was discharged after 14 days. At present he is free of symptoms. Even after tuberculostatic treatment lymphatic tuberculosis might show signs of progression that can lead to an abdominal presentation.

The topography of the cecum and the proximal loop of the colon was studied in 32 cattle of different german breeds, female gender and different age (5.2 +/- 2.0 years), which were surgically treated for cecal dilatation in the Medical and Forensic Veterinary Clinic II of the Justus-Liebig-University in Giessen. In 13 cases (41%) dilatation and dislocation--without or with torsion (along a longitudinal axis, round to the left)--of the cecum, with dilatation of the proximal loop of the colon was diagnosed. In 3 cases (9%) dilatation, dislocation and torsion (along a longitudinal axis, round to the left) of the cecum without dilatation of the proximal loop was found. In 6 cases (19%) dilatation and dislocation of the cecum with dilatation, dislocation and torsion of the proximal loop of the colon (along a longitudinal axis) to the left, and in 10 cases (31%) dilatation and dislocation of the cecum with dilatation, dislocation and torsion of the proximal loop of the colon (along a longitudinal axis) to the right, was observed. By lining up single findings, models are presented how torsion of the cecum to the left, and torsion of the proximal loop of the colon to the left or to the right may develop.

Perforation of a solitary cecal diverticulum is a rare cause of acute abdomen and an uncommon differential diagnosis for acute appendicitis. Nine hundred cases have been described since Potiers first description in 1912, either localized in the cecum or in the ascending colon. A further case and its course are described.

The knowledge of the diagnostic imaging methods features of the mucocele of the appendix is important for a correct preoperative diagnosis, especially to avoid the formation of pseudomyxoma peritonei. A case of a mucocele of the appendix with a special sonographic appearance by a patient with an additional carcinoma of the left kidney is reported. The computer-tomographic and radiological features of the mucocele (plain abdominal film, i.v. urography, barium enema) are presented and discussed with a review of the literature. A sonographically-guided fine-needle puncture of the mucocele was performed. Its importance for the diagnosis is discussed.

Over 5000 routine appendix specimens were examined at the Institute for Pathological Anatomy, Graz University, for the presence of neurogenic appendicopathy (n.a.). With light microscopy it was possible to differentiate intramucosal, finely vacuolated nerve proliferations and central neuromas (n.a. in the narrower sense), as well as neuromuscular proliferations in the submucosa. All three forms are considerably more common in females. A diagnosis of neurogenic appendicopathy was made in 17.9% of all cases. The disorder is uncommon in the first decade of life, more common in the second decade, and, after the age of 45, is diagnosed histologically in a scant half of the cases. Clinically, n.a. cannot be distinguished with certainty from purulent or chronic recurrent appendicitis; leukocytosis and fever are also not sure criteria for a differential diagnosis. N.a. in the narrower sense is frequently accompanied by vegetative symptoms (variable blood pressure, constipation and diarrhea, meteorism, sweating). These symptoms are probably caused by hormones produced by the endocrine cells which are present in abnormally large quantities in the epithelial tissue and especially in the mucous stroma. As neurogenic appendicopathy can, at present, be diagnosed only histologically, it is to be encouraged that all such material, even when macroscopically unremarkable, be so examined.