Acute abdomen: Rare and unusual presentation of right colic xanthogranulomatosis

Table 1 Reported cases of large bowel xanthogranulomatous inflammation

Ref	Age (yr)/sex	Involved organs	Clinical presentation	CT findings preoperative diagnosis	Surgical operation/ pathology
Anadol et al[2]	57/F	Cecum and appendix	RLQ abdominal pain, rectorrhagia, anemia	CT: Solid mass in the RLQ with poorly defined margins and mesenteric fatty tissue infiltrationCecum cancer	Appendectomy
					Frozen section
					Right colectomy
					XGI of the cecum
Davis et al[3]	30/F	Anorectal area	Rectal and sacral pain, nausea, weight loss, palpable tender mass on rectal examination	CT: two masses involving the intramural portion of the distal rectal wall	Posterior approach, removal of the tumors, reapproximation of the rectal wall
				Tumor involving the sacrum	XGI of a Müllerian duct remnant involving the anorectum
Lo et al[4]	72/M	Sigmoid colon	Intestinal obstruction, palpable tender mass in the LIF, tenesmus, nausea and weight loss	Barium enema: stricture at the sigmoid colon causing obstruction	Excision of the mass including sigmoid colon, proximal jejunum and part of the peritoneum
				Sigmoid cancer or diverticulitis with stricture	XGI of the sigmoid colon
Oh et al[5]	38/F	Sigmoid colon, appendix, salpinx	Abdominal pain, diarrhoea, fever, mild RLQ tenderness without any palpable mass	CT: Colonic loop around the rectosigmoid junction with mesenteric fat infiltration	Resection of the sigmoid colon, appendectomy, right salpingectomy
				Sigmoid cancer	XGI of the sigmoid colon
Dhawan et al[6]	60/M	Ascending colon	Abdominal pain, constipation, vomiting	CT: irregular circumferential thickening involving 6 cm of the ascending colon. Multiple small pericolic lymph nodes	Right colectomy
				Right colon cancer	XGI of the ascending colon with mucosal involvement
Present case	56/F	Cecum, jejunal loop	Abdominal pain, palpable mass in the RIF, fever and weight loss	CT: expansive mass originating from the cecum with necrotic areas that seems to involve VI liver segment. Many lymph nodes enlarged, especially next to the mass.	Right colectomy
				Right colon cancer	XGI of the ileocecal valve

CT: Computer tomography; M: Male; F: Female; NA: Not available; XGI: Xanthogranulomatous inflammation; RLQ: Right lower quadrant; LIF: Left iliac fossa; RIF: Right iliac fossa.