Inverted Appendiceal Stump and Appendiceal Intussusception

An inverted appendiceal stump can appear identical to a polyp (Fig. 14.13), and is located at the site of prior appendectomy. Both the appendiceal stump and intraluminal neoplasm will enhance with intravenous contrast. Close correlation with the clinical history of incidental inversion-ligation appendectomy may be revealing , but in cases where clinical history is incomplete, endoscopic correlation may be required. Appendiceal intussusception can also occur. Barium enema has the advantage of being able to attempt reduction of the intussusception manually, so that the filling defect disappears during reduction. In CT colonography, this is usu-

Inverted Appendix
Fig. 14.10a-c. Normal ileo-cecal valve. The valve should be symmetric with respect to the valve orifice on: a 2D view; c 3D view; b by narrowing the window and level settings to soft tissue settings, one can visualize the internal fatty attenuation of the valve and its associated fold (arrow)

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