Preoperative Diagnosis of Pericecal Masses Mimicking Acute Appendicitis: Ileocolic Artery and Vein Diameter Measurements

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BACKGROUND: Intraoperative ileocecal masses may be encountered in patients operated on for acute appendicitis, often leading to unexpected surgical decisions. To facilitate preoperative identification of these patients, we retrospectively analyzed patients operated on in our clinic. We investigated the potential value of ileocolic artery (ICA) and ileocolic vein (ICV) diameter measurements, which have been shown to aid in the diagnosis of acute appendicitis, for detecting pericecal masses mimicking acute appendicitis. METHODS: This retrospective study included 58 patients hospitalized with a prediagnosis of acute appendicitis. Patients were divided into two groups according to the surgical procedure performed: right hemicolectomy and appendectomy. Demographic data, duration of symptoms, physical examination findings, length of hospital stay, wound site infection, computed tomography (CT) and ultrasonography (US) findings, operative findings, laboratory parameters, and ICA and ICV diameter measurements on contrast-enhanced CT were evaluated. RESULTS: The appendectomy group included 30 patients, and the right hemicolectomy group included 28 patients. Significant differences were observed between the groups in terms of ICA and ICV diameters. In the right hemicolectomy group, ICA diameter was significantly smaller (p < 0.001), whereas ICV diameter was significantly larger (p = 0.004) compared with the appendectomy group. CONCLUSION: Measurement of ICA and ICV diameters on CT appears to be a promising tool for the preoperative detection of pericecal masses mimicking acute appendicitis. These vascular parameters may serve as complementary imaging markers to support surgical decision-making in patients presenting with suspected acute appendicitis.

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