case_images: PMC10796788_01
case_images: Computed tomography of the abdomen and pelvis. (A-C) Plain CT before the return of the cyst. (D-F) Enhanced CT after the return of the cyst. The intestinal duct structure is disordered, and the small intestine is obviously dilated.
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case_images: fig1
case_images: An external anal mass high-density shadow (CT value   90) of size   78*61*41 mm and nature unknown was identified (Figures 1A-C). A large, dense mass at the distal end of the intussusception was located in the pelvic cavity, and a cystic lesion was considered (Figure 1). The surface of the cyst was damaged by the friction caused by prolapse outside the anus (Figures 1, 2G).
case_images: Representative surgical images. (A-E) Images from various stages of the operation showing the overlap of the small intestine and colon. The colon is free and not fixed and the cyst is located in the ileocecal region. (F-I) Postoperative cyst specimen showing the smooth cyst wall and presence of fluid. The cyst is located in the ileocecal region.
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case_images: fig2
case_images: During the operation, the proximal part of the small intestine was significantly dilated, and the distal part was nested and intertwined with the colon (Figure 2A). After revealing the exposed appendix (Figure 2B), the compressed and overturned ileocecal mass fully exposed the ileocecal region. The patient's entire colon was treated in a free state and placed completely outside the abdominal cavity (Figures 2C,D). Fibrous, thickened, and enlarged lymph nodes were revealed within the mesentery (Figure 2E). Postoperatively, the cyst could be seen formed part of the ileocecal region and was almost protruding from the intestinal lumen (Figures 2F,G). The surface of the cyst was damaged by the friction caused by prolapse outside the anus (Figures 1, 2G). After wiping the posterior capsule fluid, the intact capsule wall was observed (Figures 2H,I).
case_images: Postoperative histology of the ileocecal mass. Hematoxylin and eosin-stained sections of the ileocecal mass and its link to the intestine show evidence of the enterogenous cyst. The intestinal epithelium covers the bilayer capsule wall (40x and 100x magnification).
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case_images: fig3
case_images: An external capsule was attached to the intestinal epithelial mucosa and interstitial bleeding, inflammatory cell infiltration, and a small amount of necrosis were observed (Figure 3).
case_images: Timeline of the patient's treatment scheme.
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case_images: fig4
case_images: The entire treatment process of this patient is summarized in the flowchart in Figure 4.