• Xiao-Jiao Ruan, Bai-Liang Ye, Zhi-Hai Zheng, Huan-Hao Zhou, Xiao-Feng Zheng, and Zhen-Xu Zhou.
• Department of General Surgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, China.
• Medicine (Baltimore). 2017 Nov 1; 96 (47): e8872.

RationaleA cecal submucosal fecalith is extremely rare and is likely to be misdiagnosed as appendicitis with an incarcerated fecalith.Patient ConcernsThis review presents the case of a female patient complaining of recurrent abdominal pain in the right lower quadrant, similar to the clinical symptoms of appendicitis. Physical examination revealed an abdominal tenderness in the right lower quadrant without rebound tenderness or muscular tension. An ultrasound examination found a mass located in the right lower abdomen. Computed tomography showed a high-density shadow in the cecal cavity.DiagnosesA fecalith was detected in the submucosal cecal wall. The postoperative pathologic examination showed that the fecalith was located in the submucosa.InterventionsA partial cecal excision was performed under laparoscopic surgery assisted by colonoscopy.OutcomesThe patient was discharged 1 week after surgery without postoperative complications.LessonsFecaliths should be considered in the differential diagnosis of submucosal occupying lesions of the cecum.Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

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