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caecum
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Through a midline laparotomy, the cecal and ileocecal junction was identified.
The ‘volcano sign’ described endoscopically is seen as a ‘vortical fold’ pattern on barium studies, which is the concentric ring appearance of the cecal mucosal folds as they approach the obstructed appendiceal orifice.
The digestive tract was removed from each specimen and dissected it into the upper digestive tract, gizzard, small intestine, ceca , large intestine, liver, and pancreas.
The absence of any upper-abdominal pain, nausea, and cramps suggests that the melena is of cecal or right colonic origin.
At surgery, 24 patients had perforation, and three required cecal resection.
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