We report a case of mesenteric abscess around the ascending colon due to ileal adenocarcinoma penetration. A 51-year-old man hospitalized for right lower quadrant pain demonstrated wall thickness of the terminal ileum and cecum and ascending colon on CT. He was diagnosed with perforated acute appendicitis and intraabdominal abscess necessitating laparotomy. We found a mesenteric mass between the ascending colon and terminal ileum, and conducted ileocecal resection. The 10 mm ulceration in the terminal ileum penetrated into the mesenterium, causing a mesenteric abscess between the ascending colon and terminal ileum in the resected specimen. Pathological diagnosis showed the ulceration to be moderately differentiated adenocarcinoma.
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