Mechanical intestinal obstruction secondary to appendiceal mucinous cystadenoma

Abstract

Background:Appendiceal mucinous cystadenoma can present in various ways, and it is most commonly encountered incidentally during appendectomy, but mechanical intestinal obstruction secondary to an appendiceal mucocele has been rarely reported.Methods:We report a case of mechanical intestinal obstruction secondary to appendiceal mucinous cystadenoma. After nasogastric decompression and initial aggressive intravenous fluid resuscitation, an emergency operation was performed under the diagnosis of acute mechanical intestinal obstruction.Results:We performed an appendectomy and intraoperative enteral decompression without anastomoses. The pathologic examination (PE) revealed appendiceal mucinous cystadenoma. After the operation, the patient's recovery went smoothly, and the patient was discharged on the fifth postoperative day. No tumor recurrence was recorded over an 8 month follow-up period.Conclusion:Early operative intervention should be recommended to the patient with acute mechanical complete intestinal obstruction, especially the patient who had no previous abdominal surgery. And it is vital to discriminate benign and malignantappendiceal mucocel in determining the extent of surgery.

Laparoscopic Hand-Assisted Right Colectomy for Appendiceal Mucinous Cystadenoma: A Case Report and Literature Review

“…Appendiceal tumors represent 0.5% of all gastrointestinal neoplasms and are found in 1% of appendectomy specimens [5]. Mucoceles account for 8 to 10% of appendiceal tumors, representing between 0.2 to 0.4% of all appendectomies [1][2][3][4][5][6][7][8][9][10][11][12][13]. Appendiceal mucocele was first described by Rokitansky in 1842 and was formally named by Feren in 1876 [3,4,12,17].…”

“…Cystadenomas may be asymptomatic in 25 to 50% of the cases [2-4, 6, 8, 11-15]. The most common clinical manifestation is acute or chronic right lower abdominal pain [4,6,11,14]. Abdominal pain, similar to acute appendicitis, is present in 30 to 64% of the cases [11].…”

“…Mucoceles account for 8 to 10% of appendiceal tumors [2][3][4][5]. Appendectomy specimens show mucoceles in 0.2 to 0.4% of the cases [1][2][3][4][5][6][7][8][9][10][11][12][13]. Cystadenomas are responsible for 63 to 84% of mucoceles while cystadenocarcinomas account for 11 to 20% [1,6,11].…”

“…In 25 to 50% of the cases cystadenomas are asymptomatic and diagnosed as an incidental finding during radiological examination or surgical intervention [2-4, 6, 8, 11-15]. The usual clinical presentation includes acute or chronic right lower abdominal pain (2,6,11,14). The treatment of choice is appendectomy or right colectomy depending on the histopathological diagnosis and the tumor´s extension [2,7,16].…”

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“…В исследовании J.W. Cheng et al (2017) частота возникновения перфорации пищевода во время ЛКМ ниже по сравнению с ПД и составляет соответственно 0,8% против 4,9%. При этом перфорации, которые излечены интраоперационно без последствий для пациента, не были включены в данный анализ, как осложнение.…”