Mucocele of the appendix: a report of five cases

Abstract

Mucocele of the appendix is an uncommon disorder, characterized by a cystic dilatation of the lumen. It is often diagnosed clinically from signs and symptoms of acute appendicitis or, if it is asymptomatic, as an incidental finding during ultrasonography, computed tomography, and radiographic examinations of the gastrointestinal tract, or laparotomy. The incidence of mucocele ranges from 0.2% to 0.3% of all appendectomy specimens. We report five cases of appendiceal mucocele (all women, aged 19-90 years), who were admitted from January 1993 to January 2003 to our hospital. These cases represent 0.29% of the 1720 appendectomies performed during this period. Three of the patients were symptomatic and had appendectomies. The final diagnosis for mucocele was given at laparotomy. No colon neoplasms were identified during surgery, and subsequent colonoscopic examinations were also negative. The other two patients were asymptomatic of appendiceal tumor. Colonoscopy revealed two colonic malignant tumors in one patient and an adenocarcinoma of the sigmoid colon in the other. Mucocele of the appendix was diagnosed pre-operatively by ultrasound and computed tomography. One of the two patients underwent a right hemicolectomy and sigmoidectomy; the other one underwent an appendectomy, cecostomy and sigmoidectomy. Four of the patients recovered and are doing well today; one patient died on the twenty-fifth postoperative day. The most common symptom of mucocele is abdominal pain, although many patients may be asymptomatic. Mucocele is often associated with concomitant colon cancer, thus patients with this tumor should be systematically checked for other colonic lesions.

Appendiceal mucocele: Case reports and review of current literature

“…Mucocele of the appendix is an uncommon tumor, with an incidence of 0.29%-0.4% of all appendectomied specimens [1][2][3]6] . There has been no exact reported incidence of AM in Turkey.…”

“…Although a small portion of AM is asymptomatic, clinical manifestations include right lower abdominal pain, palpable abdominal mass, or gastrointestinal bleeding in majority of the AM [1,3,7,[9][10][11][12] . Among the five cases reported above, three had abdominal pain secondary to mucocele while one had symptoms related to groin hernia and the last patient had abdominal pain due to intestinal infarction.…”

“…USG, CT and colonoscopic examinations can facilitate preoperative diagnosis of AM [1,[13][14][15] . Ultrasound is the firstline diagnostic modality for patients with acute abdominal pain or mass.…”

“…The incidence is 0.2%-0.4% of all appendectomied specimens [1][2][3] . AM is a progressive dilatation of the appendix from the intraluminal accumulation of the mucoid substance [3,4] .…”

Emergency Cholecystectomy in Situs Inversus Totalis: Report of a Case

“…Rate of preoperative and intraoperative diagnosis for detecting situs inversus with cholelithiasis, prior to the use of chest x-ray, USG and CT scan abdomen, was 55% and 32% respectiy 6 . Laparoscopic cholecystectomy in situs inversus has also been performed safely and should be the procedure of choice wherever the expertise is available 2,7,8 . In acute cholecysititis for emergency surgery, open cholecystectomy is unavoidable where difficulty is anticipated 9 .…”