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Intestinal strangulation caused by a mucocele of the appendix: report of a case

Yasuyuki Miyakura1, Shinichiro Yokota, Hisanaga Horie

  • 1Department of Surgery, Jichi Medical University, 3311-1 Yakushiji Shimotsuke, Tochigi 329-0498, Japan. miyakura@jichi.ac.jp

Surgery Today
|June 29, 2012
PubMed

Insights

Intestinal strangulation due to an appendiceal mucocele is rare and challenging to diagnose pre-operatively. This case highlights the importance of recognizing this unusual cause of bowel obstruction during surgery.

Area of Science:

  • Gastroenterology
  • Surgical Pathology

Background:

  • Appendiceal mucoceles are rare cystic dilations of the appendix, typically benign.
  • They can present with vague or acute abdominal symptoms, often mimicking other conditions.
  • Pre-operative diagnosis of appendiceal mucocele causing intestinal strangulation is uncommon.

Observation:

  • An 89-year-old female presented with acute abdominal pain and right upper quadrant tenderness.
  • CT scan revealed a closed-loop small bowel obstruction and a pelvic cystic mass.
  • Laparotomy demonstrated terminal ileum strangulation by a dilated appendix.

Findings:

  • The resected appendix measured 9x3 cm and contained mucus, consistent with a mucocele.
  • Histopathology confirmed a cystic mucocele without neoplastic cells.
  • The mucocele had encased and strangulated a loop of the terminal ileum.

Implications:

  • Appendiceal mucocele should be considered in the differential diagnosis of bowel obstruction, especially in elderly patients.
  • Prompt surgical intervention is crucial for strangulated bowel.
  • Recognition of appendiceal mucocele during surgery is vital for appropriate management and preventing complications.

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