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Distinguishing between acute appendicitis and appendiceal mucocele: is this possible preoperatively?
B Saylam1,2, C E Güldoğan3, F Coşkun4
1Department of Surgery, Ankara Numune Training and Research Hospital, Ankara, Turkey. mdbsaylam@yahoo.com.
Summary
Appendiceal mucocele, a rare appendix condition, can be diagnosed using imaging and urine tests. A 10 mm or larger diameter on ultrasound is highly indicative of mucocele, aiding in differentiating it from appendicitis.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Diagnostic Imaging
Background:
- Mucocele of the appendix is an uncommon condition involving cystic dilatation of the appendiceal lumen.
- Diagnosis often occurs during imaging for suspected appendicitis or as an incidental finding.
Purpose of the Study:
- To evaluate histological data of patients with suspected appendiceal mucocele.
- To compare these patients with a control group diagnosed with appendicitis.
Main Methods:
- Histological analysis of 23 patients with suspected mucocele and 79 controls with appendicitis.
- Sonographic evaluation focusing on appendiceal outer diameter and white blood cell count.
- Urine analysis for microscopic hematuria.
Main Results:
- Larger appendiceal outer diameter (≥10 mm) and lower white blood cell count correlated with mucocele diagnosis.
- Microscopic hematuria was present in 41.7% of mucocele patients vs. 10% of appendicitis patients (p=0.019).
- A 10 mm diameter threshold showed high diagnostic accuracy (80.2%) for appendiceal mucocele.
Conclusions:
- A 10 mm appendiceal diameter under compression is a valuable preoperative marker to distinguish mucocele from appendicitis.
- Microhematuria can significantly support the clinical diagnosis of appendiceal mucocele in emergency settings.
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