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Mechanical intestinal obstruction secondary to appendiceal mucinous cystadenoma: A case report and brief review
Zheng-Shui Xu1, Wei Xu, Jia-Qi Ying
1Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
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.
Insights
Appendiceal mucinous cystadenoma rarely causes mechanical intestinal obstruction. Prompt surgery is crucial for complete obstruction, with careful distinction between benign and malignant mucoceles guiding treatment extent.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Abdominal Surgery
Background:
- Appendiceal mucinous cystadenoma is a rare appendiceal neoplasm.
- It commonly presents incidentally during appendectomy.
- Mechanical intestinal obstruction secondary to appendiceal mucocele is an infrequent complication.
Observation:
- A case of mechanical intestinal obstruction caused by appendiceal mucinous cystadenoma is presented.
- The patient underwent emergency surgery for acute mechanical intestinal obstruction.
- Initial management included nasogastric decompression and intravenous fluid resuscitation.
Findings:
- Appendectomy with intraoperative enteral decompression was performed.
- Pathologic examination confirmed appendiceal mucinous cystadenoma.
- The patient recovered well and was discharged on postoperative day five, with no recurrence at 8-month follow-up.
Implications:
- Early surgical intervention is recommended for acute mechanical complete intestinal obstruction, particularly in patients without prior abdominal surgery.
- Differentiating between benign and malignant appendiceal mucoceles is critical for determining the appropriate surgical approach and extent.
- This case highlights a rare but serious presentation of appendiceal mucinous cystadenoma, emphasizing the need for timely diagnosis and management.
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