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Clinicopathological analysis of patients operated for appendiceal mucocele
Hasan Abuoğlu, Mehmet Kamil Yıldız, Bülent Kaya1
1Department of General Surgery, Fatih Sultan Mehmet Training and Research Hospital, İstanbul-Turkey. drbkaya@yahoo.com.
Background:
The term mucocele refers to the dilatation of the appendix due to mucus, and it is an uncommon disorder with an estimated incidence of 0.2%-0.3% of all appendectomies performed and 8%-10% of all appendiceal tumors. It is often asymptomatic, but may manifest appendicitis-like symptoms.
Methods:
Twenty-six patients (14 females and 12 males) were operated on due to mucocele of the appendix. Sixteen patients exhibiting the characteristics of clinically acute appendicitis required an emergency operation. Appendectomy was performed on 14 patients, and right hemicolectomy was carried out on 2 patients. Of the remaining 10 patients who received surgery under elective conditions, 4 underwent a right hemicolectomy and 6 underwent an appendectomy.
Results:
The patients' age ranged from 27 to 81 years. Sixteen open and 4 laparoscopic appendectomies were performed. An incidental appendiceal mucocele was identified in 2 patients who had undergone colonoscopy. According to the histopathological examination, the incidence rate of mucosal hyperplasia, mucinous cystadenoma, and mucinous cystadenocarcinoma was found to be 23.1%, 61.4%, and 15.5%, respectively.
Conclusion:
In patients with long-term pain in the right lower quadrant of the abdomen, appendiceal mucocele should be considered, and the results of radiological imaging tests should be carefully analyzed before surgery.
Insights
Appendiceal mucocele, a rare condition causing appendix dilatation, can mimic appendicitis. Careful analysis of imaging is crucial for diagnosis and surgical planning in patients with right lower quadrant pain.
Area of Science:
- Gastroenterology
- Surgical Oncology
Background:
- Mucocele of the appendix is a rare condition involving mucus dilatation.
- It occurs in 0.2%-0.3% of appendectomies and 8%-10% of appendiceal tumors.
- Symptoms can range from asymptomatic to appendicitis-like presentations.
Purpose of the Study:
- To analyze the clinical presentation, surgical management, and histopathological findings of appendiceal mucocele.
- To emphasize the importance of diagnostic imaging in suspected cases.
Main Methods:
- Retrospective analysis of 26 patients operated for appendiceal mucocele.
- Surgical procedures included appendectomy and right hemicolectomy.
- Histopathological examination to determine the nature of the mucocele.
Main Results:
- Appendiceal mucocele was diagnosed in patients aged 27-81 years.
- Histopathology revealed mucosal hyperplasia (23.1%), mucinous cystadenoma (61.4%), and mucinous cystadenocarcinoma (15.5%).
- Incidental mucoceles were found in 2 patients post-colonoscopy.
Conclusions:
- Appendiceal mucocele should be considered in patients with chronic right lower quadrant abdominal pain.
- Radiological imaging analysis is critical before surgical intervention.
- Timely diagnosis and appropriate surgical strategy are essential for favorable outcomes.
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