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Perforated mucocele of the appendix in the left upper quadrant: A challenging anatomy and an improvised surgical

Basmah Faris Alhassan1, Abdullah Saji Alharbi2, Walid Mokhtar Omar1

  • 1Department of General Surgery, King Khalid University Hospital and College of Medicine, King Saud University, Saudi Arabia.

International Journal of Surgery Case Reports
|June 28, 2019
PubMed
Abstract

Insights

Pseudomyxoma peritonei (PMP) with intestinal malrotation presents unique surgical challenges. Cytoreductive surgery (CRS) and heated intraperitoneal chemotherapy (HIPEC) offer a safe and effective treatment, even with an improvised technique for colon preservation.

Area of Science:

  • Surgical Oncology
  • Gastrointestinal Surgery

Background:

  • Pseudomyxoma peritonei (PMP) is a rare but serious complication of appendicular mucocele perforation.
  • Intestinal malrotation in adults is often asymptomatic but can complicate presentations of other conditions, delaying diagnosis.
  • The co-occurrence of PMP and intestinal malrotation is exceptionally rare, posing significant clinical and diagnostic challenges.

Purpose of the Study:

  • To present a case of PMP in a patient with co-existing intestinal malrotation.
  • To describe the management of this rare condition using cytoreductive surgery (CRS) and heated intraperitoneal chemotherapy (HIPEC).

Main Methods:

  • A case report detailing the surgical management of PMP in a patient with intestinal malrotation.
  • Application of CRS and HIPEC with an improvised surgical technique for colon preservation due to anatomical abnormalities.

Main Results:

  • The patient was successfully managed with CRS and HIPEC.
  • An improvised surgical technique allowed for safe and effective preservation of part of the colon, overcoming intraoperative challenges posed by extensive disease and abnormal anatomy.

Conclusions:

  • CRS/HIPEC is an effective treatment for PMP, improving patient outcomes.
  • This case highlights the importance of early recognition of uncommon surgical conditions.
  • The described improvised surgical technique is safe and effective for preserving colon segments in selected PMP patients with intestinal malrotation.
Keywords:
Case reportColon resectionHIPECMalrotationMucocelePseudomyxoma peritonei

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