Appendiceal mucocele presenting as a leading point in ileocolic intussusceptions: "Case report"

Appendiceal mucocele is a rare clinical scenario, which is found in 0.2-0.7 % of appendectomies. Ileocecal/ileocolic intusception caused by appendiceal mucocele is an extremely rare condition with few case reports in literatures. The treatment is surgery with the extent determined by intra-operative findings. Ultrasound and CECT scan can suggest the diagnosis, but definitive diagnosis is by histopathology. The aim of this presentation is to discuss appendiceal mucocele in terms of clinical features, diagnostic imaging and treatment. This case report can create awareness to primary care physicians, radiologists, surgeons and pathologists aiding in accurate diagnosis and early surgical intervention to prevent rupture.

A fifty years old woman presented with intermittent colicky peri umbilical abdominal pain of one-week duration. She had nausea, vomiting, mild abdominal distension, and failure to pass feces and flatus. Physical examination was normal. Imaging suggested ileocolic intussusceptions with cystic leading point on ultrasound, but on CECT scan, no leading point reported. Appendiceal mucocele diagnosed intra operatively and confirmed by pathology.

Appendiceal mucocele is rare and can be benign or malignant. Preoperative diagnosis is often difficult. Definitive diagnosis is by histopathology. Appendiceal mucocele can rarely present with ileocolic intussusceptions. Radiologists, pathologists, primary care physicians and surgeons must be aware of this condition. Accurate preoperative diagnosis and early surgical treatment of appendiceal mucocele is important to prevent complications like pseudo myxoma peritonei(PMP), which has poor prognosis.