Inverted Appendix in a Patient With Weakness and Occult Bleeding.

Area of Science:

• Gastroenterology
• Surgical Oncology
• Pathology

Background:

• Appendiceal mucinous neoplasms (AMNs) are uncommon adenomatous tumors originating in the appendix.
• Despite low malignant potential, AMNs can lead to severe complications like bowel obstruction and pseudomyxoma peritonei.
• AMNs often present with vague gastrointestinal symptoms or are incidentally discovered.

Observation:

• A 72-year-old patient presented with weakness and imaging findings suggestive of complicated acute appendicitis.
• Colonoscopy revealed an inverted appendix, which, post-appendectomy, was found to contain a perforated low-grade AMN.

Findings:

• The case highlights a perforated low-grade appendiceal mucinous neoplasm in an elderly patient with appendiceal inversion.
• This presentation underscores the importance of considering AMNs in the differential diagnosis of appendicitis, particularly in specific patient demographics.

Implications:

• Physicians should consider AMNs in the differential diagnosis for appendicitis, especially in patients over 50 with appendiceal inversion.
• Concurrent colorectal neoplasms may be associated with AMNs, warranting thorough evaluation.
• Prompt diagnosis and surgical intervention are vital to prevent potentially fatal complications associated with AMNs.