Intussusception of the mucocele of the appendix: a case report in a conflict-affected region

Intussusception of an appendiceal mucocele is an extremely rare condition, reported in approximately 0.01 % of appendectomy cases. Its preoperative diagnosis remains very difficult due to nonspecific clinical and radiological findings. Surgical management with only an appendectomy is considered adequate when the appendiceal base is not involved.

A 45-year-old female patient presented with recurrent episodes of lower abdominal pain lasting over two weeks, accompanied by decreased appetite and dysuria. The patient underwent an appendectomy, and the specimen was submitted for histopathological examination.

Mucocele of the appendix as a cause of intussusception is uncommon; it usually presents with nonspecific abdominal or urinary symptoms but can be identified through sonography. The gold standard remains CT; however, due to the war situation in this case, diagnosis relies on sonographic features such as the onion-skin sign. Surgical intervention depends on tumour size; if a malignant tumour is suspected, a right hemicolectomy should be carried out for better margin control.

Intussusception of the appendiceal mucocele is uncommon and presents considerable diagnostic difficulties, especially before surgery. These difficulties are especially evident in resource-limited settings, including conflict zones and low- and middle-income countries (LMICs).