Incidental diagnosis of pseudomyxoma peritonei associated with peritoneocele at MRI defecography: a case report

In the setting of pelvic disorders, before the introduction of MRI defecography, conventional fluoroscopic defecography was the gold standard. Compared to this latter, MRI defecography has the advantage of providing a full pelvic study, enabling the diagnosis of any coexisting diseases (i.e. oncological or inflammatory ones) that could be missed on conventional fluoroscopic defecography. We present an incidental diagnosis of pseudomyxoma peritonei causing a peritoneocele detected at MRI defecography. A 60-year-old healthy woman came to a proctology consultation complaining a sensation of pelvic heaviness over the past three months. Proctological examination revealed a soft bulge of tissue in the vagina suspect for enterocele to be included in differential diagnosis with peritoneocele. If a conventional defecography had been performed, in place of MRI defecography, it would show neither a peritoneocele nor the mucinous ascites, delaying its detection and underestimating the severity of the disease. In this clinical case, the choice to perform the MRI defecography instead of conventional defecography has been crucial in diagnosing a severe oncological disease allowing a consequent prompt treatment. This highlights the important role of MRI defecography in the global assessment of pelvic disorders, due to the ability to detect other pelvic pathological conditions.