Appendiceal mucocoele

Case contributed by RMH Core Conditions

Presentation

Diarrhoea with intermittent cramping abdo pain ?overflow.

Patient Data

Age: 77
Gender: Male
Modality: CT

Cystic lesion noted closely related to the posterior aspect of the caecum, and extending into the right paracolic gutter. No adjacent fat stranding. No mural nodularity. No normal appendix seen.

There is prominent redundant loop of sigmoid colon dilated up to 8 cm with a fluid level. There is a focal segment of luminal narrowing in the distal sigmoid, and another in the proximal sigmoid, which may represent adhesive narrowing but is felt more likely to represent focal peristalsis.

The more proximal loops of colon are normal in calibre. Small bowel loops are also normal in calibre.

Solid organs are unremarkable. Gallbladder calculus noted. No free fluid, focal collection or free gas.

Conclusion

  1. Incidental cystic lesion related to the posterior aspect of the caecum. Given that no normal appendix is seen, this could represent a mucocoele of the appendix. Enteric duplication cyst is another possibility. Suggest correlation with any history of previous appendicectomy.
  2. There is a short segment of luminal narrowing in the distal sigmoid which may represent a stricture. Correlate clinically, and with sigmoidoscopy if appropriate.
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Case Information

rID: 30305
Case created: 1st Aug 2014
Last edited: 22nd May 2016
Inclusion in quiz mode: Included

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