Appendiceal mucocoele

Case contributed by Dr Vikas Shah

Presentation

Patient with history of bilateral salpingo-oophorectomy presents with vague right lower abdominal pain.

Patient Data

Age: 40
Gender: Female
Ultrasound

Trans-abdominal ultrasound of right iliac fossa

There is an elongated tubular structure measuring 7.7 cm in length. It has mild internal echogenicity. There is no overt calcification. Given the history of previous salpingo-oophorectomy, this is unlikely to be fallopian tube in origin. This lesion has the appearances of an appendix mucocoele (mucocele for N American readers!).

CT

Single slice from CT abdomen and pelvis

This confirms a tubular lesion arising from the caecum. There is minimal calcification seen at the caecal end of the lesion but no obstructing calcified appendicolith is seen.

Case Discussion

A mucocoele of the appendix refers to distension due to accumulation of mucinous material within the lumen, occurring due to obstruction of the lumen. While hyperplasia of the mucosa is a cause, neoplastic (both benign and malignant) appendiceal neoplasms are also a cause. In these latter cases, if the appendix ruptures, pseudomyxoma peritonei is a concerning outcome. For this reason, appendiceal mucocoeles are removed.

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Case information

rID: 34989
Case created: 18th Mar 2015
Last edited: 29th Dec 2015
Inclusion in quiz mode: Included

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