Appendiceal mucocoele

Case contributed by Dr Vikas Shah


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

Patient Data

Age: 40
Gender: Female

Trans-abdominal ultrasound of right iliac fossa

Modality: Ultrasound

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!).

Single slice from CT abdomen and pelvis

Modality: CT

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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