Ileocolic intussusception due to mucocoele of the appendix causing small bowel obstruction
Updates to Study Attributes
There is a 14 cm complex ileocolic and ileo-ilealileoileal intussusception. A tubular blind-ending structure is visualised within the intussusception, with a 3.5 cm, murally calcified cyst at its base. The mid and distal small bowel proximal to the intussusception is dilated measuring up to 3.7 cm.
Small volume ascites.
Note of an incidental small simple liver cyst.
Updates to Case Attributes
The intussusception was able to be reduced at surgery and the patient underwent an uncomplicated right hemicolectomy.
Histology showed:
Sections of the appendix wall show a lumen filled with partly calcified mucous. The wall is generally thinned and composed of dense collagenous tissue and in many places lacks an epithelial lining. However, in areas the lumen is lined by a single layer of columnar mucous secreting epithelium with mild atypia of the basally located nuclei. Occasional thin papillary projections are present. The epithelium rests directly on the fibrous wall. There is no high grade dysplasia or invasive malignancy. No mucous is seen dissecting through the appendix wall.
No malignancy in nodes.
FINAL DIAGNOSIS:
Low grade appendiceal mucinous neoplasm.
Case also contributed by Dr. Shyam Sankaran
-<p>The intussusception was able to be reduced at surgery and the patient underwent an uncomplicated right hemicolectomy.</p><p>Histology showed:</p><p>Sections of the appendix wall show a lumen filled with partly calcified mucous. The wall is generally thinned and composed of dense collagenous tissue and in many places lacks an epithelial lining. However, in areas the lumen is lined by a single layer of columnar mucous secreting epithelium with mild atypia of the basally located nuclei. Occasional thin papillary projections are present. The epithelium rests directly on the fibrous wall. There is no high grade dysplasia or invasive malignancy. No mucous is seen dissecting through the appendix wall.</p><p>No malignancy in nodes.</p><p>DIAGNOSIS:</p><p>Low grade appendiceal mucinous neoplasm.</p><p> </p><p>Case also contributed by Dr. Shyam Sankaran</p>- +<p>The intussusception was able to be reduced at surgery and the patient underwent an uncomplicated right hemicolectomy.</p><p><strong>Histology:</strong></p><p>Sections of the appendix wall show a lumen filled with partly calcified mucous. The wall is generally thinned and composed of dense collagenous tissue and in many places lacks an epithelial lining. However, in areas the lumen is lined by a single layer of columnar mucous secreting epithelium with mild atypia of the basally located nuclei. Occasional thin papillary projections are present. The epithelium rests directly on the fibrous wall. There is no high grade dysplasia or invasive malignancy. No mucous is seen dissecting through the appendix wall.</p><p>No malignancy in nodes.</p><p>FINAL DIAGNOSIS: Low grade appendiceal mucinous neoplasm.</p><p> </p><p>Case also contributed by Dr. Shyam Sankaran</p>