English

Abstract

Mucocele of appendix (MA) is a rare entity and is defined as mucin filled dilated appendicular lumen which may be due to distal obstruction. It is usually asymptomatic and may present as appendicitis. We present a rare case of an elderly female who presented with features of acute intestinal obstruction secondary to mucinous cystadenoma of appendix for which she had to INTRODUCTION: MA refers to dilated mucin filled appendicular lumen which may be secondary to distal obstruction. It is a rare condition with estimated incidence of only 0.2-0.3% in appendicectomy specimens.(1) It can be asymptomatic, but acute or chronic pain in the right iliac fossa is the most frequent symptom.(2) Intestinal obstruction complicating an appendiceal mucocele has rarely been reported.(3) We describe the case of an old woman who came to emergency with signs and symptoms of intestinal obstruction due to appendiceal mucocele. CASE REPORT: We report the case of a 60years old, previously healthy woman, who presented to our emergency room with a 3day history of acute and diffusely abdominal pain, nausea, vomiting and disruption of bowel movements. Her abdomen was distended and tympanic with diffuse tenderness, especially in the periumbilical areas with exaggerated bowel sounds. She had a history of ant tubercular treatment for pulmonary koch's 5years back. She also had a history of an episode of subacute intestinal obstruction 6months back which was managed conservatively outside. The leukocyte count was 22,000 with 95% neutrophils. An erect film of the abdomen revealed multiple air fluid levels suggestive of small bowel obstruction. CECT abdomen was done which showed small bowel dilatation with abrupt tapering near IC junction with mesentric lymphadenopathy. So, a diagnosis of acute intestinal obstruction secondary to ileocaecal koch's was made. After resuscitation, patient was undertaken for exploratory laporotomy. On inspection, dilated small bowel loops with collapsed large bowel mesentry were found and a 4*3cm in size firm mass was found at the anatomical site of appendix. The mass was preileal in position and was compressing over terminal ileum. About 10ml mucinous collection was found in right iliac fossa and pelvis. So, right sided hemicolectomy was performed. The postop period was uneventful and patient was discharged on day 11 in satisfactory condition. The final histopathology showed mucinous cystadenoma of appendix collection and reactive lymphoid hyperplasia with no epithelial cells in mucin.