MDCT Diagnosis of an Appendiceal Mucocele with Acute Torsion

Abstract

WEB This is a Web exclusive article. cute torsion of the appendix is a rare cause of the acute abdomen that was first described in 1918 [1]. One pathology-based review found torsion in only two cases of more than 3,000 appendectomy specimens, whereas a second pathology-based review found no examples of torsion among 71,000 specimens [2, 3]. Mucoceles of the appendix, originally described by Rokitansky in 1842, are not as rare but are found in only about 0.1–0.3% of appendectomy specimens [4, 5]. Furthermore, torsion complicating a mucocele of the appendix is exceedingly rare, with only a few scattered cases reported in the English-language literature [4, 6, 7]. To our knowledge, only one case of appendiceal torsion (without mucocele) had preoperative imaging performed [8], and no reported cases of mucocele torsion have been documented on preoperative imaging. We report a case of acute torsion of an appendiceal mucocele that was diagnosed preoperatively on MDCT.