Mucocele of Appendix: A Rare Cause of Surgical Abdomen

Abstract

Background: Appendiceal mucocele is a rare surgical emergency caused by intraluminal accumulation of mucoid material due to obstruction. Proper diagnosis and adequate surgical management are paramount to prevent the complications. Objectives: The aim of this study is to report on our management of appendiceal mucocele and highlighting the importance of proper pre-operative workup to reach a definitive diagnosis as a possible means of avoiding the associated grave complications. Materials and Methods: The patients of mucocele of appendix encountered over the period of five years in our department were managed and reported. Results: We present a series of three cases of appendiceal mucocele and included two females and one male patient with a median age of 41.67 years. Clinical examination, biochemical parameters, and imaging studies showed features of acute appendicitis. A 65-year-old female patient, presented with signs and symptoms of acute appendicitis was admitted and on exploratory laparotomy, showed inflamed globular cystic mass of appendix 10 cm × 6 cm × 4 cm, with dilated base and subjected to right hemicolectomy. A 35-year-old male patient was operated for appendicitis and diagnosed with mucocele appendix of 6 cm × 1 cm × 1 cm. Another patient, 25-year-old female was subjected to diagnostic laparoscopy in view of recurrent pain in right iliac fossa. A diagnosis of mucocele of appendix was made and removed via endobag. Conclusion: Appendiceal mucocele with acute presentation remains a rare diagnosis. Proper pre-operative workup to reach a definitive diagnosis is imperative for adequate surgical management to prevent the associated post-operative grave complications. Pre-operative diagnosis helps in decision making for the selection of the appropriate surgical procedure and alarms the operating surgeon for meticulous surgical dissection, adequate removal of mesoappendix with utmost cautious to prevent the mucus spillage into the peritoneal cavity.