Value of ultrasound and clinical features in differential diagnosis of appendiceal mucocele and acute appendicitis

Abstract

Objective To investigate the ultrasonic manifestations and clinical features in differential diagnosis of appendiceal mucocele and acute appendicitis. Methods Thirty-six cases of appendiceal mucocele (24 cases of appendiceal neoplastic mucocele and 12 cases of appendiceal non-neoplastic mucocele) and 69 patients with acute appendicitis (19 cases of complicated appendicitis and 50 cases of uncomplicated appendicitis) were retrospective analyzed. The maximum diameter, the wall in the appendix (whether displaying, whether thickening, whether with nodules or calcification), age, sex, white blood count (WBC), carcinoembryonic antigen (CEA) were compared between groups. Results Comparing with acute appendicitis, the appendiceal mucocele's average onset age was older and the largest diameter was larger, WBC and CEA increased more commonly, the wall usually can be displayed clearly, with nodules or calcification (P<0.05). The difference between the appendiceal neoplastic mucocele and complicated appendicitis on the displaying rate of appendiceal wall, the age, the WBC and CEA was statistically significant. The onset age of the appendiceal non-neoplastic mucocele was older than uncomplicated appendicitis (P<0.05). Conclusions Appendiceal neoplastic mucocele has characters, grasping its characteristics of ultrasonographic and combination with clinical features can help correct diagnosis and differential diagnosis of the disease. The sonographic findings of the appendiceal non-neoplastic mucocele are similar to those of the uncomplicated appendicitis, it is difficult to identify before operation. Key words: Ultrasonography; Appendicitis; Appendical neoplasms