Appendiceal mucocele as an infrequent cause of acute abdomen.

Abstract

Introduction: Appendicular tumorshave a low incidence and constitute a small group within the pathology of this organ, in which inflammatory processes predominate widely. A primary appendicular tumor is diagnosed in 0.9 to 0.14% of appendectomies. Among the most commonbenign tumors are mucinous schistodenoma; the mucous tumor, which is the most common in the appendix and is associated with ovarian chostodenomas and colonic tumors. Another benign tumor is the simple mucocele.

Objective: Describe a clinical case focused on the appendicularmucocele, as a rare cause of acute abdomen.

Material and methods: Estudio descriptivo retrospectivo, presentación de caso clínico en el Hospital Básico “IESS Latacunga”, caso que fue tratado en el Servicio de Cirugía General del hospital.

Results: Patient of 59 years who per picture of abdominal pain of 4 days of evolution, diffuse location, 15 hours before his admission the pain is in right iliac pit, at the colic type, of moderate intensity, was accompanied by nausea that reaches vomiting on two occasions, thermal rise and anorexia. To the physical examination: vital signs within normal parameters, tense abdomen, depressible, painful to shallow and deep palpation in right iliac pit, with presence of mass approximately 7 cm x 5 cm in diameter, positive appendicular points. Laboratory tests showed: leukocytosis plus neutrophilia. Abdominal ultrasound: cecal appendix not visible, no free liquid is observed in abdominal cavity. Exploratory laparotomy was performed, where complex mass consisting of blind, major epilon terminal ileon and a cystic appendage approximately 10 cm in diameter larger was identified; for which right hemicolectomia was performed plus transverse ilee anastomosis term terminal. Patient with favorable evolution, is discharged on the fifth day. The anatomopathological study resulted in low-grade mucinous cystic neoplasm (mucinous cystodenoma) and tubular adenoma with low-grade dysplasia.

Conclusions: The appendicular mucocele is the most common benign tumor in the appendix. The final diagnosis is made after surgery, as a finding and with the histopathological report as in the case described. Image studies are very useful for identification.; it should be considered in the differential diagnosis of a right pelvic mass, because clinically and radiologically it is easy to confuse with complicated appendicitis.