2020 Volume 40 Issue 1 Pages 35-38
A 48–year–old man was admitted to our hospital complaining of epigastric and right lower abdominal pain. Laboratory tests showed elevated levels of inflammatory response markers, and contrast–enhanced abdominal CT showed a cystic mass extending from the cecum to the right side of the pelvis and a positive whirl sign of the appendiceal root. The patient was diagnosed as having torsion of an appendiceal mucocele, and emergency operation was performed. At laparotomy, the appendix was found to be swollen with mucus and twisted clockwise by about 720 degrees. After releasing the torsion, appendectomy was performed using an automatic suturing device. We simultaneously performed ileocecal resection with lymph node dissection, as we could not rule out the possibility of mucinous cystadenocarcinoma. The resected specimen showed that the appendix was filled with a gelatin–like substance, and histopathological examination revealed hemorrhagic and congestive changes of the front two–thirds of the appendiceal wall; based on the findings, the condition was diagnosed as a mucous cystadenoma. This case of torsion of an appendiceal mucocele in a patient who presented with the signs of acute abdomen is reported, along with a discussion of the relevant literature.
