A Case of Strangulated Bowel Obstruction due to Entrapment of Appendiceal Mucinous Carcinoma Treated by Laparoscopy in a Two-Stage Operation

Abstract

A 69-year-old man was brought into our hospital with abdominal pain and vomiting. A CT scan of the abdomen revealed strangulated bowel obstruction in the terminal ileum, and emergency laparoscopic surgery was performed. A cystic mass was found at the apical end of the appendix, and the appendix was wrapped around the ileum, causing strangulated bowel obstruction. Considering that the extent of resection of appendiceal mucus-producing tumor depends on the histological type and the risk of suture failure in case of anastomosis, we decided to perform additional resection depending on the results of histopathological examination, and the operation was completed with appendectomy and removal of the bowel obstruction. The histopathological diagnosis was mucinous carcinoma, and a laparoscopic ileal resection was performed at a later date. We believe that laparoscopic surgery is the best first surgery for strangulated intestinal obstruction caused by an appendiceal tumor, because there is a possibility of selecting the two-stage approach.