Abstract
Mucocele of the appendix defined as a state where the mucus collects in the appendiceal lumen to form a cystic swelling is not so uncommon disease but rarely complicated with strangulation ileus. We recently encountered a case of mucocele of the appendix complicated with strangulation ileus.
A 77-year-old female was admitted because of abdominal pain. Her abdomen was distended, and besides physical examination showed that she was shocked. The patient underwent emergency operation under a diagnosis of strangulation ileus by ultrasound sonography. The balloon-shaped tip of the appendix adhered to the peritoneum and an approximately 1 m ileum was starangulated by the loop of the appendix. Therefore, the necrotic ileum and the cecum including the appendix were resected. The tip of the appendix made an egg-shaped mucocele measuring 5×3.5 cm with a thin and smooth wall. The section revealed unilocular and the cavity was filled with semitransparent, milky jelly like substance. There was no communication between the mucocele and the cavity of the cecum. Histopathologically it was a mucinous cystadenoma of the appendix and the strangulated ileum proved to be transmural hemorrhagic necrosis.
Strangulation ileus is a rare complication of mucocele of the appendix and the 14th case in Japan is presented.
