A CASE OF MUCOCELE OF APPENDIX CAUSING AN INTUSSUSCEPTION

Abstract

A rare case of appendiceal mucocele causing an intussusception is reported. An 89-year-old woman was admitted to the hospital because of abdominal pain and vomiting. She was suspected to have an intussusception on abdominal ultrasonography (US) and computed tomography (CT), and a gastrographin enema revealed a typical ‘crab-finger’ finding in the hepatic flexure. Thereafter, the intussusception was spontaneously released. We could not identify any cause of the intussusception and followed the patient on an ambulant basis. Half a year later, she visited the hospital again because of right flank abdominal pain and was diagnosed as having intussusception caused by a cystic mass by abdominal CT and US. She had rebound tenderness and so we performed an emergency operation. Because the release of the intussusception was unsuccessful during surgery, a right hemicolectomy was performed. Even in the resected material, the intussusception could not be released manually. Histological diagnosis was mucinous cystadenoma.
Abdominal ultrasonography and computed tomography are useful for the preoperative diagnosis of this desease and in a case of poor risk or when the patient shows the sign of peritonitis or intestinal necrosis, the opportunity of the operation should not be missed.