Abstract
A case of a giant mucocele of the appendix presented with ileus accompanied by Chilaiditi syndrome is reported with a review of the literature.
A 41-year-old man was admitted to the hospital because of abdominal pain, diarrhea, and vomiting. Chest and abdominal X-ray studies showed ileus with Chilaiditi's sign. Abdominal CT scan revealed an encapsulated cystic lesion in the lower abdomen. After recovery of the ileus by welling an ilues tube, abdominal ultrasonography revealed a 13cm giant cystic mass with liquid content. We performed an operation under the diagnosis of an abdominal giant cystic lesion on the 7th hospital day. Laparotomy showed a giant mucocele of the appendix, and an ileocecal resection was carried out. The resected appendix was 17.2×7.7cm in size, and filled with gelatin-like substance. On pathohistlogical study, the mucosa and proper muscle layer of the appendix almost disappeared and the wall was replaced by fiberous tissue. As far as we inspected, there was no neoplastic change in the specimen. We recognized mobile cecum during surgery, and supposed that torsion of the mucocele had caused ileus and Chilaiditi syndrome.
