Preoperative assessment and treatment of appendiceal mucocele complicated by acute torsion: a case report

BMC Research Notes

Berndt Enholm³  Mikko Jousi²  Christoffer Stark¹ 

[1] Department of Surgery, Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland;Department of Radiology, Päijät-Häme Central Hospital, Keskussairaalankatu 7, 15850 Lahti, Finland;Department of Surgery, Päijät-Häme Central Hospital, Keskussairaalankatu 7, 15850 Lahti, Finland

关键词: Laparoscopy;    Appendectomy;    Magnetic resonance imaging;    Ultrasonography;    Torsion;    Mucocele;    Appendix;   

Others  :  1134996
DOI  :  10.1186/1756-0500-7-1

 received in 2013-08-14, accepted in 2013-11-18,  发布年份 2014

【 摘 要 】

Background

Mucus-producing tumours of the appendix or mucoceles can, if left untreated, lead to dissemination of its contents into the peritoneal cavity causing substantial morbidity to the patient. Symptoms for complicated mucoceles can mimic those of acute appendicitis and the final diagnosis is most likely made intraoperatively. We here present a case that is, to our knowledge, one of only ten described in the literature and the first to characterize torsion of an appendiceal mucocele with abdominal magnetic resonance imaging.

Case presentation

The patient, a 34-year-old Caucasian female presented at the emergency department with acute abdominal pain in the right lower quadrant. Initial diagnostic work-up including ultrasonography and abdominal magnetic resonance imaging showed a large tubular mass at the base of the appendix with indirect signs of torsion. A laparoscopic appendectomy was performed the following day where the finding was confirmed. The patient went on to have an uneventful recovery and was discharged from the hospital on the first postoperative day.

Conclusions

Magnetic resonance imaging is a useful tool in identifying unknown lesions of the appendix and should be considered the primary imaging modality in especially younger patients requiring diagnostic imaging. In this case the preoperative imaging findings aided in choosing the correct timing and treatment option for the patient.

【 授权许可】

   
2014 Stark et al.; licensee BioMed Central Ltd.

【 图 表 】

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