[Ileocecal invagination of a mucocele of the appendix].
METHODS
A 39-year-old patient was admitted because of pain in the right mid and lower abdomen of 2 weeks duration with vomiting and postprandial nausea. He complained of changing stool habits with diarrhoea and constipation. Clinically he showed a slight tenderness in the right lower abdomen.


METHODS
Routine laboratory test were normal including CRP and WBC. Ultrasound showed a non-compressible mass with low intensity echoes, 3.6 x 4.6 cm in diameter in the right mid abdomen, slightly tender, surrounded by a circular, intestine-like structure. A gastrografin-swallow didn't reveal any obstacle in the proximal small intestine and was inconclusive further distal. A CT scan demonstrated a ileocoecal invagination extending in the colon ascendens to the right flexure with suspicion of a tumor. At the colonoscopy on the next day the invagination was not apparent any more, but a well-rounded tumour in the appendix region was seen.


METHODS
Suspecting a coecal tumour with remitting ileocoecal invagination a ileocoecal resection was performed on the third day. The tumour proved to be a mass of mucus with parts of a villo-mucinous cystadenoma of the UMP type. Recovery was uneventful.


CONCLUSIONS
Mucoceles of the appendix can cause ileocoecal invagination in the adult.
Koch
W
W
Chirurgische Klinik, Kantonales Spital, Flawil/CH. Koch64@gmx.de
Walser
A
A
Itin
H
H
D000328:Adult; D001065:Appendix / Q000000981:diagnostic imaging / Q000473:pathology*; D003113:Colonoscopy; D006801:Humans; D007077:Ileal Diseases / Q000150:complications / Q000175:diagnosis; D007080:Ileocecal Valve / Q000000981:diagnostic imaging / Q000473:pathology*; D007443:Intussusception / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D009078:Mucocele / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D011859:Radiography; D014463:Ultrasonography