title: Intestinal strangulation caused by a mucocele of the appendix: report of a case.
abstract: Intestinal strangulation caused by a mucocele of the appendix is extremely rare and difficult to diagnose. It is not usually suspected pre-operatively. This report presents a case of intestinal strangulation due to a mucous containing cystic lesion that was wrapped around the base of a loop of the small bowel. An 89-year-old female was transferred after an acute onset of abdominal pain. A physical examination revealed severe tenderness with guarding in the right upper quadrant. CT of the abdomen showed a loop of dilated small bowel with edema on the right side of the abdominal cavity suggesting a closed loop obstruction. In addition, a low-density thin-walled mass measuring 5 cm in diameter was also seen in the pelvis. Intestinal strangulation was suspected and emergency laparotomy was thus performed. A loop of terminal ileum 25 cm in length was strangulated by a dilated appendix, and ileocecal resection was performed. The resected appendix measured 9 × 3 cm in size and contained mucus. A histopathological examination showed a mucous containing cystic appendix without mucin-producing, neoplastic epithelial cells. A mucocele of the appendix can present in various ways and it is important to recognize this entity at the time of surgery.
authors: Department of Surgery, Jichi Medical University, 3311-1 Yakushiji Shimotsuke, Tochigi 329-0498, Japan. miyakura@jichi.ac.jp
authors: Yasuyuki
authors: Y
authors: Miyakura
authors: Shinichiro
authors: S
authors: Yokota
authors: Hisanaga
authors: H
authors: Horie
authors: Kazutomo
authors: K
authors: Togashi
authors: Alan
authors: A
authors: Lefor
authors: Yoshikazu
authors: Y
authors: Yasuda
authors: Noriyoshi
authors: N
authors: Fukushima
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000369:Aged, 80 and over; D001065:Appendix / Q000000981:diagnostic imaging* / Q000601:surgery; D002429:Cecal Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D007813:Laparotomy; D009078:Mucocele / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D011856:Radiographic Image Enhancement; D035583:Rare Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed