APPENDICEAL MUCOCELE: A RARE CLINICAL ENTITY – CASE REPORT danielbarocio03@gmail.com

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APPENDICEAL MUCOCELE: A RARE CLINICAL ENTITY – CASE REPORT

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Mexico

Poster Exhibition only

Appendiceal mucocele is a cystic dilatation of the appendiceal lumen caused by obstructive processes, leading to retrograde accumulation of mucinous material. First described by Rokitansky in 1842, it may originate from primary or secondary lesions, with benign or malignant potential. This entity is rare, with an incidence of 0.2–0.3% among appendectomies and 8–10% of all appendiceal tumors

A 76-year-old female with controlled hypertension and hypothyroidism presented with diffuse colicky abdominal pain (10/10 VAS), distension, and decreased peristalsis, without nausea or fever. Abdominal CT revealed findings suggestive of reflex ileus, with differential diagnosis including appendicitis versus acute diverticulitis. Due to poor clinical evolution, surgical management was indicated.

Laparoscopic exploration identified inflammatory free fluid, multiple adhesions (Mazuji III), and a 5×3 cm appendiceal tumor. Appendectomy was performed without complications, with an estimated blood loss of 50 mL. Postoperative recovery was favorable, and the patient was discharged on postoperative day two. Pathology confirmed a low-grade appendiceal mucinous neoplasm.

Low-grade appendiceal mucinous neoplasms are uncommon but carry an excellent prognosis when diagnosed and treated early. Their nonspecific and often subtle clinical presentation poses a diagnostic challenge, highlighting the importance of maintaining a high index of suspicion, particularly in elderly patients with atypical abdominal pain. Prompt surgical intervention not only prevents complications such as pseudomyxoma peritonei but also ensures optimal outcomes. Awareness among primary care physicians and surgeons is crucial to improve detection and management of this rare but significant entity.