Appendiceal mucocele: a missed diagnosis

Abstract

A 38-year-old man presented to clinic with recurrent right iliac fossa pain from a young age; three episodes of which required hospital admission. He was otherwise well with no associated symptoms. In view of persistent pain and recurrent admissions a CT scan was arranged which showed a dilated retrocaecal appendix suggesting recurrent appendicitis. Further to CT findings the patient underwent an urgent appendicectomy for a presumed diagnosis of chronic appendicitis but histology in fact revealed a cystoadenoma of appendix. Postoperatively the patient's symptoms resolved and he was discharged from surgical care. It is important to note that in this case the diagnosis of appendiceal mucocele was not considered therefore not particularly accounted for during surgery. Has this been a malignant cystadenocarcinoma any spillage of malignant cells into the abdominal cavity during the operation could have a grave impact on long-term recovery and prognosis.

Figure 1

CT scan abdomen showing dilated appendix.