Display options
Share it on

Clin J Gastroenterol. 2012 Jun;5(3):220-4. doi: 10.1007/s12328-012-0302-9. Epub 2012 Apr 28.

Rupture of appendiceal mucocele due to endometriosis: report of a case.

Clinical journal of gastroenterology

Yasuyuki Miyakura, Hidetoshi Kumano, Hisanaga Horie, Alan T Lefor, Yoshikazu Yasuda, Takehiko Yamaguchi, Hiroshi Azuma

Affiliations

  1. Departments of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. [email protected].
  2. Department of Pathology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. [email protected].
  3. Utsunomiya Coloproctology Clinic, 1-1-7 Daikan-chou, Utsunomiya, Tochigi, 320-0867, Japan. [email protected].
  4. Departments of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
  5. Department of Pathology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
  6. Utsunomiya Coloproctology Clinic, 1-1-7 Daikan-chou, Utsunomiya, Tochigi, 320-0867, Japan.

PMID: 26182324 DOI: 10.1007/s12328-012-0302-9

Abstract

We report a rare case of a mucocele of the appendix due to endometriosis which accidentally ruptured prior to surgery. A 56-year-old woman was referred to our institution for further evaluation of a cecal tumor. Colonoscopy showed a submucosal tumor at the appendiceal orifice in the cecum. Computed tomography and magnetic resonance imaging showed a well-circumscribed mass measuring 4 cm in diameter in the right lower quadrant. A preoperative diagnosis of a simple mucocele of the appendix was established. At laparotomy, a mucocele was identified in the right side of the abdomen; however, part of the mucocele had ruptured and yellow mucin was seen around the cecum. An ileocecal resection was performed. Histopathological examination was consistent with a mucocele of the appendix due to endometriosis. Cytology specimens from the yellow mucin showed few proliferating epithelial cells with a mild degree of cytological and architectural atypia. Mechanical pressure due to excess anteflexion during administration of epidural anesthesia may have contributed to the rupture of the mucocele. It is important to handle a mucocele of the appendix with great care to avoid rupture at the time of operation, including during the administration of epidural anesthesia.

Keywords: Appendix; Endometriosis; Mucocele; Rupture

References

  1. Am J Clin Pathol. 2000 Jun;113(6):860-4 - PubMed
  2. Gastrointest Endosc. 1989 Sep-Oct;35(5):453-6 - PubMed
  3. AJR Am J Roentgenol. 1995 Dec;165(6):1552 - PubMed
  4. Am J Obstet Gynecol. 1975 Feb 1;121(3):423-6 - PubMed
  5. South Med J. 1994 Aug;87(8):833-5 - PubMed
  6. Am J Surg Pathol. 1995 Dec;19(12):1390-408 - PubMed
  7. BJOG. 2001 Jan;108(1):124-5 - PubMed
  8. Hum Pathol. 1977 Sep;8(5):585-9 - PubMed
  9. World J Gastroenterol. 2005 Aug 14;11(30):4761-3 - PubMed
  10. Surg Today. 1999;29(7):629-32 - PubMed
  11. J Minim Invasive Gynecol. 2005 Jul-Aug;12(4):299-300 - PubMed
  12. J Am Coll Surg. 2006 Apr;202(4):680-4 - PubMed

Publication Types