Volvulus of an appendiceal mucocele: report of a case. 2007

Udo Rudloff, and Sandeep Malhotra
Department of Surgery, New York University Medical Center, New York, NY 11040, USA.

Few cases of volvulus of an appendiceal mucocele have been reported. The mechanism of torsion seems to be similar to that suggested for ovarian or appendegeal torsion, where a solid organ or mass fixed onto a narrow stalk is a precondition. We report the case of a young woman who presented with signs and symptoms of acute appendicitis. Computed tomography showed a cystic mass of fluid consistency in the right lower quadrant. An emergency laparoscopy revealed a 720 degrees torsion of a gangrenous mucocele around the proximal part of the appendix. We performed a laparoscopic appendectomy and she recovered uneventfully. The presentation of volvulus of an appendiceal mucocele can mimic other common conditions. Prompt surgical intervention is essential to prevent gangrene and perforation. The combination of a cystic, right lower quadrant mass, and clinical findings suggestive of acute appendicitis should alert the clinician to include volvulus of an appendiceal mucocele in the differential diagnosis.

UI MeSH Term Description Entries
D009078 Mucocele A retention cyst of the salivary gland, lacrimal sac, paranasal sinuses, appendix, or gallbladder. (Stedman, 26th ed) Mucoceles
D010535 Laparoscopy A procedure in which a laparoscope (LAPAROSCOPES) is inserted through a small incision near the navel to examine the abdominal and pelvic organs in the PERITONEAL CAVITY. If appropriate, biopsy or surgery can be performed during laparoscopy. Celioscopy,Laparoscopic Surgical Procedures,Peritoneoscopy,Surgical Procedures, Laparoscopic,Laparoscopic Assisted Surgery,Laparoscopic Surgery,Laparoscopic Surgical Procedure,Procedure, Laparoscopic Surgical,Procedures, Laparoscopic Surgical,Surgery, Laparoscopic,Surgical Procedure, Laparoscopic,Celioscopies,Laparoscopic Assisted Surgeries,Laparoscopic Surgeries,Laparoscopies,Peritoneoscopies,Surgeries, Laparoscopic,Surgeries, Laparoscopic Assisted,Surgery, Laparoscopic Assisted
D002429 Cecal Diseases Pathological developments in the CECUM. Cecal Disease,Disease, Cecal,Diseases, Cecal
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D001062 Appendectomy Surgical removal of the vermiform appendix. (Dorland, 28th ed) Appendectomies
D001065 Appendix A worm-like blind tube extension from the CECUM. Vermiform Appendix,Appendix, Vermiform
D045822 Intestinal Volvulus A twisting in the intestine (INTESTINES) that can cause INTESTINAL OBSTRUCTION. Volvulus,Volvulus, Intestine,Volvulus, Intestinal

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