Mucocele of the appendix: An unusual cause of lower abdominal pain in a patient with ulcerative colitis-. A case report and review of literature

Peter Laszlo Lakatos, Gabriella Gyori, Judit Halasz, Peter Fuszek, Janos Papp, Balazs Jaray, Peter Lukovich, Laszlo Lakatos

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34 Citations (Scopus)

Abstract

The authors report the case of a 60-year-old male patient. In November 2001 he developed intestinal symptoms of bloody diarrhea and abdominal pain. Colononoscopy and biopsy established the diagnosis of ulcerative colitis (proctosigmoiditis). The disease activity was moderate at the beginning. No significant laboratory alterations were found (including CEA, CA19-9), and mesalazine was started orally. He was in remission until November 2003, when he was admitted to our Outpatient Clinic for upper and right lower abdominal pain and bloody diarrhea. Colonoscopy found proctosigmoiditis with a moderate activity, gastroscopy revealed chronic gastritis, laboratory data was normal. Treatment was amended with mesalazine clysma and methylprednisolone (16 mg) orally. Symptoms ameliorated; however, right lower abdominal pain persisted. US and CT examination demonstrated a pericecal cystic mass (11 cmx3.5 cm). At first pericecal abscess was suspected, as the previous US examination (6 mo earlier) had revealed normal findings. Fine needle aspiration was performed. Cytology confirmed the diagnosis of mucocele. The patient underwent partial cecum resection and extirpation of the mucocele. He recovered well and the final histology revealed a cystadenoma of the appendix. Follow up was started. The patient is now free of symptoms. Although primary adenocarcinoma of the appendix is uncommon, the authors emphasize that preoperative diagnosis of an underlying malignancy in a mucocele is important for patient magement; however, it is difficult on imaging studies.

Original languageEnglish
Pages (from-to)457-459
Number of pages3
JournalWorld journal of gastroenterology
Volume11
Issue number3
DOIs
Publication statusPublished - Jan 21 2005

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Keywords

  • Lower abdominal pain
  • Mucocele of the appendix
  • Ulcerative Colitis

ASJC Scopus subject areas

  • Gastroenterology

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