Mucocele of the appendix
(MA) is rather rare disease, which is characterized cystic expansion of appendix
gleam caused by an excess congestion of slime. Mucocele meets in 0,02-0,7%
cases of all appendectomy according to different authors. Clinical
manifestation of MA is atypical and can imitate various pathologies of small pelvis,
therefore ultrasound data as primary inspection, are extremely important.
Objective:
to show possibilities of ultrasound in MA diagnostics.
Materials and Methods: 6 patients with MA (female – 4 (66,7%), male – 2 (33,3%), average age –
56,7) were
presurgical
inspected by ultrasound. All patients were
operated on. Neoplasms were morphologically verified.
Results: The
location of the appendix was typical in 5 cases, retrocecal – in 1. The amount
of neoplasms varied ranging from 32,0x20,0x18,0 to 97,7x50,9x57,0 mm. According
to histologic classification of mucocele (Aho A. et al., 1973; Higa E. et al.,
1973) three types of neoplasms were diagnosed:
- simple
mucocele of the
appendix – 4 (unechoic
neoplasm with insignificant quantity of the isoechoic suspension in the form of
a spiral ("onion-skin");
- hyperplasia of a mucous
membrane (with myxoglobulosis) – 1 (hypoechoic neoplasm, contents are verified
as viscous liquid with insignificant quantity of isoechoic suspension at 3D-reconstruction);
- mucous cystadenoma – 1
(cystic-solid neoplasm).
Neoplasm wall’s thickness
varied ranging 0,3-0,9 mm.
Bloodflow in neoplasm capsule didn't reveal at duplex scanning. Calcium
inclusions in a wall were in 3 cases. The complicated current to a mucocele is
diagnosed in one case: peritoneum pseudomyxoma at the 3rd type of mucocele with
a retrocecal appendix location (the wrong form delimited liquid congestion (a
little non-uniform structure) around neoplasm).
Lymph nodes weren't
increased in one case.
Presurgical diagnosis: MA
– 3; ovary/appendix??? cystic-solid tumor - 1; retroperitoneal neoplasm – 2.
Conclusion: MA is a rare disease. A correct diagnosis before surgery is
very important for the selection of surgical technique to avoid severe postoperative
complications. Ultrasound allows to diagnose and differentiate MA.
