Appendiceal intussusception to the cecum caused by mucocele of the appendix: Laparoscopic approach.

INTRODUCTION: Appendiceal intussusception is a very rare disease that is found in only 0.01% of patients who have undergone an appendectomy. Clinical symptoms vary and some patients are asymptomatic. Laparoscopic surgery for appendiceal tumors is still controversial. We present a case of intussusception of the appendix with a mucinous cystadenoma treated by laparoscopic surgery. PRESENTATION OF CASE: We report a case of 47 year-old-women patient who presented with a six month history of intermittent right lower abdominal pain. Abdominal computer tomography CT showed appendiceal mass with intussusception. A laparoscopic right hemicolectomy was performed because the tumor involved the entire appendix. Histopathological examination revealed mucocele due to mucinous cystadenoma of appendix. DISCUSSION: Appendiceal intussusception to the cecum caused by mucocele of the appendix is extremely rare. It is very difficult to diagnose the presence of an intussuscepted appendix pre-operatively and investigations will usually include colonoscopy and CT scan. An appendicular intussusception should not be reduced by colonoscopy. Laparoscopic surgery for appendiceal tumors is still controversial; the main concerns to be addressed are the adequacy of resection and intraperitoneal rupture of the tumor. Our patient successfully underwent laparoscopic surgery without any complications.
CONCLUSION: Appendiceal intussusception to the cecum caused by mucocele of the appendix is a rare cause of abdominal pain and difficult to diagnose. The laparoscopic surgery for appendiceal tumors is safe, feasible, and even may be beneficial.