Asian Journal of Case Reports in Surgery

A Rare Case of Appendiceal Intussusception Secondary to Low-Grade Mucinous Neoplasm

Rajendra Shinde

Department of General Surgery, MGM Medical College and Hospital, Aurangabad, Maharashtra, India.

Nikita N. Marathe *

Department of General Surgery, MGM Medical College and Hospital, Aurangabad, Maharashtra, India.

Naresh B. Kumar

Department of General Surgery, MGM Medical College and Hospital, Aurangabad, Maharashtra, India.

Amit Lathoriya

Department of General Surgery, MGM Medical College and Hospital, Aurangabad, Maharashtra, India.

Gopal Chitlange

Department of General Surgery, MGM Medical College and Hospital, Aurangabad, Maharashtra, India.

Pratik Jadhav

Department of General Surgery, MGM Medical College and Hospital, Aurangabad, Maharashtra, India.

*Author to whom correspondence should be addressed.

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Abstract

Appendiceal intussusception is an unusual clinical entity, and when it is caused by a low-grade mucinous neoplasm, it becomes exceptionally rare. A 27-year-old female sought medical attention with a 3-day history of abdominal pain and recurrent vomiting. Clinical examination revealed right iliac fossa tenderness. Emergency imaging, ultrasound of abdomen, revealed a blind-ending, thick-walled, non-compressible tubular structure with a target appearance, suggesting appendiceal intussusception. Laboratory findings showed lymphocytosis, while other parameters were within the normal range. Confirmation of the diagnosis and assessment of disease extent were achieved through contrast-enhanced computed tomography (CECT) of the abdomen and pelvis. CECT revealed a soft tissue mass at the ileocecal junction with peripheral enhancing walls, indicative of an inflammatory process. A dilated and inflamed appendix, with post-contrast enhancement, was observed to be contributing to this mass. The patient underwent laparotomy, where approximately 100-150ml of inflammatory fluid was drained, and the inflamed appendix was identified intussuscepted into the cecum with associated adhesions. Appendicitis intussusception is a rare condition that requires appendectomy for treatment. Based on a study of 71,000 human appendix surgical specimens, the incidence of appendix intussusception has been estimated to be.01%.

Keywords: Appendiceal intussusception, low-grade mucinous neoplasm, hemicolectomy, appendectomy, appendicitis

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