Asian Journal of Case Reports in Surgery

Ileocecal Intussusception Caused by Appendiceal Mucinous Neoplasm

Maria João Vale *

Surgery Department, Hospital Sousa Martins, Unidade Local de Saúde da Guarda, Portugal.

Pedro Caldes

Surgery Department, Hospital Sousa Martins, Unidade Local de Saúde da Guarda, Portugal.

Sónia Bispo

Surgery Department, Hospital Sousa Martins, Unidade Local de Saúde da Guarda, Portugal.

Augusto Lourenço

Surgery Department, Hospital Sousa Martins, Unidade Local de Saúde da Guarda, Portugal.

*Author to whom correspondence should be addressed.

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Abstract

Aims: To present an unusual case and our therapeutic approach about a clinical case of ileocecal intussusception caused by appendiceal mucinous neoplasm.

Presentation of Case:  A 54-year-old female patient came to the emergency department with abdominal pain. Complementary diagnostic exams showed an image of ileocolic invagination due to an appendicular mass, confirmed intraoperatively.  A right hemicolectomy was performed for oncological purposes. The anatomopathological study revealed a low-grade appendicular mucinous neoplasm.

Discussion and Conclusion:  Ileocecal intussusception is a rare diagnosis in adults, 80-92% of cases are secondary to an underlying pathology, usually identified intraoperatively. The treatment is surgical, due to the high incidence of a malignant etiology. In this particular case, there was already a preoperative suspicion of an appendicular neoplasm, which justified proposing a right hemicolectomy. There is no general consensus on the post-operative monitoring of Low-Grade Appendiceal Mucinous Neoplasm (LAMN). In this case, the follow up was an analytical study with tumor markers, computed tomography and colonoscopy. After 5 years, the patient was asymptomatic, with no signs of recurrence.

Keywords: Ileocecal intussusception, ileocecal appendix, mucinous neoplasm

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