1/26. intussusception of a mucocele of the appendix secondary to an obstruction by endometriosis: report of a case.We treated a patient with a complete invagination of the cecum which contained a mucocele of the appendix secondary to an obstruction by endometriosis. Preoperatively, a barium enema showed a crab's claw-like area without filling in the oral side of the transverse colon. An emergency laparotomy was performed and revealed a mucocele of the appendix to have induced appendicecal invagination; however, no colonic invagination was observed. An appendicecal resection was thus done. Pathologically, the resected specimen was a mucosal hyperplasia with mucin-secreting lesions of the appendix. The theories regarding the pathogenesis of appendicecal mucocele are reviewed and discussed.- - - - - - - - - - ranking = 1keywords = colon (Clic here for more details about this article) |
2/26. Enteric mucocele formation after endorectal pull-through: report of a case.We report a case of enteric mucocele formation in a 4-year-old boy after endorectal pull-through correction for Hirschsprung's disease with proximal intestinal neuronal dysplasia. On 17 April 1997, when the patient was 2 years old, a loop ileostomy was performed after an ineffective endorectal pull-through operation involving the right colon. Because of frequent prolapse of the stoma, when the child was two-and-a-half years old an end ileostomy was made by a resection of the distal ileotoma and redundant terminal ileum. When he was 4 years old, he was readmitted because of ileus, peritonitis, and a huge abdominal mass. Complete atresia of the colon at the level of pelvic reflection with proximal enteric mucocele formation was noted at laparotomy. He made an uneventful recovery after resection of the mucocele. This is the first reported case of such a complication after an endorectal pull-through operation. The possible causes and techniques for the prevention of this complication are discussed.- - - - - - - - - - ranking = 1keywords = colon (Clic here for more details about this article) |
3/26. A large mediastinal tumor with spontaneous regression 30 years after esophageal bypass surgery.We describe the case of an 80-year-old man admitted to the hospital for the first time with chest pain and progressive respiratory difficulty. Radiographic findings of the chest showed a large, cystic mediastinal mass from the jugulum to the diaphragm. The patient's history revealed bypass operation for a benign esophageal stricture 30 years ago. During the hospital stay, clinical symptoms resolved within 48 hours without specific treatment. Seven days after admission a chest roentgenogram showed almost complete regression of the tumor, which was supposed to be a mucocele of the colon bypassing the esophagus.- - - - - - - - - - ranking = 0.5keywords = colon (Clic here for more details about this article) |
4/26. intussusception of an appendiceal mucocele: report of a case.A 66 year old Japanese female was admitted to our department for the examination and treatment of a mass in the cecum. She had experienced no symptoms or signs other than a positive test result for fecal occult blood. The mass in the cecum was confirmed by barium enema, colonofiberscopy and CT scanning. The presumptive diagnosis was a submucosal tumor of the cecum, however, a laparotomy subsequently revealed intussusception of an appendiceal mass. An ileocaecal resection with an ileocolic anastomosis was therefore performed and the mass was histologically diagnosed as a mucocele of the appendix. This patient is only the 24th case of intussusception of a mucocele of the appendix to be reported in japan. A review of the available literature on this condition follows the case report.- - - - - - - - - - ranking = 0.5keywords = colon (Clic here for more details about this article) |
5/26. carcinoembryonic antigen elevation due to bowel sequestration with mucocele formation following colonic resection.carcinoembryonic antigen (CEA) is recommended as a serologic marker to monitor colorectal carcinoma recurrence. Elevations of CEA due to causes other than carcinoma exist and may lead to a misdiagnosis of recurrent carcinoma. We report a case of bowel sequestration with mucocele formation at the site of previous colo-colic anastomosis causing a mild elevation in CEA. The patient exhibited increasing CEA levels 6 years after resection of a sigmoid colon carcinoma with end-to-end anastomosis. Subsequently, computed tomographic and positron emission tomographic scans documented the presence of a cystic mass showing increased uptake at the anastomotic site. At exploratory laparotomy a mass lesion with mucus-filled protrusions was resected. Pathologic examination documented the presence of sequestration of a segment of the bowel wall with a mucocele and no overlying defect at the mucosal anastomotic site by demonstrating the presence of all bowel layers. After resection of the lesion, the CEA level normalized.- - - - - - - - - - ranking = 2.5keywords = colon (Clic here for more details about this article) |
6/26. cystadenocarcinoma of the appendix: an incidental imaging finding in a patient with adenocarcinomas of the ascending and the sigmoid colon.BACKGROUND: Primary adenocarcinomas of the appendix are uncommon. Mucoceles that result from mucinous adenocarcinomas of the appendix may be incidentally detected on imaging. CASE PRESENTATION: A case of a mucocele of the appendix, due to cystadenocarcinoma, is presented as an incidental imaging finding in a female, 86-year-old patient. The patient was admitted due to rectal hemorrhage and underwent colonoscopy, x-ray, US and CT. Adenocarcinoma of the ascending colon, adenomatous polyp of the sigmoid colon and a cystic lesion in the right iliac fossa were diagnosed. The cystic lesion was characterized as mucocele. The patient underwent right hemicolectomy, excision of the mucocele and sigmoidectomy. She recovered well and in two-year follow-up is free from cancer. CONCLUSIONS: Preoperative diagnosis of an underlying malignancy in a mucocele is important for patient management, but it is difficult on imaging studies. Small lymph nodes or soft tissue stranding in the surrounding fat on computed tomography examination may suggest the possibility of malignancy.- - - - - - - - - - ranking = 3.5keywords = colon (Clic here for more details about this article) |
7/26. mucocele of the appendix: a report of five cases.mucocele of the appendix is an uncommon disorder, characterized by a cystic dilatation of the lumen. It is often diagnosed clinically from signs and symptoms of acute appendicitis or, if it is asymptomatic, as an incidental finding during ultrasonography, computed tomography, and radiographic examinations of the gastrointestinal tract, or laparotomy. The incidence of mucocele ranges from 0.2% to 0.3% of all appendectomy specimens. We report five cases of appendiceal mucocele (all women, aged 19-90 years), who were admitted from January 1993 to January 2003 to our hospital. These cases represent 0.29% of the 1720 appendectomies performed during this period. Three of the patients were symptomatic and had appendectomies. The final diagnosis for mucocele was given at laparotomy. No colon neoplasms were identified during surgery, and subsequent colonoscopic examinations were also negative. The other two patients were asymptomatic of appendiceal tumor. colonoscopy revealed two colonic malignant tumors in one patient and an adenocarcinoma of the sigmoid colon in the other. mucocele of the appendix was diagnosed pre-operatively by ultrasound and computed tomography. One of the two patients underwent a right hemicolectomy and sigmoidectomy; the other one underwent an appendectomy, cecostomy and sigmoidectomy. Four of the patients recovered and are doing well today; one patient died on the twenty-fifth postoperative day. The most common symptom of mucocele is abdominal pain, although many patients may be asymptomatic. mucocele is often associated with concomitant colon cancer, thus patients with this tumor should be systematically checked for other colonic lesions.- - - - - - - - - - ranking = 3keywords = colon (Clic here for more details about this article) |
8/26. mucocele of the appendix: computed tomographic, endoscopic, and pathologic correlation.Mucoceles of the appendix are a rare group of lesions thought to occur as a sequelae of luminal obstruction as well as certain benign and malignant neoplasms of the appendix. Early, preoperative diagnosis is rare. We report a case of an appendiceal mucocele in which the diagnosis was suggested by computed tomographic imaging and colonoscopy, and confirmed at surgery. Radiologic, endoscopic, and pathologic correlations of this rare entity are discussed.- - - - - - - - - - ranking = 0.5keywords = colon (Clic here for more details about this article) |
9/26. Recovery from idiopathic thrombocytopenic purpura (ITP) following right hemicolectomy for mucocele of appendix.A 61-year-old woman with a 2-year medication-free history of idiopathic thrombocytopenic purpura was referred to our hospital complaining of right lower abdominal pain. The platelet count was about 3-4x10(4)/mm3. This patient was diagnosed with mucocele of the appendix on computed tomography and colonoscopy. We performed only right hemicolectomy without splenectomy. The pathological diagnosis was mucinous cystadenoma of the appendix. The platelet count increased to 18.1x10(4)/mm3 on postoperative-day 7, and remained stable, at 20-24x10(4)/mm3, for 14 months after the operation. Platelet-associated immunoglobulin g decreased remarkably after the operation, to 30.2 ng/10(7) cells, from 240 ng/10(7) cells preoperatively. We describe the first case of recovery from idiopathic thrombocytopenic purpura following right hemicolectomy performed for mucocele of the appendix. Considering our patients clinical course, it is possible that mucinous cystadenoma of the appendix may have influenced the thrombocytopenia. Findings in this patient suggest that mucocele of the appendix may be associated with a new diagnosis and idiopathic thrombocytopenic purpura treatment.- - - - - - - - - - ranking = 0.5keywords = colon (Clic here for more details about this article) |
10/26. Retention mucocele of distal viable remnant tip of appendix: an unusually rare late surgical complication following incomplete appendectomy.A 67-year old man was presented with a 6-mo history of recurrent right lower quadrant abdominal pain. On physical examination, a vague mass was palpable in the right lumbar region. His routine laboratory tests were normal. ultrasonography showed a hypoechoic lesion in the right lumbar region anterior to the right kidney with internal echoes and fluid components. Abdominal contrast-enhanced computed tomography (CECT) showed a well-defined hypodense cystic mass lesion lateral to the ascending colon/caecum, not communicating with the lumen of colon/caecum. After complete open excision of the cystic mass lesion, gross pathologic examination revealed a turgid cystic dilatation of appendiceal remnant filled with the mucinous material. On histopathological examination, mucinous cyst adenoma of appendix was confirmed. We report this rare unusual late complication of mucocele formation in the distal viable appendiceal remnant, which was leftover following incomplete retrograde appendectomy. This unusual complication is not described in the literature and we report it in order to highlight the fact that a high index of clinical and radiological suspicion is essential for the diagnosis of mucocele arising from a distal viable appendiceal remnant in a patient who has already undergone appendectomy presenting with recurrent abdominal pain.- - - - - - - - - - ranking = 1keywords = colon (Clic here for more details about this article) |
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