Published in IJCP December 2018
Giant Mucocele Appendix: A Hybrid Laparoscopic Approach
December 11, 2018 | Ashok Kumar Sharma, Renu, Sandeep Singh Mavi

Appendicular mucocele is a rare but well-described clinicopathological diagnosis. It denotes dilatation of the appendix due to luminal obstruction by mucinous secretions. We report a case of a 71-year-old male patient with chronic kidney disease on regular hemodialysis with lump in right iliac fossa since 4 months with no history of pain abdomen. Ultrasonography abdomen followed by contrast enhanced computed tomography of abdomen suggested a diagnosis of mucocele appendix. Patient was taken up for laparoscopic appendectomy which revealed appendix that was hugely dilated with wide base impinging into the cecal wall. In order to prevent intraoperative rupture of mucocele and keeping malignancy as a differential, procedure was converted into open and cecum was repaired at the site of wide appendicular base. Surgery is the definitive treatment for mucocele and laparoscopic assist provides precision of dissection and minimizes injury to surrounding viscera. The aim of this publication is to demonstrate that laparoscopic surgery is as safe as traditional open approach. Also, surgeon should never hesitate to convert the procedure to open if there is risk of peritoneal spillage and doubt of malignancy in mind.