Woman 73 yo has pain at right pelvis for 6 days, crisis, hyperperistalsis. Ultrasound shows one cystic mass nearby urinary bladder, with size of 4 cm, round border with the neck connecting to lumen of intestine.
See 3 ultrasound pictures with 3.5 MHz curve probe, and with linear probes 12 MHz; this cystic mass has multilayer wall, calcification of the border, the fluid is cloudy. This cystic mass is moving with hyperperistalsis due to intussusception (3 images).
On MDCT this mass is cystic, intra intestine lumen, portion of terminal ilium.
This case has emergent onset. Ultrasound first says that intussusception, but don't know what the cyst is; MDCT suggests an appendicular mucocele. Do you agree with the idea ?
Operation is laparotomy which detects right colon very mobile with one mass at appendix site.
Procedure is right hemicolectomy. In macroscopic dissection, specimen is an appendicular mucocele. Wait for confirmation of microscopy.
The clinical case of intussusceptions in old woman has the cause. Ultrasound detects cystic mass close to urinary bladder which is not common cause for ileo-colic intussusception.
MCDT reveals cyctic mass intra intestinal lumen with mural calcification is the key point for diagnosing this case.
Microscopic report is mucinous carcinoma of appendix.
Microscopic report is mucinous carcinoma of appendix.
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