Global Journal of Medical Research, I: Surgeries and Cardiovascular System, Volume 22 Issue 2

Treatment and Evolution of Appendicular Mucoceles in Six Cases Kouakou Ibrahim Anzoua α , Bernadin Kouamé Kouakou σ , Mamadou Traoré ρ , Ismael Kalou Leh BI Leh BI Ѡ , Ahou Bernadette N’Dri ¥ , Serge Amos Ekra § , Amos Kouakou χ , Inza Bamba ν , Akowendoand Roger Lebeau Ѳ & Bamourou Diané ζ Abstract- Purpose: To report our experience in the management of appendicular mucoceles. Method: Retrospective and descriptive study carried out in the Department of General and Digestive Surgery of the University Hospital of Bouaké. Results: We recorded six cases of appendicular mucocele. The average age of onset was 53 years. The male sex predominated. Pain in the right iliac fossa was the predominant sign. The average duration of evolution was four months. Appendectomy was performed in four patients and appendectomy with partial excision of the coecum in one patient. Histologically, three patients had a simple mucocele, one had a mucinous cytadenoma and one had a cystadenocarcinoma. In the latter, the indication of a right hemicolectomy was recommended but the patient refused the operation. Morbidity was nil. The average follow-up time was 13 months, after which the patients were lost to follow-up. Conclusion: The treatment of appendicular mucocele is surgical. The evolution and the prognosis are conditioned by the histological type, the surgical gesture and the peritoneal cytology. Keywords: mucocele-tumor-appendicectomy. I. I ntroduction ppendiceal mucocele (AM) or mucosecretory tumor of the appendix is a pathological entity referring to cystic dilatation of the appendiceal lumen, secondary to intraluminal accumulation of mucinous, gelatinous, or translucent secretions, which may involve the entire organ or a segment of it, most often distal [1]. This condition is rare. It is observed in 0.15 to 0.6% of appendectomies and represents 7% to 8% of appendicular tumors [2]. Its treatment ranges from simple appendectomy in benign forms to right hemicolectomy for cancer in malignant mucoceles [3]. The most serious complications are the risk of malignancy and peritoneal pseudomyxoma (PMP) in case of perforation [4,5]. The objective of this work was to report our experience in the management of appendiceal mucoceles. Author σ ρ Ѡ ¥ § χ ν Ѳ ζ : General and Digestive Surgery Department, Bouaké Teaching Hospital (Côte D'ivoire). Corresponding Author α : Medical Doctor, General and Digestive Surgery Department, Bouaké Teaching Hospital. e-mail: ankib7@yahoo.fr II. O ur O bservations Over an 11-year period from 2010 to 2020 we performed 2024 appendectomies. An anatomopathological examination of the surgical specimen was performed in 876 cases. This examination showed an appendicular mucocele in 6 cases (0.68%). We report below the observations of these 6 patients. Observation 1 A 44-year-old patient with no prior history of any kind visited the surgical emergency room with right iliac fossa pain that had been evolving for three days. The patient had nausea but no transit disorders. On clinical examination, the temperature was 38.5°C, the general condition was preserved and there was pain and tenderness in the right iliac fossa. Clinically the diagnosis of appendicular syndrome was retained. The sedimentation rate was accelerated with figures of 50 at the first hour and 75 at the second hour. On the blood count, the white blood cell count was 10500/mm3. Abdominal ultrasound revealed pain in the right iliac fossa when the probe was passed, and a thick-walled non-compressible appendix. The diagnosis of appendicitis was made and the patient was operated on using the McBurney approach. Intraoperatively, an appendix measuring 8.5 cm x 5 cm with a point of increased volume was discovered. Appendectomy was performed. The postoperative course was simple and the patient was discharged at D3 postoperatively after resumption of transit and oral feeding. Anatomopathological examination of the appendicular specimen (figure 1) showed a simple appendicular mucocele without any degenerative focus (figure 2, 3). The colonoscopy performed at 3 months was normal. The patient was lost to follow-up after 12 months. A 19 Year 2022 Global Journal of Medical Research Volume XXII Issue II Version I ( D ) I © 2022 Global Journals