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

Figure 3: HE x 250: histological aspect of an appendicular mucocele showing in the periphery of the wall, in the peritoneum, mucus patches without tumor masses and malignant tumor cells. Observation 2 A 63-year-old patient with no previous history consulted for a painful but non febrile mass in the right iliac fossa that had appeared three months earlier. The mass had progressively increased in size until it reached the present dimensions. There was no transit disorder (diarrhea, constipation) and no rectal bleeding. The physical examination revealed a painful right iliac fossa with a regular surface, poorly limited, fixed to the deep and superficial plane. On rectal examination, the lower pole of the mass could not be felt. Clinically, the diagnosis of colonic tumor was evoked. Colonoscopy could not be performed and tumor markers (CEA, CA 19-9) were not detected. The sedimentation rate was accelerated with figures of 45 at the first hour and 85 at the second hour. The white blood cell count was 13500/mm3. The C-reactive protein was increased to 200 mg/l. Abdominal ultrasound revealed a heterogeneous mass in the right iliac fossa, suggesting an abscess. The patient was operated by median laparotomy. When the abdomen was opened, there was no abscess in the right iliac fossa, but a large appendix measuring 15 cm x 7 cm, with a pedicle base on the cecum. On palpation of the colonic frame there was no tumor, there was no adenopathy in the abdomen, no ascites or mucus. The diagnosis of appendicular mucocele was evoked. An appendectomy with resection of the base of the cecum was performed. The postoperative course was simple and the patient was discharged at 5 days postoperatively after resumption of transit and oral feeding. The anatomical-pathological examination showed a simple appendicular mucocele without any degenerative focus. Colonoscopy performed at 3 months postoperatively was normal. The patient was lost to follow-up after 6 months. Observation 3 A 38-year-old G3P3 patient with no particular medical or surgical history consulted the surgical emergency room for right iliac fossa pain evolving for three days. The date of the last ones was known by the patient, there was no menstrual cycle disorder. The patient also complained of nausea and vomiting. The physical examination revealed pain and tenderness in the right iliac fossa, the temperature was 38.9°C. The rectal examination revealed pain at the top and right fingertips. The vaginal touch was normal. The sedimentation rate was 45 at the first hour and 70 at the second hour. The white blood cell count was 14500/mm3. The C-reactive protein was increased to 78mg/l. Abdominopelvic ultrasound showed a hypoechoic structure with a thickened wall suggesting a periappendicular abscess. The right uterine adnexa and uterus were normal. The patient was operated by laparotomy (Mc Burney). During the operation, an appendix measuring 8 cm long was discovered, enlarged in its proximal part and indurated in its median 21 Year 2022 Global Journal of Medical Research Volume XXII Issue II Version I ( D ) I © 2022 Global Journals Treatment and Evolution of Appendicular Mucoceles in Six Cases