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

Figure 9: Appearance of an appendiceal mucocele after appendectomy. Note the pearly white oblong appendicular mass. III. D iscussion Appendicular mucocele is a rare condition, observed in 0.2% to 0.7% of appendectomy specimens according to the literature [6-8]. The first Ivorian case seems to have been reported by Kouadio L et al in 2003 [9]. The treatment of appendiceal mucocele is surgical, balancing appendectomy in healthy tissue and right hemicolectomy. The surgical procedure can be conducted by laparotomy or laparoscopic surgery [10- 12]. To prevent any risk of rupture of the appendicular mass, some authors perform the appendicular resection with automatic suture forceps [12-14]. Appendectomy is sufficient for a simple appendicular mucocele or a mucinous cystadenoma. When in doubt intraoperatively, some authors excise the caecal insertion of the appendicular base [12, 15], others perform a resection of the cecum, and still others perform a right hemicolectomy [16, 17]. In the present study, simple appendectomy was performed in five patients and excision of the caecal insertion of the appendicular base in one patient (observation 2). Intraoperatively, exploration of the colonic framework is important if the operation is performed by a large laparotomy or by laparoscopic surgery, otherwise a colonoscopy should be performed in the follow-up of the patient to look for a synchronous or metachronous colonic tumor [6,15]. In women it is essential to explore the adnexa [7,18]. It is important to avoid intraoperative rupture and to look for this rupture on anatomopathological examination of the specimen. This rupture has a poor prognosis because it exposes the risk of peritoneal pseudomyxoma [15,19]. This was not found in our observations. Anatomopathological examination is essential in the subsequent management, especially if a simple appendectomy has been performed. If there is no invasion of the appendicular base, no metastatic embolism in the vessels and no perineural envelopment, a simple appendectomy can be performed, otherwise a right hemicolectomy with lymph node curage should be performed [1, 15, 20]. Long-term postoperative follow-up is crucial because cancers have been discovered after a follow- up of 12 to 33 months and a peritoneal pseudomyxoma occurred after a follow-up of more than 60 months [7,15]. 26 Year 2022 Global Journal of Medical Research Volume XXII Issue II Version I ( DD ) I © 2022 Global Journals Treatment and Evolution of Appendicular Mucoceles in Six Cases