Taylan KARA, Mehmet Sedat DURMAZ, Gökhan DARILMAZ

Appendiks mukoseli: olgu sunumu

Appendiks mukoseli, appendiks lümeninin mukusla dolması sonucu obstrüktif dilatasyonuyla karakterize nadir bir hastalıktır. Bu olgu sunumunda nonspesifik şikayetlerle başvuran hastada saptanan appendiks mukoselini bilgisayarlı tomografi (BT) görüntüleri eşliğinde sunmayı amaçladık. 46 yaşında erkek hasta hafif karın ağrısı ve iştahsızlık şikayetleri ile hastanemize başvurdu. Hastaya ultrasonografi (US) ve sonrasında BT yapıldı. US’de appendiks lojunda yoğun içerikli tubuler yapıda kistik kitle saptandı. Abdomene yönelik oral ve intravenöz opak sonrası yapılan BT’de appendiks lojunda 4x9 cm boyutlu tübüler yapıda, heterojen su dansitesinde belirgin kontrastlanma göstermeyen kitle saptandı. Radyolojik tanı mukosel ile uyumluydu. Hasta bu ön tanıyla laparoskopiye alındı. Sağ alt kadranda çekum komşuluğunda, appendiks lojundaki kitle görüldü. Kitlenin boyutunun büyük olması ve appendiks mukosellerinde tanımlanmış olan perforasyon riski nedeniyle laparotomi yapıldı. Kitle disseke edilerek çekumdan ayrıldı ve perfore edilmeden çıkarıldı. Patolojik tanı müsinöz kistadenoma bağlı mukoseldi. Patolojik materyalde malignite bulgusu saptanmadı. Postoperatif 3. gün hasta taburcu edildi. Tedavinin doğru bir şekilde yönlendirilebilmesi için appendiks kitlelerinde mukosel, ayırıcı tanıda akılda tutulmalıdır. Bu hastalarda perforasyon sonucu gelişebilecek psödomiksoma peritonei riskine karşı dikkatli olunmalıdır.

Appendix mucocele: a case report

Mucocele of the appendix is a rare entity, characterized by distention of the lumen due to collection of mucoid material. In this case, our aim is to report a mucocele of appendix with computed tomography (CT) findings. A 46-year old male presented to our department with abdominal pain and decreased appetite. Ultrasonography (US) and CT were performed. A tubular cystic mass was detected with US. On contrast enhanced abdomen CT, a nonenhanced cystic mass, measured 4x9cm, was detected at the right lower quadrant near cecum. Radiologic diagnosis was appendix mucocele. By this diagnosis laparoscopy was performed. A mass located at the right low quadrant near cecum was seen. Because of the big size of mass and possible perforation risk laparoscopy was converted to open laparotomy. Mass was excised without perforation. The pathologic diagnosis was mucinous cystadenoma, and there was no malignity evidence. The postoperative course was unremarkable, so he was discharged at the 3rd day postoperatively. Mucocele should be kept in mind as a differential diagnosis of appendix mass. During the operation, surgeon should be aware of possible risk of perforation and pseudomixoma peritonei.

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