Intussusception of a mucocele of the appendix secondary to an obstruction by endometriosis: Report of a case

Hironobu Kimura, Kohji Konishi, Kazuhisa Yabushita, Kiichi Maeda, Masahiko Tsuji, Atsuo Miwa
In: Surgery Today · 1999 · vol. 29(7) , pp. 629–632 · doi:10.1007/bf02482989 · W2094783679
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-07 ⓘ

This case report describes a patient with cecal intussusception caused by an appendiceal mucocele obstructed by endometriosis, leading to appendiceal resection.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This paper reports an adult case of complete invagination of the cecum caused by a mucocele of the appendix, attributed to obstruction by endometriosis. Preoperative barium enema showed a “crab’s claw-like” appearance without oral filling on the transverse colon, and emergency laparotomy demonstrated appendicecal invagination with a mucinous appendiceal mucocele but no colonic invagination, leading to appendicecal resection; pathology showed mucosal hyperplasia with mucin-secreting lesions. The authors also review and discuss theories of the pathogenesis of appendicecal mucocele. This paper is centrally about endometriosis — it describes appendix mucocele and cecal/appendicecal intussusception secondary to endometriosis-induced obstruction.

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Abstract

We treated a patient with a complete invagination of the cecum which contained a mucocele of the appendix secondary to an obstruction by endometriosis. Preoperatively, a barium enema showed a crab's claw-like area without filling in the oral side of the transverse colon. An emergency laparotomy was performed and revealed a mucocele of the appendix to have induced appendicecal invagination; however, no colonic invagination was observed. An appendicecal resection was thus done. Pathologically, the resected specimen was a mucosal hyperplasia with mucin-secreting lesions of the appendix. The theories regarding the pathogenesis of appendicecal mucocele are reviewed and discussed.
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Abstract

We treated a patient with a complete invagination of the cecum which contained a mucocele of the appendix secondary to an obstruction by endometriosis. Preoperatively, a barium enema showed a crab’s claw-like area without filling in the oral side of the transverse colon. An emergency laparotomy was performed and revealed a mucocele of the appendix to have induced appendicecal invagination; however, no colonic invagination was observed. An appendicecal resection was thus done. Pathologically, the resected specimen was a mucosal hyperplasia with mucin-secreting lesions of the appendix. The theories regarding the pathogenesis of appendicecal mucocele are reviewed and discussed. Similar content being viewed by others

References

Collins DC (1963) 71 000 human appendix specimens: a final report summarizing a forty-year study. Am J Proctol 14:365–381 Hapke MR, Bigelow B (1977) Mucocele of the appendix secondary to obstruction by endometriosis. Hum Pathol 8:585–589 Bachman AL, Clemett AR (1971) Roentgen aspects of primary appendicecal intussusception. Radiology 101:531–538 Gilsang V (1977) Displacement of the appendix in intussusception. Am J Roentgenol 142:791–792 Kimura H, Satou T, Takahashi N, Kurachi M, Fujii H, Nakanishi (1995) Intussusception of the cecum with calcified fecaliths. Am J Gastroenterol 90:318–319 Rollenston HD (1898) Intussusception of the appendix. Edinburgh Med J 4:21 Wallner B, Friedrich JM, Oettinger W (1990) Colorectal invagination in adults following removal of a sigmoid polyp. Rontgenblatter 43:78–79 Martin E, Douglas H, Anton T (1981) The ultrasonic appearance of ileocolonic intussusception. J Clin Ultrasound 9:516–518 Weissberg DL, Scheible W, Leopold GR (1977) Ultrasonographic appearance of adult intussusception. Radiology 124:791–792 Kimura H, Yabushita K, Tsuneda A, Tazawa K, Inoue T, Earashi M, Maeda K, Kuroda Y, Tsuji M, Miwa A (1996) Adult colorectal invagination associated with colonic cancer and established by fiberscopy of the sigmoid colon. Endoscopy 28:636 Higa E, Radia J, Pizzimbono CA, Wise L (1973) Mucosal hyperplasia, mucinous cystadenoma, and mucinous cystadenocarcinoma of the appendix. Cancer 32:1525–1541 Uohara JK1, Kobara TY (1975) Endometriosis of the appendix. Am J Obstet Gynecol 121:423–426 Author information Authors and Affiliations Rights and permissions About this article Cite this article Kimura, H., Konishi, K., Yabushita, K. et al. Intussusception of a mucocele of the appendix secondary to an obstruction by endometriosis: Report of a case. Surg Today 29, 629–632 (1999). https://doi.org/10.1007/BF02482989 Received: Accepted: Issue date: DOI: https://doi.org/10.1007/BF02482989

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