Appendiceal mucocele as an exceptional cause of ileocecocolic intussusception in adults: a case report

Adult ileocecocolic intussusception with mucocele of the appendix: a rare presentation

Introduction and importance

Intussusception is a condition in which part of the intestine telescopes into an adjacent segment, causing bowel obstruction. It is common in children but rare in adults, comprising only 5% of all intussusceptions and 1-5% of adult intestinal obstructions. Adult cases often have identifiable causes, making early diagnosis and intervention crucial. Appendiceal mucocele is an exceptionally rare lead point for intussusception.

Case presentation

A 53-year-old male presented with abdominal distension and severe periumbilical pain, accompanied by nausea and vomiting. Physical examination revealed tenderness but no mass. Imaging studies identified ileocecocolic intussusception with an appendiceal mucocele as the lead point. Exploratory laparotomy and right limited hemicolectomy were performed. Histopathology confirmed a low-grade appendiceal mucinous neoplasm. The patient recovered uneventfully and was discharged in stable condition.

Clinical discussion

Adult intussusception is often triggered by bowel wall lesions or luminal irritants that disrupt normal peristaltic activity. Diagnosis is challenging due to non-specific symptoms and requires advanced imaging techniques. Surgical intervention is crucial, especially when there are concerns about malignancy. Prompt treatment is essential to prevent severe complications. Appendiceal mucocele, a rare lead point, necessitates careful surgical management to avoid rupture and ensure successful outcomes.

Conclusion

This case emphasizes the rarity and complexity of ileocecocolic intussusception with an appendiceal mucocele, highlighting the need for prompt diagnosis and surgical intervention. Early detection is crucial to prevent serious complications and improve patient outcomes.

A case report of a giant ileocecal cystic prolapse through the anus and literature review

Intussusception refers to the invagination of a proximal loop of the bowel into an adjacent distal segment. This condition is rare in adults, especially when it involves a complete folding of the ileocecal area out of the body cavity. Meanwhile, enterogenous cysts are congenital malformations that are largely identified in childhood following symptoms of bowel obstruction. While surgical treatment is ultimately required for both diseases, deciding on the type of surgery and the right time to operate can be a challenge for clinicians. It is especially difficult to decide on treatment for an adult with the coincidental occurrence of both conditions and no definitive pathologic diagnosis prior to surgery. Here, we present the case study of a 19-year-old female patient who presented with a prolapsed anus due to intussusception caused by a large ileocecal mass. The patient was admitted to the emergency department with a "massive anal mass." She remained symptomatic after receiving conventional conservative treatment and had to undergo emergency surgery after developing an intestinal obstruction. While the patient's intraoperative condition also confirmed the preoperative CT findings, the situation became more complicated during surgery. The postoperative pathological report indicated the presence of an enterogenous cyst. After recovery from surgery, the patient was successfully discharged. Intussusception or intestinal obstruction caused by an intestinal mass is a surgical indication, and removal is the only way to cure the condition. This case study provides a helpful reference for general surgeons, especially anorectal surgeons, imaging physicians, and pathologists, and informs the diagnosis and treatment of this patient population.