腸重積合併虫垂粘液嚢胞腺腫の1例

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  • A case of mucinous cystadenoma in the appendix causing intussusception

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A 58-year-old woman visited our hospital complained of right lower abdominal pain. The ultrasound sonography and computed tomography examination showed intussusception in the ileocecal lesion. Barium enema examination revealed an elevated lesion in the ostium of appendix and the contrast barium was not fully filled in the appendix. Endoscopic examination also revealed an elevated lesion with redness in the ostium and obstruction of the hole, which is called volcano sign. These findings suggested that the mucocele in appendix caused ileocecal intussusception. During her admission the lower abdominal pain due to ileocecal intussusception was frequently occurred and therefore ileocecal resection was performed. Histological findings showed mucinous cystadenoma in the distal appendix and fibrous change in the appendix wall. It was suggested that this fibrous mucosa caused intussusception in the cecum. Mucinous cystadenoma in the appendix causing intussusception is rare, and in most of the cases preoperative diagnosis has not been made because emergency operation has been performed. Here we report a rare case of mucinous cystadenoma causing intussusception which was preoperatively suggested from the findings of the barium enema and endoscopic examination.

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