2026, Number 1-2
Rev Mex Cir Endoscop 2026; 27 (1-2)
Appendicular volvulus secondary to mucocele: case report
García-Silva JF, Balderas-Montoya C, Balcázar-Hurtado A, Ugalde-Rivera J, Rosas-García CR, Lerma-Alvarado RM, Aburto-Fernández MC
Full text
10.35366/122998
Language: Spanish
References: 9
Page: 58-62
PDF size: 535.08 Kb.
ABSTRACT
Introduction: appendiceal volvulus is a rare cause of acute appendicitis, with fewer than 80 cases reported in the literature, and only a few associated with mucocele. This condition involves torsion of the appendix along its longitudinal axis, leading to luminal obstruction, ischemia, and necrosis. Its clinical presentation often mimics typical acute appendicitis, making preoperative diagnosis challenging. Intraoperative identification is crucial, particularly when an underlying neoplasm is suspected, to guide safe surgical management. Case report: we present the case of a 43-year-old male with no relevant medical history who presented with right lower quadrant abdominal pain and clinical signs of appendicitis. Ultrasound revealed a "target sign". Laparoscopic exploration identified a 540° counterclockwise appendiceal volvulus associated with a mucocele. The appendix was safely removed using a specimen retrieval bag. Histopathology confirmed a benign appendiceal mucocele with no evidence of malignancy. The patient had an uneventful postoperative recovery and was discharged without complications. Conclusion: this case highlights the importance of including rare conditions such as appendiceal volvulus secondary to mucocele in the differential diagnosis of acute appendicitis, especially in the presence of atypical ultrasound findings like the target sign. It underscores the need for careful surgical technique and histopathologic evaluation to rule out neoplastic disease. Sharing such clinical experiences enhances diagnostic awareness and promotes a safer, more critical surgical approach to uncommon pathologies.REFERENCES