A Rare Case of Appendiceal Intussusception Secondary to Low-Grade Mucinous Neoplasm

Abstract

Appendiceal intussusception is an unusual clinical entity, and when it is caused by a low-grade mucinous neoplasm, it becomes exceptionally rare. A 27-year-old female sought medical attention with a 3-day history of abdominal pain and recurrent vomiting. Clinical examination revealed right iliac fossa tenderness. Emergency imaging, ultrasound of abdomen, revealed a blind-ending, thick-walled, non-compressible tubular structure with a target appearance, suggesting appendiceal intussusception. Laboratory findings showed lymphocytosis, while other parameters were within the normal range. Confirmation of the diagnosis and assessment of disease extent were achieved through contrast-enhanced computed tomography (CECT) of the abdomen and pelvis. CECT revealed a soft tissue mass at the ileocecal junction with peripheral enhancing walls, indicative of an inflammatory process. A dilated and inflamed appendix, with post-contrast enhancement, was observed to be contributing to this mass. The patient underwent laparotomy, where approximately 100-150ml of inflammatory fluid was drained, and the inflamed appendix was identified intussuscepted into the cecum with associated adhesions. Appendicitis intussusception is a rare condition that requires appendectomy for treatment. Based on a study of 71,000 human appendix surgical specimens, the incidence of appendix intussusception has been estimated to be.01%.