Mucocele of the Appendix Causing Acute Appendicitis with a Rare Phenomenon- A Case Report

Abstract

Introduction: Acute appendicitis is a very common emergency encountered in surgical practice. The common cause of acute appendicitis is obstruction to the lumen of the appendix due to fecolith, lymphoid hyperplasia or worms. Very rarely an uncommon cause of appendicitis is encountered during surgery. One such rare cause of appendicitis due to a mucocele of the appendix was encountered in our surgical practice. The mucocele also unexpectedly presented with multiple spherical balls of mucin appearing like Sago Pearls, which by itself is a very rare phenomenon. It is also termed as myxoglobulosis a morphological variant of mucocele. Case Report: A 62 years old male patient presented with clinical features of acute appendicitis. An ultrasound abdomen was done, which showed a dilated and elongated appendix with probe tenderness. Due to the enlarged size of the appendix, surgery was planned by open method. The appendix was removed intact and bench dissection was done. Mucin was present inside the lumen of the appendix along with multiple spherical balls of mucin similar in appearance to “Sago Pearls”, usually used in cooking. The histopathological type was simple mucocele or retention cyst, which is not a common presentation. Conclusion: Mucocele of appendix presenting as a cause of acute appendicitis is very rare. Moreover, mucocele presenting like spherical mucin balls similar to “Sago Pearls” is by itself, a very uncommon phenomenon. We present this manuscript for the rarity of the presentation of the mucocele causing acute appendicitis with an unusual Sago Pearls like appearance, which is an unusual phenomenon.