Management of mucocele of the appendix with peritoneal dissemination in pregnant women: a case report and literature review. Issue 2 (4th March 2023)

• Record Type: Journal Article
• Authors: Derbal, Sophiane; Klapczynski, Clemence; Charissoux, Aurélie; Durand Fontanier, Sylvaine; Taibi, Abdelkader
• Is Part Of: Acta chirurgica belgica. Volume 123:Issue 2(2023)
• Page Start: 185
• Page End: 191
• Publication Date: 2023-03-04
• Subjects: Appendiceal mucocele -- pregnant -- appendix -- cytoreductive surgery -- HIPEC; Surgery -- Periodicals; General Surgery; Chirurgie -- Périodiques; Surgery; Chirurgie (geneeskunde); Periodicals; Periodicals; 617.005
• DOI: 10.1080/00015458.2021.1956800
• Languages: English
• ISSNs: 0001-5458

Abstract

Abstract: Background: This is the first case report of a patient with a twin pregnancy who developed appendiceal mucocele (AM) with peritoneal dissemination in the context of endometriosis and ovarian hyperstimulation. A review of the literature on AM during pregnancy, with a focus on management, is provided as well. Case presentation: A 36-year-old woman was admitted to the emergency department for abdominal pain in the right iliac fossa at 17 weeks of amenorrhoea (WA). She was pregnant with twins, achieved by in vitro fertilisation (IVF) and complicated by ovarian hyperstimulation syndrome. Abdominal ultrasonography indicated a diagnosis of uncomplicated acute appendicitis. However, the histopathological findings revealed low-grade appendicular mucinous neoplasia (LAMN) with peritoneal dissemination of acellular mucin. Maximal cytoreductive surgery with hyperthermic intraperitoneal mitomycin chemotherapy was performed post-partum. Conclusions: Specialised management is required for AM during pregnancy and must take into account the progress of the pregnancy, the histology of the AM and the risk of perforation.