Management of mucocele of the appendix with peritoneal dissemination in pregnant women: a case report and literature review

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.

Keywords:

• Appendiceal mucocele
• pregnant
• appendix
• cytoreductive surgery
• HIPEC

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from participant included in the study.

Author contributions

Study conception and design: Dr DERBAL and Dr TAIBI.

Provision of study materials or patients: Dr DERBAL, Pr DURAND FONTANIER and Dr TAIBI.

Data and statistical analysis and interpretation: Dr DERBAL, Pr DURAND FONTANIER, Dr CHARISSOUX and Dr TAIBI.

Drafting and editing of manuscript: all authors.

Critical manuscript review and approval of final version: All authors.

All authors read and approved the final version of the manuscript.

Study conception and design: Dr DERBAL, Dr TAIBI.

Provision of study materials or patients: Dr DERBAL, Pr DURAND FONTANIER, Dr TAIBI.

Data and statistical analysis and interpretation: Dr DERBAL, Pr DURAND FONTANIER, Dr CHARISSOUX, Dr TAIBI.

Drafting and editing of manuscript: all authors.

Critical manuscript review and approval of final version: All authors.

Disclosure statement

All authors declare that have no conflict of interest.