Laparoscopic management of a huge appendiceal mucocele in a patient with ulcerative colitis: case report and literature review.

INTRODUCTION AND

IMPORTANCE

Appendiceal mucoceles are rare pathological entities characterized by cystic mucinous dilatation of the appendix, occurring in only 0.4% of appendectomy specimens. The management of large appendiceal mucoceles requires careful surgical planning to prevent complications such as pseudomyxoma peritonei.

CASE PRESENTATION: We report the case of a 45-year-old male with a history of ulcerative colitis and primary sclerosing cholangitis who presented with right lower quadrant abdominal pain. Computed tomography (CT) revealed a 14 × 6 cm appendiceal mucocele, representing one of the largest reported cases. The patient underwent successful laparoscopic right hemicolectomy with careful excision of the appendiceal mucocele to prevent rupture and potential seeding. The procedure was completed without complications, and histopathological examination confirmed a benign mucocele with inflammatory changes and mucinous metaplasia.

DISCUSSION: Abdominal CT scans are considered the gold standard for diagnosis. Surgery to this day remains the main treatment of appendiceal mucocele, but the exact surgical approach depends on multiple tumor characteristics.

CONCLUSION

This case demonstrates that laparoscopic management of large appendiceal mucoceles can be performed safely with appropriate surgical technique and careful handling to prevent tumor rupture. The coexistence of inflammatory bowel disease does not preclude successful laparoscopic intervention when proper preoperative planning and surgical expertise are employed.