The Effect of Prior Abdominal and Pelvic Surgery on Colonoscopy Completion and Insertion Time

Colonoscopic Diagnosis of Mucocele of the Appendix Simon A. Zanati, Norman E. Marcon, Gregory B. Haber, Gabor Kandel, Paul Kortan Aims: Mucoceles of the appendix are an uncommon and heterogeneous group of cystic neoplasms characterized by distension of the appendiceal lumenwithmucus. They may come to attention by causing pain or vague right lower quadrant symptoms or, occasionally, are an incidental finding at abdominal imaging or colonoscopy. There have been no reported series of colonoscopically-diagnosed mucoceles with clinico-pathological correlation. Methods: A retrospective review of colonoscopies performed at our institution over the past 12 years was undertaken. For those reports identifying a mucocele of the appendix, patient demographics, clinical data, surgical outcomes and histopathology were obtained from hospital records. Results: Eight patients (7 female) with mucocele of the appendix were identified at colonoscopy. Four had complained of right lower quadrant pain. Of 5 patients who have had surgical resection to date, histopathological review has demonstrated mucinous cystadenoma in all cases. No cases have revealed carcinoma and there have been no deaths related to any mucocele. One patient is awaiting surgery. Conclusions:Mucocele of the appendix has a characteristic endoscopic appearance, creating a smooth bulbous indentation of the cecum with an ‘‘eye’’ formed by the appendiceal orifice. Its recognition at colonoscopy is important as it enables accurate diagnosis and directs management. Surgery is recommended in all cases given the risk for malignancy or perforation with resultant pseudomyxoma peritonei.