Asymptomatic intussusception secondary to a giant appendiceal mucocele treated via a laparoscopic approach.

摘要

A 57-year-old asymptomatic man underwent colono-scopy to evaluate an elevated serum carcinoembryonic antigen (CEA) level of 14.24 ng/mL (normal <5.0 ng/mL); a polypoid tumor was seen in the cecum that extended to the hepatic flexure and had a yellowish depression on its top (A). The tumor was soft and had a cyshion sign" when poked with a forceps; it easily was pushed downward into the cecum with air inflation and with pressure from the advancing colonoscope, suggesting cecocolic intussusception (B). Abdominal US revealed a cystic tumor filled with layers of a gel-like substance. Multidetector CTwith coronal reformation demonstrated a cup-and-ball appearance of the lesion that was moved downward on air inflation (C). Laparoscopy revealed a dilated appendix with intussusception (D); there was neither ascites nor lymphadenopathy. Laparoscopic resection of the appendix and cecum with an ileocolic anastomosis was performed.