CLINICAL CASE OF APPENDIX MUCOCELL, COMPLICATED BY PERFORATION AND THE FORMATION OF RETROPERITONEAL SPACE PHLEGMON
Summary. The aim. To analyze the anamnestic data, clinical symptoms, preoperative diagnosis, features of surgical intervention and the results of histological examination in a patient with mucocele of the appendix (MA), complicated by necrosis and perforation of the wall and formation of retroperitoneal space phlegmon (FRS).
Material and methods. An analysis of the case of MA, which was complicated by the atypical course and the development of retroperitoneal space phlegmon, which was diagnosed after multispiral computered tomography of the abdominal cavity (MSCT AC).
Results. The patient, despite periodic atypical complaints of discomfort in the right iliac region, did not seek medical attention and was not examined. Operated urgently after performing MSCT AC. Intraoperatively, a rupture of the MA was diagnosed with formation of FRS, which significantly complicated the course of the operation and the course of the postoperative period. Appendectomy, drainage of the abdominal cavity and retroperitoneal space were performed. Gradual improvement and recovery.
Conclusions: The acute situation resulting from the rupture of the MA, led to a complex operation. Performing MSCT AC at the prehospital stage makes it possible to diagnose the problem and perform the operation in a timely manner, without waiting for serious complications.
2. Lisiczkaya MV. Rol` mul`tispiral`noj komp`yuternoj tomografii v neotlozhnoj diagnostike opukholevy`kh i vospalitel`ny`kh zabolevanij organov pravoj podvzdoshnoj oblasti. Dis. na sоisk. uch. st. kand. med. nauk. Moskva, 2015, 132 s. (In Russ.).
3. Malucani K, Nandedkar S. Mucoceles of the appendix – a retrospective study from a tertiary health care centre. Journal of Evolution of Medical and Dental Sciences. 2012;1(6):1127-36.
4. Sidorova EE, Pugacheva OG, Stepanova Yu A, i dr. Mukoczele appendiksa. Obzor literatury` i opisanie sobstvennogo klinicheskogo nablyudeniya. Mediczinskaya vizualizacziya. 2008;1:72 (In Russ.).
5. Mastoraki A, Sakorafas G, Vassiliu P, Contopoulou C, Arkadopoulos N. Mucocele of the Appendix: Dilemmas in Differential Diagnosis and Therapeutic Management. Indian Journal of Surgical Oncology. 2016;7(1): 86-90.
6. Yakan S, Caliskan C, Uguz A, et al. A retrospective study on mucocele of the appendix presented with acute abdomenor acute appendicitis. Hong Kong Journal of Emergency Medicine. 2011;18(3):144-49.
7. Zharko SV, Al`-Kanani E`S, Yarosh AA, i dr. Muczinoznaya czistadenoma cherveobraznogo otrostka kak prichina psevdomiksomy` bryushiny` (klinicheskij sluchaj). Nauchny`e vedomosti Belgorodskogo Gosudarstvennogo universiteta. Seriya: Mediczina. Farmacziya. 2019;1:126-32 (In Russ.).