Nadir bir akut karýn tablosu nedeni: Apendiks müsinöz kistadenomu

AMAÇ: Akut karýn bulgularý oluþturan, apendiksin müsinöz kistadenomlarý araþtýrýldý.
GEREÇ-YÖNTEM: Histopatolojik olarak apendiksin müsinöz kistadenomu tanýsý alan 11 hasta geriye dönük olarak deðerlendirildi. Hastalarýn, dosya taramalarýndan elde edilen, demografik veriler, klinik özellikler, ultrasonografi (USG), kolonoskopi ve bilgisayarlý tomografi (BT) bulgularý, patoloji raporlarý, ameliyat öncesi, ameliyat ve sonrasý bulgularý incelendi. BULGULAR: Patolojik incelemesi yapýlan apendektomi parçalarýnda müsinöz kistadenom görülme sýklýðý %0,95 olarak saptandý. Toplam 11 olgunun beþi kadýndý. Ortalama yaþ 70 (50-85) idi. Olgularda en sýk görülen klinik bulgu ise karýn aðrýsýydý (%81,8). Karýn USG’si yapýlan sekiz olguda kistik kitle ve kist duvar kalsifikasyonlarý izlendi. BT incelemelerinde sekiz olguda düzgün kenarlý kistik kitle ve kist duvar kalsifikasyonu izlendi. Kolonoskopik inceleme yapýlan bir olguda ise kolonda kitle izlendi. Diðer bir olguda ise eþlik eden kolon kanseri saptandý. Olgularýn dokuzuna apandektomi, ikisine sað hemikolektomi ameliyatlarý yapýldý. SONUÇ: Kolonoskopi, USG ve BT mukosel tanýsý ve yandaþ kanser olgularýnýn araþtýrýlmasýnda faydalý yöntemler olmasýna raðmen kesin taný, ameliyat bulgularý ve ameliyat sonrasý yapýlan patolojik incelemelerle belirlenir. Apendiksin müsinöz kistadenomlarýnýn tedavisi apandektomidir, ancak ameliyat esnasýnda mukosel içeriðinin batýn içine dökülmemesine özen gösterilmelidir.

Mucinous cystadenoma of the appendix: a rare cause of acute abdomen

BACKGROUND: We aimed to assess the acute abdominal conditions due to appendiceal mucinous cystadenomas. METHODS: We retrospectively evaluated 11 patients with histopathologically confirmed appendiceal mucinous cystadenoma. Patient charts and data on patient demographics; clinical features; ultrasonography (US), colonoscopy and computed tomography (CT) findings; pathology reports; and operative and postoperative management were reviewed. RESULTS: The incidence of appendiceal mucinous cystadenoma was 0.95% of all appendectomy specimens reviewed. In our review, there were 11 patients, five of whom were women. The median age was 70 years (50-85 years), and the most common presentation was abdominal pain (81.8%). On US in eight patients, findings were abdominal cystic mass and cyst wall calcification. The CT finding was well-encapsulated cystic mass in eight patients. In one case, a colonic mass was found in colonoscopic examinations. There was one patient with concomitant colon cancer. Appendectomy was performed in nine patients and right hemicolectomy was performed in two patients. CONCLUSION: Colonoscopy, US, and CT are useful tools in diagnosing mucocele and synchronous cancer. However, diagnosis is usually made intraoperatively or postoperatively on histopathological examination. Appendectomy is the standard of care for mucinous cystadenoma. Furthermore, it is important to prevent spillage of the mucocele content.