[Mucocele of the appendix]. / Mucoceles apendiculares.

INTRODUCTION: Mucoceles of the appendix are infrequent entities and are found in only 0.25% of all appendectomies and 8% of all appendicular tumors. MATERIAL AND METHODS: We describe 27 cases of mucocele of the appendix treated at Donostia Hospital between January 1978 and December 2006. RESULTS: The mean age of the patients was 54.4 +/- 21.7 years (range: 17-88). Of the 27 patients, 15 (55.5%) were males and 12 (44.5%) were females. Emergency surgery was performed in 17 patients (62.9%). Mucoceles were identified as operative findings during surgery for other reasons in seven patients (25.9%). Three patients (11.1%) underwent surgery because of a diagnosis of abdominal tumor. The main reason for emergency surgery was lower right abdominal pain in 14 patients (82.2%), intestinal obstruction in one (5.8%), a diagnosis of endometriosis in one (5.8%) and a diagnosis of pyosalpinx in one (5.8%). Three patients underwent surgery due to pseudomyxoma peritonei after 24, 36 and 41 months' follow-up. The third patient is asymptomatic after peritonectomy and a follow-up of 78 months. We found an overall incidence of 11 cases (40.7%) presenting with synchronous or metachronous neoplasms from other locations. CONCLUSIONS: We recommend monitoring of all patients with mucocele of the appendix, because these masses can sometimes be associated with neoplasms in other locations and there is a risk of pseudomyxoma peritonei even after a long follow-up.

Mucoceles apendiculares / Mucocele of the appendix

Introducción. Los mucoceles apendiculares son una entidad infrecuente; representan sólo el 0,25% de todas las apendicectomías y un 8% de todos los tumores apendiculares. Material y métodos. Describimos 27 casos de mucoceles apendiculares tratados entre enero de 1978 y diciembre de 2006 en el Hospital Donostia. Resultados. La edad media ± desviación estándar de los pacientes fue de 54,4 ± 21,7 años (rango, 17-88). De los 27 pacientes, 15 (55,5%) eran varones y 12 (44,5%) mujeres. Fueron intervenidos de urgencia 17 pacientes (62,9%). Resultaron hallazgos operatorios en el curso de intervenciones por otra razón en 7 (25,9%) ocasiones; 3 pacientes fueron operados con diagnóstico de tumoración abdominal no filiada (11,1%). La causa principal de intervención de urgencia fue el dolor en la fosa ilíaca derecha, 14 (82,2%); obstrucción intestinal, 1 (5,8%); diagnóstico de endometriosis, 1 (5,8%), y diagnóstico de piosalpinx, 1 (5,8%). Se intervino a 3 pacientes por presentar seudomixoma peritoneal pasados 24, 36 y 41 meses. El último caso se encuentra bien tras peritonectomía y pasados 78 meses. Hemos encontrado una incidencia global de 11 casos (40,7%) de neoplasias isocronas o metacronas de otra localización en estos pacientes. Conclusiones. Recomendamos el seguimiento de todos los pacientes con mucocele apendicular porque a veces se asocian a neoplasias de otra localización y riesgo de seudomixoma peritoneal, incluso en fases más avanzadas del seguimiento (AU)

Introduction. Mucoceles of the appendix are infrequent entities and are found in only 0.25% of all appendectomies and 8% of all appendicular tumors. Material and methods. We describe 27 cases of mucocele of the appendix treated at Donostia Hospital between January 1978 and December 2006. Results. The mean age of the patients was 54.4 ± 21.7 years (range: 17­88). Of the 27 patients, 15 (55.5%) were males and 12 (44.5%) were females. Emergency surgery was performed in 17 patients (62.9%). Mucoceles were identified as operative findings during surgery for other reasons in seven patients (25.9%). Three patients (11.1%) underwent surgery because of a diagnosis of abdominal tumor. The main reason for emergency surgery was lower right abdominal pain in 14 patients (82.2%), intestinal obstruction in one (5.8%), a diagnosis of endometriosis in one (5.8%) and a diagnosis of pyosalpinx in one (5.8%). Three patients underwent surgery due to pseudomyxoma peritonei after 24, 36 and 41 months' follow-up. The third patient is asymptomatic after peritonectomy and a follow-up of 78 months. We found an overall incidence of 11 cases (40.7%) presenting with synchronous or metachronous neoplasms from other locations. Conclusions. We recommend monitoring of all patients with mucocele of the appendix, because these masses can sometimes be associated with neoplasms in other locations and there is a risk of pseudomyxoma peritonei even after a long follow-up (AU)

Fascioliasis: an exceptional cause of acute pancreatitis.

CONTEXT: Fasciola hepatica is known to cause bile duct inflammation and biliary obstruction but is rarely reported as responsible for producing acute pancreatitis. CASE REPORT: We report on a patient complaining of acute pancreatitis. Endoscopic retrograde cholangio-pancreatography showed distinct features and sphincterotomy allowed extraction of multiple parasites. CONCLUSIONS: Pancreatitis may occur in some patients with fascioliasis, but the condition may be overlooked in chronic cases. Endoscopic retrograde cholangio-pancreatography rule out other possible causes of irregularity and thickening of the common bile duct wall. Parasite removal during endoscopic retrograde cholangio-pancreatography is one therapeutic option. Hepatic involvement must be ruled out and complete pharmacological treatment is advised in this patient.