Submucosal mucoid as a late complication after appendectomy-A case report

Introduction: Shortly after an operation infection, intraabdominal abscess, seroma, haemorrhage or development of paralytic ileus may occur. Postoperative adhesions, nonspecific abdominal pain without signs of obstruction, incisional hernia and appendicitis or mucocele in appendiceal stump present common late complications. We present a unique case of a late complication after appendectomy.

Presentation of case: The case report describes a unique expansion in the ascending colon of a young athlete with long-lasting abdominal pain in the lower right quadrant. Colonoscopy showed a lesion in a wall of the ascending colon. Computed tomography (CT) confirmed a cystoid formation of high content density in a wall of the caecum. A right hemicolectomy was performed. Histology showed a lesion located in the submucosa with intestinal lining and stroma rich in lymphoid cells. These are the typical attributes of the wall of the appendix. Other parts of the wall were not demonstrated, and there was no communication with the lumen of the native bowel.

Conclusion: A submucosal cavity filled with acellular matter, which were probably disintegrated epithelioid structures, and calcifications were found in the ascending colon, while no intestinal cell atypia or dysplasia was found. The case cannot be classified under any previously presented diagnosis.