Symptomatic Colonic Mucocele in an Adult Patient with Imperforate Anus
Mantilla Nathalie, Blumetti Jennifer, Singer Marc and Abcarian Herand
World Journal of Surgical Research 2014, 3:10
Mucocele is a rarely encountered complication in the lower gastrointestinal tract. It has been most commonly described in the appendix however, it is also known to occur in the colon. The case of woman with a symptomatic mucocele 20 years after an ileostomy for imperforate anus is detailed.
A 20 year old woman presented with one week history of crampy abdominal pain and progressive abdominal distention. The patient has significant medical and surgical history having been born a conjoined twin with multiple congenital anomalies including imperforate anus for which she had an ileostomy and mucus fistula. The output from the mucus fistula had gradually decreased over time. On physical examination her abdomen was much distended but non tender to palpation. She had a functioning ileostomy with a mucus fistula. No perineal opening was present. A CT scan identified large fluid filled bowel loops in the pelvis. A small bowel follow-through and fistulogram were performed, revealing a markedly stenotic area of either colon or small bowel approximately 15 cm in length, with an area of post stenotic dilatation, and ending in a blind pouch. Malrotation of small bowel was also identified. At exploratory laparotomy, an extremely dilated colon was found with stenotic terminal ileum. The colon was filled with copious amounts of yellow mucus. The terminal ileum and cecum were resected, and the ascending colon was brought to the abdominal wall as a new mucus fistula.
Colonic mucocele is a rare entity with few case reports in the literature. The majority of these cases are due to sequestration of mucosal islands after resection.
Mucocele, Obstruction, Colon, Congenital Malformation.