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• W2060091840 abstract "Although more than five hundred cases of cystic dilatation of the appendix have been recorded in the literature (19), little has appeared concerning the diagnostic aspects of the condition. Since the original description by Rokitansky (18) in 1842, a fairly complete knowledge of the surgical and pathological features has been gathered. At the Mayo Clinic, 146 cysts were found among 43,000 appendectomies, an incidence of one in three hundred (22). It is generally accepted that the primary etiologic factor is obstruction of the lumen of the appendix, in the absence of pyogenic infection (2). Naeslund (12), in 1928, produced typical mucoceles in rabbits by simple ligature of the vermiform processes. Clinically, the lesion varies in size from a slight localized enlargement of the appendix to a globular mass 10 cm. or more in diameter (13). It is usually benign but, in the event of rupture into the peritoneal cavity, pseudomyxoma peritonei may result. Woodruff and McDonald (22), however, present evidence to support the belief that this malignant complication can arise only when the cyst is the seat of an adenocarcinoma, none of 8 benign cysts encountered with rupture having eventuated in this fashion. But, since there are no means of distinguishing the malignant from the benign forms of the disease, except by histologic study, any diagnostic method which will increase the frequency of its preoperative recognition is of more than academic importance. Anatomically, there are certain features of the disease which should render it susceptible of roentgen diagnosis in many instances. When the cyst attains sufficient size, it will produce significant displacement and deformity of the cecum, to which it is attached. For the same reason, if the cecum is mobile, and it usually is, the mass will move with it. Calcific deposits in the wall or substance of the cyst are of not infrequent occurrence (2, 14, 15). The closed nature of the cyst makes its lumen impermeable to contrast media administered orally or by enema, unless patency is re-established. The latter situation is known to occur, cases recognized roentgenoscopically having been reported by Vorhaus (21) in 1930 and by Lifvendahl and Ries (10) in 1932. But the frequency of such an occurrence must be insignificant; Woodruff and McDonald (22) did not report a single instance in a series of 146 cysts. In spite of these distinctive features, most writers have been pessimistic with regard to the likelihood of a preoperative diagnosis of appendiceal mucocele (3, 4, 6, 9). Jackson (7), however, in 1936, expressed the opinion that more careful x-ray studies might prove of value in the future recognition of the condition. In the same year, Åkerlund (1) demonstrated a correlation between the roentgen and pathological findings in two cases in which the roentgenograms had been inadequately interpreted preoperatively." @default.
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• W2060091840 date "1947-02-01" @default.
• W2060091840 modified "2023-09-27" @default.
• W2060091840 title "Roentgen Features of Mucocele of the Appendix" @default.
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• W2060091840 doi "https://doi.org/10.1148/48.2.113" @default.
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