A 50-year-old man was successfully treated for a rare mucinous tumor of the appendix with the help of laparoscopic surgery at Fortis Hospital, Vasant Kunj. The patient complained of pain and fullness in the right lower abdomen for the last few days. An initial ultrasound followed by a CT scan of the abdomen indicated a burst appendix. There was a large collection of fluid in the region of appendix, around the liver with thickening of fat surrounding the intestines. The patient was further referred to Dr. Amit Javed, Director – Gastrointestinal Oncology and Laparoscopic Surgery, Fortis Hospital, Vasant Kunj.
The patient was stable and did not have signs of infection which mostly happens in a burst appendix , thus it was crucial to make a correct diagnosis. On discussing with radiologists, the doctors at Fortis could not separately identify a perforated appendix, hence considered the possibility of a giant mucinous tumor of the appendix. The patient was planned for a laparoscopic surgery. The surgery involved removing the appendix (12 X 7 cms – ten times the size of a normal appendix), a portion of the small and large intestine along with removal of the thickened fat surrounding the intestines.
Dr Amit Javed, Director Gastrointestinal Oncology and Laparoscopic Surgery, Fortis Hospital, Vasant Kunj said, “This was an extremely rare case, we were able to save the life of the patient owing to timely diagnosis and treatment. The challenge was that we had to be extremely careful and meticulous while doing this laparoscopic surgery. We had to avoid perforation of the appendix and any improper handling would have led to rupture of the organ resulting in spread of the tumor. We removed a part of the small intestine, the huge appendix and a part of the large intestine along with the tumor deposits in the fat with a meticulous laparoscopic approach. This was definitely a life-threatening case as cancers of the appendix are very rare and the patient had minimal symptoms. Any delay in treatment would to have led to rupture of the appendix and further complications. “
Dr. Rajeev Nayyar, Facility Director, Fortis Vasant Kunj said, “It was a very rare case, the surgery was extremely critical. Despite being a life-threatening case, the doctors at Fortis Vasant Kunj under the leadership of Dr. Amit Javed could successfully perform the surgery. Since long, Fortis is gaining trust of patients and their family in such critical clinical procedures. Our aim is to provide patient care with the latest technology. Our team of doctors have displayed their commitment to patient-centric care and clinical excellence. We will continue to do our best for our patients and ensure they receive the highest quality of medical care and attention.”
Appendicular tumors are very rare and account for less than 1% of GI Cancers. Most patients present non-specific symptoms, and the diagnosis is made in the later stages. In some patients an acute appendicitis like presentation and right lower abdominal pain secondary to distension of the appendix can occur.
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