# Stepwise management of adult intussusception caused by an appendiceal mucocele: a case report of endoscopic reduction followed by interval laparoscopic resection

## TL;DR

A rare case of adult intussusception caused by an appendiceal mucocele was successfully managed using a staged approach involving endoscopic reduction and laparoscopic surgery.

## Contribution

This case report presents a novel staged management strategy for appendiceal mucocele-induced intussusception in adults.

## Key findings

- Endoscopic reduction was safely performed without evidence of malignancy or bowel ischemia.
- Interval laparoscopic resection allowed for complete tumor removal with negative margins and no rupture.
- The staged approach minimized bowel resection and maintained oncologic safety in a stable patient.

## Abstract

Adult intussusception caused by an appendiceal mucocele is rare, and according to the WHO classification many such lesions are neoplastic, including low-grade appendiceal mucinous neoplasms (LAMNs). A woman in her forties presented with right lower abdominal pain. Computed tomography showed ileocecal intussusception with a 34-mm cystic mass as the lead point. As there were no imaging findings suggestive of malignancy or bowel ischemia, cautious endoscopic reduction was performed. Post-reduction imaging suggested an appendiceal mucocele. After one week of bowel rest, laparoscopic ileocecal resection was performed while avoiding direct tumor manipulation. Histopathology confirmed a LAMN with negative margins and no rupture. This case demonstrates that a staged strategy incorporating endoscopic reduction, bowel rest, and interval laparoscopic surgery can stabilize the patient, enable safe tumor removal, and minimize the extent of bowel resection in carefully selected, clinically stable patients without increasing operative risk or compromising oncologic principles in practice settings.