Ruptured Appendiceal Mucocele Presenting as a Ventral Hernia: A Case Report of a Rare Presentation of Appendiceal Mucocele

Mucocele of the appendix (MA) is a rare disease characterized by chronic accumulation of mucin within an appendix. Although MA can be an asymptomatic finding, some patients with MA may present with right lower quadrant (RLQ) pain, pelvic pain, or even hernias. The later presentation is usually related to rupture of the mucin-filled appendix, a condition referred to as pseudomyxoma peritonei (PMP). Herein, we present a case of ruptured MA presenting as an irreducible paraumbilical hernia, where the patient presented with a lump to the surgical clinic. computed tomography (CT) of the abdomen revealed an RLQ lesion extending through the hernial neck. Further characterization of the lesion was performed with magnetic resonance imaging (MRI), revealing an appendiceal origin of the lesion. The patient underwent an exploratory laparotomy during which an omental sample was taken. Histopathology confirmed the diagnosis of metastasizing low-grade appendiceal mucinous neoplasm. We believe that our case is unique due to the rarity of ruptured MA as well as the rarity of it presenting as a paraumbilical hernia.