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- VRU case report-another place for mucocele
Background
This case report details the first documented diagnosis of a cecal mucocele in a cat. The condition, resembling appendiceal mucoceles in humans, is characterized by obstructive dilatation due to mucinous material. The study explores the ultrasonographic, surgical, and histopathological features of this rare condition, previously unreported in cats.
Methods
A 3-year-old neutered male domestic medium-hair cat presented with vomiting, anorexia, and depression. Ultrasonography was employed to investigate acute clinical symptoms. Exploratory laparotomies were performed for diagnostic and therapeutic purposes. The excised cecal tissue underwent histopathological examination.
Results
Initial ultrasonography revealed severe cecal distension filled with hyperechoic material causing distal attenuation, thickened hypoechoic cecal walls, and right colic adenomegaly. Surgical resection and histopathology identified a retention cyst cecal mucocele complicated by mucosal ulceration and inflammation. The cat recovered post-surgery, but recurrence of symptoms necessitated a second surgery. Histological findings confirmed a mucus-filled cecum with inflammatory changes and absence of malignancy. The cat exhibited no further abnormalities five months postoperatively.
Limitations
The case report's conclusions are based on a single instance, limiting generalizability. It remains unclear whether feline cecal mucoceles can be asymptomatic or if other potential cases have been misdiagnosed as unrelated cecal abnormalities.
Conclusions
This report establishes the presence of cecal mucoceles in cats, adding to the differential diagnoses of cecal masses. Ultrasonographic findings of hyperechoic cecal contents with shadowing and lack of vascularization may aid in diagnosis. Surgical resection is necessary for definitive diagnosis and treatment.
Ultrasonography of the ileocecocolic junction and cecal mucocele. A, Longitudinal view of the cecum. The cecal wall was hypoechoicand layering faintly visible. Wall thickness is increased (2.91 mm shown between arrows). The cecal lumen was dilated by heterogeneous contents,the uppermost portion of the content being echogenic with distal attenuation. B, The ileocecocolic junction is visible in the left part of the image.Colic wall thickness and layering were preserved. Peritoneal fat was slightly hyperechoic, and the right colic lymph node was slightly enlarged(between calipers).F I G U R E 2 Ultrasonography of the cecal mucocele 1 day beforethe second surgery. Transverse view of the cecum. There is a slightthickening of the cecum walls (2–3.5 mm—between arrows), with lossof layering, and distension of the cecal lumen by heterogeneousmaterial, of nonliquid appearance, slightly hypoechoic to peritoneal fatfor its most superficial part and distal attenuation. Colic adenomegalyis shown between calipers.material slightly hypoechoic to peripheral fat that strongly attenuatedthe ultrasounds distally, and a cecal wall of similar appearance, slightlythickened and homogeneously hypoechoic, with complete attenuationof wall layering. Peripheral peritoneal fat and right colic adenomegalywere similar to the previous examination (Figure 2).A mucosecreting tumoral process was then strongly suspected,complicated by bacterial infection of the cecum walls involved in thepathologic process.Recurrence of the same clinical and ultrasonographic abnormali-ties indicated surgical resection of the lesion, and en bloc resection ofF I G U R E 3 Macroscopic view of the surgical excision site. Theterminal portion of the ileum is on the left of the image, and the cranialportion of the colon is on the right. The cecum in the center is severelydistended.the cecum and ileocecocolic junction was performed during a secondsurgery and sent for histopathology. Severe distension of the caecumwith depressible but unmovable contents was again identified dur-ing laparotomy, and the cecal walls appeared slightly erythematousand thickened (Figure 3). An ileocecocolic anastomosis was performedusing PDS 3-0 with simple interrupted sutures. The rest of the abdomi-nal examination was unremarkable, and the cat recovered very quicklyafter being treated with antibiotics.Fifteen days after the second surgery and 5 days after the endof the antibiotic treatment, the postoperative check-up showed
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