Rare and exceptional forms of acute appendicitis: Case series and literature review

The acute appendicitis constitutes the most frequent abdominal surgical emergency, its reputation of benign pathology is not entirely justified because one still dies of appendicitis On the one hand, its an unpredictable course which could expose the patient to serious complications; and on the other,its rare ans atypical forms, sometimes serious,masked by a simple appendicular syndrome. For that, we report a series of 42 cases of rare appendicitis among 11000 appendectomies: 27 mucoceles,11 oxyuroses,2 tuberculosis, 1 taenia saginata and 1 cystic lymphangioma, collected over a period of 15 years from January 2004 to December 2019 jointly in the general surgery department of the military hospital of rabat and 5eme military hospital of Guelmim, we have studied the epidemiological, clinical, paraclinical, therapeutic and anatomopathological characteristics A literature review made it possible to compare our data with those published. After a cross-sectional comparison of our rare cases, the average age of our patients is 30ans with a male predominance in the mucocele and female in the other forms. Clinically, a typical appendicular syndrome was dominated, ultrasound and scanner allowed to evoke the diagnosis of appendicular mucocele in 13 cases, the rest of the forms were revelealed by direct and indirect signs of appendicitis without etiological orientation. Surgical treatment is instituted in all forms with different approaches, and medical treatment was subsequently started responding to each etiology. The pathology examination remained the cornerstone for making the diagnosis.