Case of the month: Jelly belly?

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Case of the month:

A 75 year old man presents with a 2 month history of abdominal distension and lethargy. Clinical examination demonstrates shifting dullness and investigations reveal he has a microcytic anaemia with raised tumour markers (CA19-9-208 U/ml , CEA-88 µg/L)  Ascitic aspiration yields a gelatinous fluid, the coronal section of his abdominal CT scan is shown above. What is the diagnosis (hint:the arrows point to the primary pathology)

Submitted by N. Patodi

  • abhichauhan

    The diagnosis here is pseudomyxoma peritonei. The arrows highlight the mucinous ascites producing appendiceal mucocele. This is a rare condition, treated by surgical debulking (sugar baker procedure) and heated intraperitoneal chemotherapy.