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The caecal mucus sign
  1. Jason Behary1,
  2. Jason Minco Hui2
  1. 1Department of Gastroenterology and Hepatology, The Sutherland Hospital, Caringbah, New South Wales, Australia
  2. 2Department of Gastroenterology and Hepatology, The University of New South Wales, The Sutherland Hospital, Caringbah, New South Wales, Australia
  1. Correspondence to Dr Jason Behary, Department of Gastroenterology and Hepatology, The Sutherland Hospital, Caringbah, New South Wales, Australia; jbehary{at}gmail.com

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Clinical presentation

A 60-year-old man with a history of colonic adenoma underwent routine surveillance colonoscopy. He has been asymptomatic. At colonoscopy, there was adherent mucus identified at the base of the caecal pole (figure 1A). The adherent mucus covered the appendiceal orifice (figure 1B). A CT scan of the abdomen revealed no abnormality.

Figure 1

(A) Endoscopic view of the caecal pole. (B) Close-up view of the adherent mucus.

Question

What is the most likely diagnosis and management?

Answer

Adherent mucus at appendiceal orifice should alert the endoscopist to suspect appendiceal mucinous neoplasm (appendiceal …

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