Our algorithm recommends avoidance of conservative management. For chronic lesions, percutaneous aspiration should not be used in isolation. Sclerodesis using doxycycline is appropriate for lesions up to 400 ml, where evidence suggests high degrees of efficacy. Larger lesions should be treated with open surgery. Quilting sutures, curettage and low suction drains are useful adjuncts. We hypothesise this algorithm would also be effective for post-operative seromas.
Mucocoele of the appendix is a rare diagnosis. However, given the possibility of neoplastic peritoneal dissemination, it should be considered as a diagnosis, especially in older females with non-specific symptoms similar to appendicitis.
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