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Case Reports
. 2019 May 28;2019(5):rjz163.
doi: 10.1093/jscr/rjz163. eCollection 2019 May.

A snake in the grass: retroperitoneal abscess due to perforated appendicitis-management, approach and recommendations

Ahmad Nahhas  1   2 , Abderahman Abderahman  3 , Ayman Kharaba  4
Affiliations
Case Reports

A snake in the grass: retroperitoneal abscess due to perforated appendicitis-management, approach and recommendations

Ahmad Nahhas et al. J Surg Case Rep. .

Abstract

A perforated retrocecal appendix resulting in a retroperitoneal abscess is a rare complication of a common disease. The first description of this condition was published in 1948. We present a case involving a 50-year-old woman who presented with abdominal pain inconsistent with the typical presentation of acute appendicitis and was eventually found to have a perforated retrocecal appendix accompanied by a retroperitoneal abscess. The patient was diagnosed using CT and operated upon but unfortunately had a resistant inflammatory process that led to persistent pus drainage from the abdomen despite multiple evacuation attempts and a prolonged hospital stay. In such cases, if the source of this type of inflammatory process has not yet been controlled or even identified, we recommend a second surgical examination, with additional surgical examinations as needed, and offer other suggestions.

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Figures

Figure 1:
Figure 1:
Coronal section CT scan image of the patient’s abdomen.
See this image and copyright information in PMC

References

    1. Hardin DM., Jr Acute appendicitis: review and update. Am Fam Physician 1999;60:2027–34. - PubMed
    1. Hsieh CH, Wang YC, Yang HR, Chung PK, Jeng LB, Chen RJ. Extensive retroperitoneal and right thigh abscess in a patient with ruptured retrocecal appendicitis: an extremely fulminant form of a common disease. World J Gastroenterol 2006;12:496–9. - PMC - PubMed
    1. Hsieh CH, Wang YC, Yang HR, Chung PK, Jeng LB, Chen RJ. Retroperitoneal abscess resulting from perforated acute appendicitis: analysis of its management and outcome. Surg Today 2007;37:762–7. - PubMed
    1. van den Wildenberg FA. The retrocaecal appendix: a snake in the grass. Neth J Surg 1982;34:133–5. - PubMed
    1. Bird GC Jr., Fissel GE, Young BR. A pathognomonic roentgen sign of retroperitoneal abscess; report of two cases of ruptured appendix with positive roentgen findings. Am J Roentgenol Radium Ther 1948;59:351–3. - PubMed

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