A Case of Laparoscopic Appendicostomy for a Longstanding Appendico-cutaneous Fistula

Abstract

The patient was a 34-year-old man who had suffered from perforation of the small intestine due to an incarcerated right inguinal hernia and undergone inguinal hernia repair by the anterior approach with a temporary ileostomy at two months of age. The ileostomy closure was performed two months after the initial surgery, and an appendicostomy was created for the purpose of decompression of the anastomosis. The tube was removed a few months later and the appendicostomy closed naturally. At the age of 34, the patient noticed a swelling of the skin after the fistula was closed. After undergoing drainage at other hospitals, he was admitted to our hospital because of leakage of the bowel contents from the fistula. X-ray fluoroscopy under endoscopic guidance showed an appendico-cutaneous fistula.Therefore, laparoscopic appendectomy and resection of the fistula containing the skin were performed.We report the case of a patient who developed an appendico-cutaneous fistula after closure of an appendicostomy.