Acute Appendicitis Following Blunt Abdominal Trauma

Abstract

Inflammation of the appendix is a common cause of acute abdominal pain. The etiology and pathophysiology of appendicitis have been well described. The initiating factor often is obstruction of the appendiceal lumen by inspissated stool, barium, food, parasites, or hyperplastic lymphoid tissue. Two patients have been identified who developed appendicitis temporally related to blunt abdominal trauma, without other clear etiology. Although absolute documentation of trauma as an etiologic factor in these cases is difficult, theoretical mechanisms for the occurrence are discussed. In the setting of right lower quadrant pain following mild to moderate blunt abdominal trauma, acute appendicitis should be considered as a possibility.

Traumatic Appendicitis

“…Because of the frequency of both events and the propensity for both conditions to occur in children and young adults, some authors have attributed acute appendicitis in the injured to coincidence. 3 Others have proposed various theories to explain their co-existence ( The present case is convincing of a cause and effect relationship. There was direct trauma to the right flank and lower quadrant.…”

The effect of blunt abdominal trauma on appendix vermiformis

“…Hennington et al in their report on one adult and one paediatric patient noted that following BAT with a direct effect on the appendix, appendiceal oedema, inflammation, and/or hyperplasia of intrinsic lymphoid tissues had resulted in obstruction of the appendiceal lumen. 3 Çiftçi et al reported a series of five children with TA following direct trauma, suggesting the same mechanism. 2 Oedema and haematoma of the caecal wall and the root of the appendix, revealing possible direct trauma to the appendix, was identified in our case 2 but he also had associated intra-abdominal injuries.…”

Traumatic Appendicitis: A Case Report.

“…reported two cases of blunt abdominal trauma producing acute appendicitis. In both cases, blunt abdominal trauma has produced appendiceal edema with inflammation and hyperplasia of appendix lymphoid tissue, and then, obstruction of the appendiceal lumen, leading to acute appendicitis [4]. Ciftçi and al reported 5 cases of appendicitis occurring after abdominal trauma suggesting the same mechanism [2].…”