Appendicitis Presenting As Cellulitis of the Right Leg

Perforated Appendicitis Presenting as a Soft Tissue Infection of the Thigh: An Example of Successful Non-Operative Management

“…This case demonstrates successful non-operative management of perforated retrocecal appendicitis with inflammation and abscesses tracking through the right thigh and into the leg. Previous case reports of perforated appendicitis with associated lower extremity soft tissue infection have described the need for urgent surgical intervention [4][5][6][7][8][9][10][11][12]. In our case, surgical management of the diffuse inflammatory process would have likely involved an exploratory laparotomy, right hemicolectomy with end ileostomy, and extensive debridement of the right lower extremity.…”

“…The conventional standard of care for perforated appendicitis is percutaneous drainage and interval appendectomy [14]. However, when this disease process involves retroperitoneal fistulization extending into the soft tissues of the lower extremity, prior cases described in the literature have almost exclusively required surgical intervention, unlike in our patient [4][5][6][7][8][9][10][11][12].…”

“…Thigh pain has been documented by a number of case reports as the presenting symptom of perforated retrocecal appendicitis in both adults [ 4 ] and children [ 5 , 6 ]. Specific etiologies of thigh pain included cellulitis [ 4 , 7 ], thigh abscess [ 8 ], subcutaneous emphysema [ 9 , 10 ], and necrotizing fasciitis [ 11 ]. The proximity of a retrocecal appendix to the posterior abdominal wall can result in the development of a retroperitoneal abscess with inflammation extending into the thigh [ 12 ].…”

Recurrent right loin abscess: an atypical presentation of chronic appendicitis

“…Similar to our case, this patient did not have any abdominal symptoms to suggest an intra-abdominal pathology. However, in this case the CT clearly demonstrated a perforated retrocaecal appendix as the cause [1]. Fanning et al published a case of perforated acute appendicitis causing a right lumbar abscess in a 66-year-old male who was a type-2 diabetic; similarly, Kawashima et al reported a 78-year-old female with appendicitis causing right gluteal cellulitis [2,3].…”

The red leg dilemma: a scoping review of the challenges of diagnosing lower‐limb cellulitis

“…Next, 533 full‐text articles were assessed for eligibility and 71 were included for data extraction (Fig. ) . Nine papers were foreign‐language texts: six French, two Spanish and one Turkish.…”