Complicated acute appendicitis presenting as a rapidly progressive soft tissue infection of the abdominal wall: a case report

Abstract

BackgroundWe report a case of a rare complication of acute appendicitis with perforation through the abdominal wall. The case points out that an intraabdominal origin should be considered in patients presenting with rapidly spreading soft tissue infections of the trunk.Case presentationA 58-year-old European woman presented to our hospital with a 1-week history of severe abdominal pain accompanied by rapidly spreading erythema and emphysema of the lower abdomen. On admission, the patient was in septic shock with leukocytosis and elevation of C-reactive protein. Among other diagnoses, necrotizing fasciitis was suspected. Computed tomography showed a large soft tissue infection with air-fluid levels spreading through the lower abdominal wall. During the operation, we found a perforated appendicitis breaking through the fascia and causing a rapidly progressive soft tissue infection of the abdominal wall. Appendicitis was the origin of the soft tissue infection. The abdominal wall was only secondarily involved.ConclusionsEven though perforated appendicitis as an etiology of a rapidly progressive soft tissue infection of the abdominal wall is very rare, it should be considered in the differential diagnosis of abdominal wall cellulitis. The distinction between rapidly spreading subcutaneous infection with abscess formation and early onset of necrotizing fasciitis is often difficult and can be confirmed only by surgical intervention.

Case report of open appendectomy in treating acute perforated appendicitis with necrotizing fasciitis of the abdominal wall: A rare complication of a common disease

“…Appendectomy can be performed through an open or laparoscopic medical procedure, and it is the most effective way to prevent complications is to remove the inflamed appendix early by open surgery or laparoscopically. 12 For acute appendicitis, laparoscopic appendectomy is associated with a reduction in postoperative recovery time ( p ˂ .025). For the north of a century, laparotomy (open appendectomy) was the standard treatment for intense a ruptured appendix.…”

Laparoscopic management of perforated appendicitis-a study of 90 cases

“…Which method of surgery to be undertaken -remains an unsolved issue 21 . In an endeavor to seek answer to this question-whether laparoscopic appendicectomy can become the preferred option and infact the gold standard over the conventional open appendicectomy 22,23 , We performed this study. Three port technique was used (10mm port in the supraumbilicus for the camera, two 5mm ports in the left iliac fossa and supra-pubic as the working ports).…”

Complicated Spigelian Hernia with Incarcerated Appendicitis Presenting as a Local Cellulitis

“…Few cases of abdominal wall cellulitis were reported [1][2][3]. The first one, written by Yamaguchi et al, concerning a neurologically disabled patient, did not report the surgical technique but emphasized the importance of being aware of such cases and cautious with patients suffering from communication troubles.…”