Pneumomediastinum and pneumoretroperitoneum: an extremely rare presentation of acute appendicitis

Abstract

A 22-year-old woman presented with abdominal pain for 12 days. On examination, the abdomen was slightly distended and painful to palpation in the right flank. Subsequent abdominal imaging showed inflammation in the right iliac fossa, retroperitoneal air pockets with inflammation, and signs of pneumomediastinum. Exploratory laparotomy revealed a perforated retrocaecal appendix with abscess extending to the retroperitoneum. Surgical intervention involved a right hemicolectomy followed by end-to-side anastomosis of the ileum to the transverse colon. Histopathological examination of the resected specimen revealed intense inflammation of the caecum and no signs of malignancy. The patient was discharged in good condition 54 days after surgery.

Pericardial disease as a rare complication of pediatric appendicitis: a systematic literature search

“…Similarly, in our previous case report, we attributed SIRS secondary to perforated appendicitis as the cause of the cardiac tamponade after ruling out/ providing evidence against other likely etiologies which included autoimmune/rheumatologic diseases, malignancy, infection, and trauma [5]. Additionally, another mechanism contributing to the etiology of pericardial disease may have been the contiguous spread of inflammation and/or infection from the retroperitoneal space to the mediastinum [12][13][14]. Finally, 71% of the cases were females (Table 1), and this may have been because women are more commonly affected by systemic inflammatory diseases (SID) than men and are more commonly affected by pericarditis related to SID [15].…”