“…83 The fistulae to vascular structures comprised 14 to the aorta 10,[90][91][92][93][94][95][96][97][98][99][100][101][102] and five to the iliac artery. [103][104][105][106][107] Appendiceal fistulae to the GI tract included 10 cases to the sigmoid colon alone, [108][109][110][111][112][113][114][115][116][117] with an additional two concurrently fistulating to the bladder. 118,119 There were 21 cases of fistula to the ileum, 84,[120][121][122][123][124][125][126][127][128] two to the jejunum, 84,129 six to the duodenum, 84,[130][131][132]…”
Section: Resultsmentioning
confidence: 99%
“…Appendiceal fistulae to the GI tract included 10 cases to the sigmoid colon alone, with an additional two concurrently fistulating to the bladder . There were 21 cases of fistula to the ileum, two to the jejunum, six to the duodenum, eight to the caecum, three to the ascending colon, one to the transverse colon, one to the rectum, and one to a gastrojejunal anastomosis from prior gastroenterostomy .…”
Section: Resultsmentioning
confidence: 99%
“…A congenital communication between the appendix and the caecum is termed a 'horseshoe appendix', in contradistinction to an acquired fistula. 161 Cases of fistula to the sigmoid, [108][109][110][111][112][113][114][115][116][117][118][119] ascending colon, 48,139,140 transverse colon 141 and rectum 142 are encountered with a frequency that is roughly concordant with their anatomical proximity to the appendix.…”
Section: Small Bowelmentioning
confidence: 99%
“…There were four cases in which sigmoid diverticulitis resulted in a fistulae between the sigmoid colon and the appendix. 112,[115][116][117] Diverticulitis can also occur in other parts of the GI tract such as the appendix, leading to a case of fistula involving the appendix, bladder and ileum. 24 Of the three reported cases of fistula to a Meckel's diverticulum, two are presumed to be due to Meckel's diverticulitis 144,146 and one to appendicitis.…”
Background
The appendix has a unique place in surgical history. Although the first ever appendicectomy involved a fistula to the skin, fistulae involving the appendix remain uncommon and can lead to unique surgical considerations.
Methods
A systematic review of the literature was performed for case reports of appendiceal fistulae. We excluded cases in which the patient had a history of appendicectomy. Cases were categorized by site and aetiology, with information regarding relative frequency and demographics obtained.
Results
A total of 301 case reports of fistula involving the appendix were found. The most common sites of these fistulae were to the bladder (148 cases), skin (40 cases), vasculature (19 cases), umbilicus (16 cases) and to the gastrointestinal tract. The most common aetiology in sub‐analysis was appendicitis alone (150 cases), with less common causes including appendiceal adenocarcinoma (32 cases) and congenital abnormalities (18 cases). There were significantly more appendiceal fistulae in males than in females, with a ratio of 1.7:1. In patients with appendiceal adenocarcinoma as a cause for fistula, there were significantly more females than males with a ratio of 2.3:1.
Conclusion
In conducting a systematic review of case reports of fistulae involving the appendix, we identified 301 unique case reports, with a range of different sites and aetiologies.
“…83 The fistulae to vascular structures comprised 14 to the aorta 10,[90][91][92][93][94][95][96][97][98][99][100][101][102] and five to the iliac artery. [103][104][105][106][107] Appendiceal fistulae to the GI tract included 10 cases to the sigmoid colon alone, [108][109][110][111][112][113][114][115][116][117] with an additional two concurrently fistulating to the bladder. 118,119 There were 21 cases of fistula to the ileum, 84,[120][121][122][123][124][125][126][127][128] two to the jejunum, 84,129 six to the duodenum, 84,[130][131][132]…”
Section: Resultsmentioning
confidence: 99%
“…Appendiceal fistulae to the GI tract included 10 cases to the sigmoid colon alone, with an additional two concurrently fistulating to the bladder . There were 21 cases of fistula to the ileum, two to the jejunum, six to the duodenum, eight to the caecum, three to the ascending colon, one to the transverse colon, one to the rectum, and one to a gastrojejunal anastomosis from prior gastroenterostomy .…”
Section: Resultsmentioning
confidence: 99%
“…A congenital communication between the appendix and the caecum is termed a 'horseshoe appendix', in contradistinction to an acquired fistula. 161 Cases of fistula to the sigmoid, [108][109][110][111][112][113][114][115][116][117][118][119] ascending colon, 48,139,140 transverse colon 141 and rectum 142 are encountered with a frequency that is roughly concordant with their anatomical proximity to the appendix.…”
Section: Small Bowelmentioning
confidence: 99%
“…There were four cases in which sigmoid diverticulitis resulted in a fistulae between the sigmoid colon and the appendix. 112,[115][116][117] Diverticulitis can also occur in other parts of the GI tract such as the appendix, leading to a case of fistula involving the appendix, bladder and ileum. 24 Of the three reported cases of fistula to a Meckel's diverticulum, two are presumed to be due to Meckel's diverticulitis 144,146 and one to appendicitis.…”
Background
The appendix has a unique place in surgical history. Although the first ever appendicectomy involved a fistula to the skin, fistulae involving the appendix remain uncommon and can lead to unique surgical considerations.
Methods
A systematic review of the literature was performed for case reports of appendiceal fistulae. We excluded cases in which the patient had a history of appendicectomy. Cases were categorized by site and aetiology, with information regarding relative frequency and demographics obtained.
Results
A total of 301 case reports of fistula involving the appendix were found. The most common sites of these fistulae were to the bladder (148 cases), skin (40 cases), vasculature (19 cases), umbilicus (16 cases) and to the gastrointestinal tract. The most common aetiology in sub‐analysis was appendicitis alone (150 cases), with less common causes including appendiceal adenocarcinoma (32 cases) and congenital abnormalities (18 cases). There were significantly more appendiceal fistulae in males than in females, with a ratio of 1.7:1. In patients with appendiceal adenocarcinoma as a cause for fistula, there were significantly more females than males with a ratio of 2.3:1.
Conclusion
In conducting a systematic review of case reports of fistulae involving the appendix, we identified 301 unique case reports, with a range of different sites and aetiologies.
“…A detailed review of the literature revealed only five cases15–19 of fistulation between appendix and colon (in English language case reports) all in the presence of diverticular disease. A sixth case describes the first case of appendico-sigmoid fistulation in the absence of diverticular disease 20.…”
The case of a boy with cystic fibrosis who presented with an unusual complication of appendicitis is reported. Delayed presentation, with complications of appendicitis such as perforation and abscess formation, is not uncommon in cystic fibrosis; however, this case represents the first report of an isolated appendico-colic fistula following appendicitis in association with cystic fibrosis.
IntroductionUlcerative colitis is a chronic disease characterized by diffuse mucosal inflammation limited to the colon. It mostly affects young adults, yet a large number of middle-aged and older patients with ulcerative colitis have also been reported.Case presentationA 58-year-old Caucasian man presented to our hospital in August 2006 with continuous and diffuse abdominal pain, meteorism, fever and bloody diarrhea. He had a two-year history of ulcerative colitis. Our patient was treated with intravenous medical therapy. As his condition worsened, he underwent surgery. An explorative laparotomy revealed that the entire colon was distended and pus was found around an appendiceal-sigmoid fistula.ConclusionsTherapy for ulcerative colitis is a rapidly evolving field, with many new biological agents under investigation that are likely to change therapeutic strategies radically in the next decade. Indications for surgery are intractability (49%), stricture, dysplasia, toxic colitis, hemorrhage and perforation. To the best of our knowledge, this is the first case of an appendiceal-sigmoid fistula in a patient affected by ulcerative colitis reported in the literature. Fistulae between the appendix and the sigmoid tract are rarely reported in cases of diverticular disease and appendicitis.
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