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Acute pancreatitis complicated with periappendicitis
Hsiao-Chung Hsia1, Lie-Kai Shoung, Mei-Ling Chen
1Department of Internal Medicine, Puli Christian Hospital, Nantou, Taiwan, ROC. hch918@tcts.seed.net.tw
Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China Ed
|March 15, 2003
Summary
Mild acute pancreatitis can rarely cause periappendicitis, mimicking appendicitis. This case highlights the importance of considering pancreatic inflammation in right lower quadrant pain, even in mild cases.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Colonic complications from severe acute pancreatitis are rare, typically affecting the transverse colon and splenic flexure.
- This case examines an unusual presentation in mild acute pancreatitis.
Observation:
- A 47-year-old male with mild acute pancreatitis presented with right lower quadrant pain.
- Appendectomy revealed periappendicitis, not appendicitis, with evidence of pancreatic inflammatory exudate spread.
Findings:
- Periappendiceal inflammation, mimicking acute appendicitis, occurred in a patient with mild acute pancreatitis.
- Ascitic lipase levels and small bowel ileus suggested a pancreatic origin for the periappendicitis via mesenteric spread.
Implications:
- This case underscores that periappendiceal involvement is a rare but possible complication of even mild acute pancreatitis.
- Clinicians should consider atypical presentations of pancreatitis when evaluating right lower quadrant pain.
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