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Appendico-cutaneous fistula: a diagnostic dilemma
1Department of Surgery, University College of Medical Sciences, Associated Guru Tegh Bahadur Hospital, Dilshad Garden, Delhi 110095. jolviv12@vsnl.net
Tropical Gastroenterology : Official Journal of the Digestive Diseases Foundation
|November 8, 2003
Summary
Appendico-cutaneous fistula, a rare condition causing abdominal wall discharge, is challenging to diagnose. Exploratory laparotomy is the gold standard for confirming and surgically treating this appendiceal inflammation.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Appendiceal inflammation can manifest as an appendico-cutaneous fistula, a discharging tract on the abdominal wall.
- This condition is distinct from fistulas occurring after appendectomy for acute appendicitis.
Observation:
- Appendico-cutaneous fistulas are rare, with only 16 cases found in a PubMed search.
- Diagnosis can be difficult, even with advanced radiological imaging.
- The presentation involves inflammation of the appendix leading to an abdominal wall fistula.
Findings:
- An exploratory laparotomy is the definitive diagnostic and therapeutic approach.
- Surgical management includes appendectomy and excision of the fistulous tract.
Implications:
- Highlights the diagnostic challenges of appendico-cutaneous fistulas.
- Emphasizes the role of exploratory laparotomy in managing this rare condition.
- Contributes to the limited literature on appendico-cutaneous fistulas, aiding future case recognition and treatment strategies.