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Colon Ascendens Stent Peritonitis (CASP) - a Standardized Model for Polymicrobial Abdominal Sepsis
06:45

Colon Ascendens Stent Peritonitis (CASP) - a Standardized Model for Polymicrobial Abdominal Sepsis

Published on: December 18, 2010

[Polymicrobial sepsis and perityphlic abscess: case report and review of literature]

Ivan Puljiz1, Ilija Kuzman, Kristijan Bayer

  • 1Klinika za infektivne bolesti Dr. Fran Mihaljević, Zagreb, Hrvatska. ipuljiz@bfm.hr

Acta Medica Croatica : Casopis Hravatske Akademije Medicinskih Znanosti
|February 11, 2005
PubMed
Abstract

Insights

Conservative therapy effectively treated polymicrobial anaerobic sepsis and appendiceal mass in an 18-year-old. This case highlights successful non-operative management for this complex condition.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Surgical Pathology

Background:

  • Appendiceal mass formation can result from delayed diagnosis of acute appendicitis.
  • Distinguishing appendiceal mass from other ileocecal pathologies like terminal ileitis is clinically challenging.
  • Polymicrobial anaerobic sepsis is a serious complication associated with appendiceal mass.

Observation:

  • An 18-year-old presented with fever, abdominal pain, and vomiting, later diagnosed with an appendiceal mass.
  • Blood cultures identified Fusobacterium species and Bacteroides ovatus, indicating polymicrobial anaerobic sepsis.
  • Imaging revealed a 6.5x5.5 cm appendiceal mass, while colonoscopy showed terminal ileitis.

Findings:

  • The patient received 21 days of intravenous antibiotics (amoxicillin + clavulanic acid and metronidazole).
  • Follow-up ultrasound demonstrated complete resolution of the appendiceal mass.
  • Conservative management proved safe and efficacious in this case.

Implications:

  • Successful non-operative management of appendiceal mass and associated sepsis is feasible.
  • This case supports conservative approaches, potentially avoiding unnecessary surgery.
  • Further research into optimal management strategies for appendiceal mass is warranted.

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