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[Appendicitis necessitatis: appendicitis perforating the abdominal wall]

I Gockel1, F Jäger, S Shah

  • 1Klinik für Allgemein- und Abdominalchirurgie, Johannes-Gutenberg-Universität, Langenbeckstrasse 1, 55131 Mainz, Germany. gockel@ach.klinik.uni-mainz.de

Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen
|March 8, 2007
PubMed

Insights

Appendicitis perforating the abdominal wall is rare. This case describes a 37-year-old with a perityphlitic abscess and abdominal wall perforation, termed appendicitis necessitatis.

Area of Science:

  • Gastroenterology
  • Surgical Pathology

Background:

  • Appendicitis is a common condition, but perforation through the anterior abdominal wall is exceptionally rare.
  • This presentation mimics other abdominal wall pathologies, necessitating accurate diagnosis.

Observation:

  • A 37-year-old patient presented with purulent discharge from the right lower abdomen.
  • Computed tomography (CT) revealed a perityphlitic abscess with anterior abdominal wall perforation.

Findings:

  • Surgical exploration (laparotomy) confirmed appendiceal perforation and abscess.
  • The patient underwent appendectomy and abdominal wall repair.
  • The condition was termed 'appendicitis necessitatis' by analogy to 'empyema necessitatis'.

Implications:

  • This rare entity, appendicitis necessitatis, expands the spectrum of appendiceal complications.
  • Accurate diagnosis and surgical management are crucial for favorable outcomes.
  • Recognizing this rare complication is important for surgical training and clinical practice.

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