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Retroperitoneal abscess and extensive subcutaneous emphysema in perforated appendicitis: a case report
N B Tomasoa1, J M Ultee, B C Vrouenraets
1Department of Surgery, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands.
Acta Chirurgica Belgica
|September 24, 2008
Summary
A rare, fatal case of appendicitis in an elderly man highlights the risks of delayed diagnosis. This case involved retroperitoneal abscesses and subcutaneous emphysema, leading to multiple organ failure despite surgical intervention.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Geriatric Medicine
Background:
- Appendicitis diagnosis and treatment are typically routine.
- Missed appendicitis diagnosis can result in severe, life-threatening complications.
- Prompt diagnosis and intervention are crucial for favorable outcomes.
Observation:
- A 76-year-old male presented with progressive abdominal pain.
- Clinical presentation included retroperitoneal abscesses and extensive subcutaneous emphysema.
- Laparotomy revealed a perforated appendix into the retroperitoneum without peritonitis.
Findings:
- The patient experienced a fatal outcome due to multiple organ failure.
- Despite multiple surgical interventions, the patient succumbed two months post-admission.
- This case underscores the potential for severe morbidity and mortality in atypical appendicitis presentations.
Implications:
- Highlights the importance of considering appendicitis in elderly patients with atypical abdominal pain.
- Emphasizes the critical need for thorough diagnostic evaluation to prevent delayed diagnosis.
- Underscores the potential for catastrophic complications, including retroperitoneal abscess and emphysema, in perforated appendicitis.
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