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Retroperitoneal Laparoscopic Debridement and Drainage for Pancreatic Abscess
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An uncommon late complication of appendicitis
1Department of Emergency Medicine, Children's Memorial Hermann Hospital, University of Texas Health Science Center, Houston, TX, USA. robert.m.lapus@uth.tmc.edu
Pediatric Emergency Care
|October 9, 2010
Summary
A retained appendicolith from a previous appendicitis can cause a retroperitoneal abscess, leading to leg pain and flank masses in children. This rare complication highlights the need for thorough evaluation of late-onset abdominal symptoms.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Radiology
Background:
- Appendicitis is a common pediatric surgical emergency.
- Complications can arise even after successful treatment, such as interval appendectomy.
- Late complications are often overlooked in the differential diagnosis.
Observation:
- A 10-year-old boy presented with a 2.5-week history of right leg pain and limp.
- A right flank mass was noted by the parent.
- Past medical history included perforated appendicitis treated with laparoscopic appendectomy 2 years prior.
Findings:
- Abdominal and pelvic computed tomography (CT) revealed a retroperitoneal mass with calcifications.
- The mass was suggestive of a retained appendicolith with abscess formation.
- This indicated a very late complication of appendicitis.
Implications:
- This case underscores the importance of considering delayed complications of appendicitis.
- Retroperitoneal abscesses from retained appendicoliths can present with vague symptoms like leg pain and flank masses.
- A high index of suspicion and advanced imaging are crucial for diagnosing such rare pediatric conditions.
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