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A rare diagnostic challenge in acute appendicitis: a case report.
Masumi Kawashima1, Yasushi Hashimoto, Takeshi Sudo
1Department of Surgery, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University Hiroshima 734-8551, Japan.
Hiroshima Journal of Medical Sciences
|June 19, 2012
Summary
Acute appendicitis can rarely cause remote abscesses, even without typical gastrointestinal symptoms. This case highlights the importance of considering perforated appendicitis in gluteal abscess diagnoses.
Area of Science:
- Gastroenterology
- Radiology
- Surgical Pathology
Background:
- Acute appendicitis is a common surgical emergency.
- Unusual presentations can pose diagnostic challenges.
Observation:
- A 78-year-old woman presented with a large, gas-forming abscess in the right gluteal region.
- She had no significant gastrointestinal symptoms.
- Computed tomography (CT) revealed a retroperitoneal abscess extending to subcutaneous tissues.
Findings:
- Laparotomy confirmed perforated retrocecal appendicitis.
- The abscess was contained within the retroperitoneum without peritonitis.
- This represents an atypical manifestation of appendicitis.
Implications:
- Anatomical considerations are crucial for interpreting imaging findings in complex cases.
- Perforated appendicitis should be included in the differential diagnosis for gluteal or thigh abscesses.
- Highlights the importance of a broad differential diagnosis in abscess presentations.
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