Retroperitoneal perforation of the appendix presenting as a right thigh abscess

Area of Science:

• Gastroenterology
• Surgical Case Reports
• Diagnostic Imaging

Background:

• Retroperitoneal appendix rupture is an uncommon surgical emergency.
• Patients may present with atypical symptoms, delaying diagnosis.

Purpose of the Study:

• To report a rare case of retroperitoneal appendix rupture.
• To emphasize the importance of considering gastrointestinal sources for unexplained abscesses.

Main Methods:

• Case presentation of a 53-year-old male with a thigh abscess.
• Diagnostic workup included imaging (MRI, CT) and microbiological culture.
• Surgical intervention involved laparotomy and segmental ileocaecal resection.

Main Results:

• Imaging revealed fluid tracking from the paracolic gutter to the thigh.
• CT confirmed appendiceal perforation into the retroperitoneum.
• Patient recovered well after surgical resection.

Conclusions:

• Absence of abdominal symptoms can delay diagnosis of retroperitoneal appendix rupture.
• Persistent thigh or groin abscesses warrant gastrointestinal tract investigation.
• Microbiological cultures can provide crucial diagnostic clues.