Faecolith migrating from the appendix to produce liver abscess after subhepatic laparoscopic appendectomy

Area of Science:

• Gastroenterology
• Hepatology
• Surgical Pathology

Background:

• Subhepatic appendix location complicates appendicitis diagnosis and management.
• Lost appendicular faecoliths are known complications, often resulting from spillage or perforation during appendectomy.

Observation:

• A case is presented involving a faecolith migrating into the liver parenchyma.
• This migration occurred subsequent to an intraoperative hepatic injury.
• A liver abscess developed at the site of the migrated faecolith.

Findings:

• Preoperative computed tomography revealed a calcified lesion in the liver, identified as a free-lying faecolith.
• The liver abscess was presumed to be caused by the implantation of this foreign object into the liver parenchyma.
• Pigtail drainage of the liver abscess yielded positive results.

Implications:

• This case underscores the potential for unusual complications arising from appendicitis management.
• It highlights the importance of recognizing faecolith migration as a cause of liver abscesses.
• Prompt diagnosis and intervention, such as abscess drainage, are crucial for favorable outcomes in such rare scenarios.