An Uncommon Course Of Acute Appendicitis With Sepsis--A Case Report

Authors report a case of 54-years-old patient, who presented to the hospital due to three-day history of weakness, abdominal pain and diarrhea. His general shape was severe, abdomen was tender at palpation in hypogastrium, peritoneal signs were positive, and blood tests showed highly elevated markers of inflammation, including procalcitonin, what suggested the sepsis. Despite unclear clinical picture, the presence sepsis was an argument to give the patient surgery. Intraoperatively, perforated appendix was found, being in mass with the omentum and small bowel. An appendectomy was performed. Postoperative course was complicated by the wound infection, but recovery progressed quickly and patient was dismissed at 5 days after operation. In the discussion the authors referred to the similar cases reported in the literature, concluding that acute appendicitis can be a life threatening event for - to date - healthy adult person. Although a tendency to treat conservatively an uncomplicated acute appendicitis and to delay operations is supported by scientific evidence, the cases may occur in which only prompt surgical intervention protects the patient from serious complications.