[Synchronous acute cholecystolithiasis and perforated acute appendicitis. Case report]

Area of Science:

• General Surgery
• Abdominal Surgery
• Gastroenterology

Background:

• Acute appendicitis and acute cholecystitis are common surgical diagnoses.
• Synchronous presentation of these two conditions is exceptionally rare in surgical literature.

Observation:

• A 43-year-old woman presented with right upper quadrant pain, fever, and elevated white blood cell count, indicative of acute cholecystitis.
• Ultrasound confirmed acute cholecystitis; surgical exploration revealed a pyogenic gallbladder with a sub-hepatic abscess.
• Simultaneously, a perforated retrocecal appendix with a fecalith and pelvic abscess was discovered.

Findings:

• The patient underwent subtotal cholecystectomy and appendectomy for synchronous gallbladder and appendix pathologies.
• Histopathology confirmed cholecystolithiasis and complicated appendicitis.
• The patient recovered well and was discharged.

Implications:

• This case underscores the importance of considering concurrent pathologies in patients with complex abdominal pain.
• Open surgical approaches can facilitate comprehensive exploration and management of synchronous intra-abdominal conditions.
• Further investigation into the etiological factors and incidence of synchronous appendicitis and cholecystitis is warranted.