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Autoamputation of the appendix, a rare complication of Ladd's procedure, can cause intermittent abdominal pain. This condition is benign, with the appendix passing naturally in stool, resolving symptoms for pediatric patients.

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Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Emergency Medicine

Background:

  • Autoamputation of the appendix is a rare complication following Ladd's procedure for intestinal malrotation.
  • Ladd's procedure is a surgical technique used in pediatric patients to correct intestinal malrotation.

Observation:

  • A 4-year-old male with a history of Ladd's procedure presented with "passing intestine" in his stool.
  • The patient experienced weeks of intermittent, crampy abdominal pain that resolved after bowel movements.
  • Examination of the stool revealed a devascularized appendix.

Findings:

  • Autoamputation of the appendix is an uncommon but benign presentation in the Emergency Department.
  • Passing a devascularized appendix can resolve intermittent abdominal pain in pediatric patients.
  • Appendix remnants can persist in the intestinal lumen years after Ladd's procedure.

Implications:

  • Emergency physicians should be aware of this rare phenomenon to confidently diagnose and reassure parents.
  • Early recognition can prevent unnecessary interventions for a benign condition.
  • Understanding this complication aids in managing pediatric patients with a history of Ladd's procedure.