Hepatic abscess: An uncommon complication after laparoscopic appendectomy

Area of Science:

• Gastroenterology
• Surgical Innovation
• Infectious Disease Management

Background:

• Laparoscopic appendectomy is the standard treatment for acute appendicitis.
• Appendicoliths are present in 30% of appendicitis cases.
• Dropped appendicoliths leading to intra-abdominal abscesses are exceptionally rare complications.

Observation:

• A 23-year-old female presented with acute appendicitis and a retained appendicolith.
• Laparoscopic appendectomy was performed, but a persistent liver abscess developed.
• The intrahepatic appendicolith was successfully removed using a Dormia basket via percutaneous drainage.

Findings:

• This case highlights an unusual intrahepatic localization of a dropped appendicolith.
• Percutaneous drainage combined with Dormia basket retrieval proved effective for treating the liver abscess.
• Antibiotics and drainage alone are often insufficient for such complications.

Implications:

• This case expands the understanding of rare complications following laparoscopic appendectomy.
• Percutaneous intervention offers a minimally invasive option for managing intrahepatic appendicoliths.
• Effective management requires prompt diagnosis and targeted retrieval of the foreign body.