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Uterine abscess as an appendicitis complication: a case report
Oğuz Lafcı1, Elif Ergün1, Hasan Yiğit1
1University of Health Sciences, Ankara Training and Research Hospital, Radiology Department, Ankara, TURKEY.
Introduction:
Acute appendicitis is a frequent cause of abdominal pain that requires surgical intervention. Rarely complications such as appendico-vesical, appendico-cutaneous, or appendico-uterine fistula formation may occur.
Case And Outcomes:
We present a case of an 83-year-old woman who suffered from a very rare complication of acute appendicitis. Multimodal radiologic examination including ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) revealed complicated appendicitis with an abscess formation involving the right adnexal region and uterine cavity. The patient was treated conservatively with percutaneous drainage of the abscess and IV antibiotics.
Discussion:
Acute appendicitis is one of the common causes of emergency surgery. It is important to differentiate simple and complicated appendicitis to determine the best treatment option, thus, the diagnostic accuracy of certain US and CT findings in making this differentiation has been the subject of investigation. Even though some imaging findings suggest appendiceal perforation, deciding a conservative treatment plan based solely on imaging findings is still inaccurate. MRI is complementary to CT and US as a problem solving modality in certain situations.
Conclusion:
This case report reminds us that physicians and radiologists should be aware of rare complications of acute appendicitis such as fistula formation to visceral organs. MRI is superior in order to differentiate complex fluid collections such as abscess formations.
Insights
This case highlights a rare complication of acute appendicitis: an abscess extending to the uterine cavity. Multimodal imaging, particularly MRI, is crucial for diagnosing such complex cases and guiding conservative treatment.
Area of Science:
- Radiology
- Gastroenterology
- Gynecology
Background:
- Acute appendicitis is a common surgical emergency.
- Rarely, appendicitis can lead to fistulas or abscesses involving adjacent organs.
Observation:
- An 83-year-old woman presented with complicated appendicitis and an abscess involving the adnexal region and uterine cavity.
- Diagnosis was established using ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI).
Findings:
- Multimodal imaging confirmed a complex abscess formation.
- The patient was successfully treated conservatively with percutaneous drainage and antibiotics.
Implications:
- Physicians and radiologists must consider rare appendicitis complications.
- MRI is valuable for differentiating complex fluid collections like abscesses.
