Appendicolith as a cause of late complications after appendectomy - a case report and literature review

Area of Science:

• Gastroenterology
• Surgical Pathology
• Infectious Disease

Background:

• Acute appendicitis is a common surgical emergency.
• Postoperative abscess formation, including retroperitoneal abscesses, can occur following appendectomy.
• Appendicoliths, calcified fecaliths from the appendix, are implicated in infectious complications due to retained bacteria.

Observation:

• This case report details a rare instance of a retroperitoneal abscess caused by an incarcerated appendicolith.
• A significant delay was noted between the initial appendectomy and the manifestation of abscess symptoms.
• The patient required surgical intervention for abscess drainage and appendicolith removal.

Findings:

• Appendicoliths left in the peritoneal cavity can serve as a nidus for infection.
• Incarcerated appendicoliths can lead to delayed-onset abscess formation, even long after the primary surgery.
• Negative wound pressure therapy facilitated adequate postoperative wound healing.

Implications:

• Surgeons must be vigilant about the potential for appendicolith displacement during appendectomy.
• Thorough intraoperative inspection of the peritoneal cavity is essential to prevent retained foreign bodies.
• Postoperative imaging may be necessary to identify retained appendicoliths causing infectious complications.