Perforated retrocecal appendicitis presenting with lung abscess-A case report

Retrocecal appendicitis usually presents with atypical signs and symptoms which may lead to delayed diagnosis, perforation and serious complications. Development of a large lung abscess secondary to perforation of retrocecal appendicitis in an adolescent patient is an extremely rare entity and to the best of our knowledge has not been described in literature. We present a 15-year-old boy with complaint of chest pain, cough, fever, vague abdominal pain and raised inflammatory markers who underwent CT examination. On CT, a collection with focal calcification was noted in the right iliac fossa that extended along the right retroperitoneum through the retrocrural space in the right lung base communicating with a cavitary pulmonary lesion with air-fluid level. A diagnosis of perforated retrocecal appendicitis with retroperitoneal and right lung abscesses was made. The patient underwent appendectomy and the entire retroperitoneal and lung abscesses were drained. A lung abscess as a complication of perforated retrocecal appendicitis should be in consideration in septic patients with thoracoabdominal infectious manifestations.