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Uncommon Presentation of a Perforated Appendicitis Leading to Duodenal Fistula: Case Report and Literature Review

Jad El Bitar1, Hani Maalouf1, Souad Ghattas1

  • 1Department of General Surgery Balamand University Saint Georges Hospital University Medical Center, Beirut, Lebanon.

Case Reports in Surgery
|June 17, 2024
PubMed

Insights

A rare duodenal fistula occurred in an 18-year-old male with complicated appendicitis and abscess. Prompt diagnosis and management are crucial to prevent further complications from this unusual presentation.

Area of Science:

  • Gastroenterology
  • Surgical Pathology

Background:

  • Appendicitis is a common condition, but associated fistulas are rare.
  • Duodenal fistula from perforated appendicitis is exceptionally uncommon, with only one prior report.

Observation:

  • An 18-year-old male presented with complicated appendicitis and abscess formation.
  • Initial treatment included IV antibiotics and CT-guided drainage.
  • Biliary output from the drain led to further investigation.

Findings:

  • CT fistulography and diagnostic laparoscopy confirmed a duodenal fistula.
  • The fistula originated from perforated acute appendicitis.

Implications:

  • This case highlights the importance of considering duodenal fistula in complicated appendicitis.
  • Early recognition and management are vital to prevent severe complications like duodenal perforation.

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