Complicated appendicitis with bladder perforation treated with laparoscopic surgery: case report

Erik D Álvarez-Sores1, Leonardo Barba-Valadez1, César A Martínez-Ortiz1

  • 1Servicio de Gastrocirugía, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social.

Cirugia Y Cirujanos
|April 16, 2025
PubMed

Insights

Acute appendicitis perforation into the bladder is rare but serious. This case highlights successful laparoscopic treatment involving right hemicolectomy, ileostomy, and bladder repair, demonstrating the approach

Area of Science:

  • Gastroenterology
  • Urology
  • Surgical Innovation

Background:

  • Delayed diagnosis of acute appendicitis elevates risks of visceral perforation and severe complications.
  • Appendiceal rupture into the urinary bladder is an infrequent but recognized complication.
  • Standard treatment involves open surgery (laparotomy) for appendectomy and bladder repair.

Purpose of the Study:

  • To present a case of complicated appendicitis with bladder perforation.
  • To describe the successful laparoscopic management of this rare clinical scenario.
  • To evaluate the feasibility of minimally invasive surgery for complex appendiceal complications.

Main Methods:

  • A case report detailing a patient with appendicitis and bladder perforation.
  • Surgical intervention performed laparoscopically.
  • Procedures included right hemicolectomy, creation of a terminal ileostomy, and primary closure of the bladder wall defect.

Main Results:

  • Successful laparoscopic treatment of appendiceal-bladder fistula.
  • Minimally invasive approach achieved primary repair of the bladder.
  • Demonstrated the viability of laparoscopy in complex appendicitis cases.

Conclusions:

  • Laparoscopic right hemicolectomy, ileostomy, and bladder repair is a feasible option for appendiceal-bladder perforation.
  • Minimally invasive surgery can be safely applied to complex and rare appendicitis complications.
  • This approach may offer advantages over traditional open surgery.