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.
Abstract:
Misdiagnosis and delay in the treatment of acute appendicitis increases the risk of complications secondary to visceral perforation. Appendicular rupture into the bladder is an uncommon complication, but possibly to happen; treatment generally consists of a laparotomy with appendectomy and repair of the bladder wall. The laparoscopic approach is a viable option in cases of complicated appendicitis, even in complex and infrequent clinical scenarios. The aim of this paper is to describe a case of complicated appendicitis with bladder perforation, treated with a laparoscopic right hemicolectomy, terminal ileostomy and closure of the urinary bladder wall.
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.
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