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Cocket syndrome: thrombotic-septic disease post-appendicectomy complication
R Luque Mialdea1, R Diez, A Casanova
1Pediatric Surgery Service, University Hospital General Gregorio Marañón, Madrid, Spain.
Insights
A rare case of childhood venous thrombosis occurred after appendicitis surgery. This involved a congenital vascular malformation compressing the iliac vein, highlighting a rare cause of deep vein thrombosis in pediatric patients.
Area of Science:
- Pediatric Surgery
- Vascular Surgery
- Pediatric Thrombosis
Background:
- Acute appendicitis is common in children, with surgical complication rates below 5%.
- Thromboembolic disease is exceptionally rare in the pediatric population.
Observation:
- A 13-year-old male developed deep vein thrombosis (DVT) involving the left iliac vein and inferior vena cava six days post-appendectomy for gangrenous appendicitis.
- Diagnostic imaging, including ultrasonography, plethysmography, and CT scans, confirmed the venous thrombosis.
Findings:
- The DVT was attributed to an underlying congenital vascular anomaly, specifically Cocket syndrome, where the iliac artery compressed the iliac vein.
- This case highlights an unusual etiology for venous thromboembolism in a pediatric patient.
Implications:
- This case underscores the importance of considering rare vascular malformations in pediatric patients presenting with unexplained venous thrombosis.
- Early diagnosis and management of such conditions are crucial for preventing severe complications.
- Further research into the incidence and management of Cocket syndrome in children is warranted.
Abstract:
The incidence of complications following treatment of acute appendicitis in childhood is lower than 5%, while thromboembolic disease at that age is exceptional. The case of a 13-year-old male who was operated on in our pediatric surgery department for acute gangrenous appendicitis is presented. His condition improved until the sixth day after the operation when he suffered thrombosis in both the left iliac vein and the inferior cava. Ultrasonography, plethysmography and computer tomography (CT) studies were carried out and a diagnosis of venous thrombosis was made with an underlying congenital vascular malformation where the iliac vein was compressed by the overlying iliac artery; known as the Cocket syndrome. The etiology diagnosis and treatment of this rare disease in childhood is reviewed.