Extensive retroperitoneal and right thigh abscess in a patient with ruptured retrocecal appendicitis: An extremely fulminant form of a common disease

Chi Hsun Hsieh, Yu Chun Wang, Horng Ren Yang, Ping Kuei Chung, Long Bin Jeng, Ray Jade Chen

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

As a disease commonly encountered in daily practice, acute appendicitis is usually diagnosed and managed easily with a low mortality and morbidity rate. However, acute appendicitis may occasionally become extraordinarily complicated and life threatening. A 56-year-old man, healthy prior to this admission, was brought to the hospital due to spiking high fever, poor appetite, dysuria, progressive right flank and painful swelling of the thigh for 3 d. Significant inflammatory change of soft tissue was noted, involving the entire right trunk from the subcostal margin to the knee joint. Painful disability of the right lower extremity and apparent signs of peritonitis at the right lower abdomen were disclosed. Laboratory results revealed leukocytosis and an elevated C-reactive protein level. Abdominal CT revealed several communicated gas-containing abscesses at the right retroperitoneal region with mass effect, pushing the duodenum and the pancreatic head upward, compressing and encasing inferior vena cava, destroying psoas muscle and dissecting downward into the right thigh. Laparotomy and right thigh exploration were performed immediately and about 500 mL of frank pus was drained. A ruptured retrocecal appendix was the cause of the abscess. The patient fully recovered at the end of the third post-operation week. This case reminds us that acute appendicitis should be treated carefully on an emergency basis to avoid serious complications. CT scan is the diagnostic tool of choice, with rapid evaluation followed by adequate drainage as the key to the survival of the patient.

Original languageEnglish
Pages (from-to)496-499
Number of pages4
JournalWorld Journal of Gastroenterology
Volume12
Issue number3
Publication statusPublished - Jan 21 2006
Externally publishedYes

Fingerprint

Appendicitis
Thigh
Abscess
Psoas Muscles
Dysuria
Suppuration
Leukocytosis
Appendix
Inferior Vena Cava
Appetite
Knee Joint
Peritonitis
Duodenum
Abdomen
C-Reactive Protein
Laparotomy
Drainage
Lower Extremity
Emergencies
Fever

Keywords

  • Acute appendicitis
  • Complication
  • Retrocecal appendicitis
  • Retroperitoneal abscess
  • Thigh abscess

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Extensive retroperitoneal and right thigh abscess in a patient with ruptured retrocecal appendicitis : An extremely fulminant form of a common disease. / Hsieh, Chi Hsun; Wang, Yu Chun; Yang, Horng Ren; Chung, Ping Kuei; Jeng, Long Bin; Chen, Ray Jade.

In: World Journal of Gastroenterology, Vol. 12, No. 3, 21.01.2006, p. 496-499.

Research output: Contribution to journalArticle

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