A rare complication of acute appendicitis – case presentation

ABSTRACT

Introduction. Considered by many authors a vestigial structure, the appendix is a small dimensions organ with mostly unknown functions. Acute appendicitis is the most common condition of the ileocecal appendix, having multifaceted clinical manifestations, often masquerading as various unrelated syndromes, but causing increased morbidity, especially when diagnosed late. Although the disease could manifest at any age, there is a progressive increase of its incidence from birth, with a maximum between 10 to 40 years.

Case presentation. We report the case of an 84 years-old female patient, who presented with significant abdominal pain in the lower quadrants, mainly in the right iliac fossa and in whom the CT examination was suggestive of a utero-appendicular fistula, a very rare complication in daily practice and even more seldomly encountered in the elderly.

Conclusions. Acute appendicitis remains a condition for which surgery is still the optimum treatment, especially in the case of an elderly patient having a radiologically suspected fistula with the uterus that could easily lead to septic gynecological complications and possibly progression to multiple organ failure.

Keywords: appendicitis, fistula, diagnosis, appendicitis in the elderly.

Corresponding author:
Dan DUMITRESCU
Emergency University Hospital Bucharest, General Surgery Clinic IV, Bucharest, Romania
Address: Splaiul Independentei 169, 7th floor, Bucharest, Romania
E-mail dumitrescu_v_dan@yahoo.com; Phone +40 722210489