Intra-abdominal abscess after appendectomy

Case contributed by Dr Bruno Di Muzio

Presentation

Fever and RIQ tenderness 10 days after laparoscopic appendectomy.

Patient Data

Age: 25
Gender: Male

CT Abdomen and pelvis

CT

CT demonstrates a small hypoattenuating collection between surgical clips in the medial aspect of the cecum. There is a mild ring enhancement and prominent regional lymph nodes and inflammatory changes in the adjacent fat planes. Remainder of the exam is unremarkable. 

CT Abdomen and pelvis (selected images) - 10 days before

CT

Previous CT showing an enlarged appendix with an appendicolith

Case Discussion

This case demonstrates an acute appendicitis treated with laparoscopic appendectomy and which evolved with a small intra-abdominal abscess in the surgery bed. This is a complication that has been observed more frequently in the laparoscopic approach than in the traditional surgery 1

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