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Case Report
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| Delayed acute abdomen of a farthest wandering fecalith retained after laparoscopic appendectomy | ||||||
| Ahmet Kocakusak1, Mehmet Kulus2, Yusuf Emre Altundal2 | ||||||
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1General Surgeon in General Surgery Clinic, Health Ministery Haseki Education and Research State Hospital, Istanbul, Turkey.
2Resident in General Surgery Clinic, Health Ministery Haseki Education and Research State Hospital, Istanbul, Turkey. | ||||||
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| How to cite this article |
| Kocakusak A, Kulus M, Altundal YE. Delayed acute abdomen of a farthest wandering fecalith retained after laparoscopic appendectomy. Int J Case Rep Images 2016;7(12):827–831. |
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Abstract
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Introduction:
Retained fecaliths are avoidable complications of laparoscopic appendectomy. We reported herein a case of delayed acute abdomen caused by a far wandering appendicolith retained after laparoscopic appendectomy.
Case Report: A 24-year-old male who had been operated on because of acute appendicitis in our emergency department 15 days ago, was readmitted with signs and symptoms of acute abdomen. According to his medical history, laparoscopic appendectomy had been converted into open surgery because of perforated appendix and the patient had been discharged from the hospital on the second postoperative day without any complication. Laboratory results were within normal ranges except for the elevated levels of C-reactive protein and leukocyte count. Direct abdominal X-ray, ultrasonography and computed tomography detected a stoney structure of 2 cm surrounded by omentum and intestines at the right side of the vertebral column superior to umbilicus. The stoney fecalith of 2 cm which was found under the leaflet of the transverse mesocolon was surrounded by omentum and intestines creating a mass of almost 10 cm. The fecalith together with the surrounding and necrotizing omentum were resected. The patient was discharged from the hospital on the third postoperative day without any complication. Conclusion: The fecalith is an incidental finding and not always the primary cause of acute or gangrenous (perforated) appendicitis. Insufflation of carbon dioxide used during laparoscopy could have resulted in the far wandering of the fecalith during the initial surgical intervention in the present case. One should keep in mind that retained appendicoliths after laparoscopic appendectomy might cause some complications which could have been avoided. | |
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Keywords:
Acute, Appendicitis, Appendicolith, Fecalith, Laparoscopy
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Author Contributions
Ahmet Kocakusak – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Mehmet Kulus – Substantial contributions to conception and design, Analysis and interpretation of data, Drafting the article, Final approval of the version to be published Yusuf Emre Altundal – Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2016 Ahmet Kocakusak et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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