A Case of Acute Abscess-forming Appendicitis Treated by Percutaneous Abscess Drainage Therapy in a Patient with a Ventriculoperitoneal Shunt

Uematsu Yoshimasa, Hatate Kazuhiko, Kuwano Koji, Okoshi Yuji, Sakamoto Yumiko, Kanazawa Hideki

doi:10.11231/jaem.43.93

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Other Title

脳室腹腔シャント留置患者の膿瘍形成性虫垂炎に対し，経皮的ドレナージ治療を選択した1例
ノウシツフクコウシャントリュウチカンジャノノウヨウケイセイセイチュウスイエンニタイシ,ケイヒテキドレナージチリョウオセンタクシタ 1レイ

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Abstract

<p>An 80-year-old woman with a ventriculoperitoneal shunt (VPS) was admitted to our hospital for right lower quadrant pain, and we made a diagnosis of acute appendicitis with abscess. Since the patient was elderly, on chemotherapy for cancer, and at high risk for surgery, and the risk of retrograde CNS infection was considered low because the abscess and the tip of the VPS catheter were far apart, she was treated by conservative antibiotic therapy and percutaneous abscess drainage in order to delay performing an appendectomy. However, three days later the inflammation and pain became worse due to the development of a new abscess, and the VPS catheter had become displaced to the vicinity of the abscess. Emergency appendectomy was performed and the VPS catheter was removed, because nonoperative therapy was unsuccessful and the risk of retrograde CNS infection had increased. This is the first report of a case in which percutaneous abscess drainage was selected to treat a patient with ruptured appendix who had a VPS. Strict follow-up of a VPS catheter is important, because the tip of a catheter can migrate.</p>

Journal

Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine)

Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) 43 (1), 93-96, 2023-01-31

Japanese Society for Abdominal Emergency Medicine

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