LAPAROSCOPIC SURGERY FOR ACUTE APPENDICITIS WITH ILIOPSOAS ABSCESS

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  • 腹腔鏡下に治療した腸腰筋膿瘍合併急性虫垂炎の1例

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A 73-year-old man was admitted to our hospital with right lower quadrant abdominal pain and right thigh pain. He also exhibited right abdominal tenderness. Laboratory data indicated high inflammatory status. We suspected acute appendicitis and performed abdominal computed tomography (CT). He was diagnosed with acute appendicitis with iliopsoas abscess. The abscess was relatively localized, and laparoscopic appendectomy and drainage were performed. The appendix vermiformis was behind the cecum ; and the retroperitoneal abscess was induced by the rupture from the tail end of the appendix vermiformis. CT examination on the 10th day after operation revealed no residual abscess, and he was discharged on the 25th day after the operation. Laparoscopic surgery was successful because of the following factors : localized abscess, effective drainage, and good sensitivity toward antibiotics. Laparoscopic appendectomy helped in maintaining the quality of life of our patient. This is an interesting case report that will lead to widening of the indication of laparoscopic surgery.

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