Traumatic acute appendicitis: A case report

Abstract

Acute appendicitis and trauma are commonly seen surgical emergencies. Whether or not the trauma is a cause of appendicitis has been subject to discussions for many years. A 36-year-old male patient presented to our clinic complaining about pain in his right lower abdomen, vomiting and lack of bowel movement. His anamnesis revealed that he fell off a bicycle and his right lower abdominal quadrant hit handlebar of the bicycle approximately 13-14 hours ago. In physical examination, tenderness to palpation, guarding and rebound tenderness in right lower abdominal quadrant were detected. Laboratory tests showed that hemoglobin was 12.6 g/dL and leukocyte 21.600/ mm3. In abdominal ultrasound, the diameter of appendix was measured to be 10 mm and an increased density and edema were found in appendiceal mesentery and periappendiceal adipose tissue. Abdominal tomography showed that the diameter of appendix was 11 mm. The patient was urgently operated. During exploration, intense hematoma was seen in the root, wall and mesentery of the edematous appendix. Mesoappendix with hematoma was also resected during appendectomy. After pathological examination of the removed specimen, the case was reported to be an acute gangrenous appendicitis. The patient was asymptomatic after 6 months of follow-up. Although rarely, acute appendicitis may be develop after a serious blunt abdominal trauma. Clinicians should absolutely suspect acute appendicitis especially in cases with right lower quadrant pain and tenderness following a blunt abdominal trauma for early management and an uneventful postoperative course.