Skrotal fistül ile komplike olan apandisit: Olgu sunumu ve literatürün gözden geçirilmesi

Apandisit günümüzde yapýlan acil abdominal cerrahilerin en sýk sebebidir. Sýk görülen komplikasyonlarý iyi bilinmesine raðmen, retroperitoneal abse ve skrotal abse nadir görülen ve daha az bilinen komplikasyonlardýr. Bu çalýþmada apendektomi sonrasý retroperitoneal abse ve skrotal fistül ile komplike olan hastamýzý ve PubMed üzerinden yaptýðýmýz literatür taramasýný sunduk.
69 yaþýnda erkek hasta yaklaþýk 7 gündür devam eden karýn aðrýsý, bulantý-kusma ve son 24 saat içinde ateþ ve mental durum deðiþikliði þikayetleri ile acil servise baþvurdu. Perforasyon ve retroperitoneal abse ön tanýsý ile acil ameliyata alýndý. Laparotomide perfore apandisit ve buna baðlý retro-peritoneal abse görüldü. Apendektomi yapýldý ve abse boþaltýldý. Sepsis nedeniyle 4 gün yoðun bakým ünitesinde kalan hasta postoperatif 15. günde taburcu edildi. Taburcu olduktan 15 gün sonra skrotumdan kötü kokulu akýntý nedeniyle tekrar baþvurdu. Tomografisinde retroperitoneal alandan sol skrotuma uzanan abse tespit edilen hastaya perkütan drenaj uygulandý. Absesi gerileyen hasta yatýþýndan 17 gün sonra þifa ile taburcu edildi. Apandisit ile iliþkili bu nadir komplikasyonlar, erken ve doðru taný koyabilmek için mutlaka cerrahlarýn aklýnda olmalýdýr. Tedavide gecikme morbidite ve mortalitenin artmasýna neden olabilir.

Complicated appendicitis with scrotal fistula: case report and review of the literature

Appendicitis is the most common emergency abdominal surgery today. Although its common complications are well-known, retroperi-toneal abscess and scrotal abscess are rare and less known complications. In this study, we presented our patient who presented with appendicitis complicated with retroperitoneal abscess and scrotal fistula after appendectomy, and the literature review we conducted through PubMed. A 69-year-old man was admitted to the emergency department with complaints of abdominal pain, nausea-vomiting continuing for about 7 days, and fever and mental status change in the last 24 h. He was taken to emergency surgery with the pre-liminary diagnosis of perforation and retroperitoneal abscess. At laparotomy, perforated appendicitis and associated retroperitoneal abscess were seen. An appendectomy was performed, and the abscess was drained. The patient, who stayed in the intensive care unit for 4 days due to sepsis, was discharged on the 15th postoperative day with full recovery. He was admitted 15 days after his discharge because of an abscess from the scrotum. Percutaneous drainage was performed in the patient, whose tomography revealed an abscess extending from the retroperitoneal area to the left scrotum. The patient, whose abscess regressed, was discharged with recovery 17 days after hospitalization. These rare complications associated with appendicitis should be on the minds of surgeons to make an early diagnosis. Delay in treatment may lead to increased morbidity and mortality.