Misdiagnosis of appendiceal abscess with intestinal malrotation: A case report [Ulus Travma Acil Cerrahi Derg]
Ulus Travma Acil Cerrahi Derg. Ahead of Print: UTD-92836 | DOI: 10.14744/tjtes.2020.92836  

Misdiagnosis of appendiceal abscess with intestinal malrotation: A case report

Zhi-bin Zhang, Tao Yang
Department of general Surgery,Tianjin First Central Hospital, No. 24 Fukang Road, Nankai District, 300192, Tianjin, China

Here, we report the case of a 75-year-old male with abdominal pain who was admitted to our Emergency Department. Computed tomography (CT) scan revealed a torsion of the mesenteric root with fluid surrounding the area. Emergency laparotomy, performed under general anesthesia, revealed appendiceal abscess with intestinal malrotation. Appendicectomy was performed after the torsional mesentery restoration. Antibiotics and other symptomatic treatments were administered postoperatively. The patient recovered well and was discharged at one week after surgery. Intestinal malrotation is more common in neonates than adults. The diagnosis of appendicitis could be further obscured by intestinal malrotation. Therefore, the rare situation of intestinal malrotation and ectopic appendicitis in the abdomen should be considered in cases with an absence of right lower abdominal pain, where preoperative abdominal CT shows mesenteric volvulus and the surrounding intestinal wall is thickened and demonstrating exudation.

Keywords: appendiceal abscess, intestinal malrotation, misdiagnosis

Corresponding Author: Tao Yang, China

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