Traumatic acute appendicitis: A case report

Özet

Acute appendicitis and trauma are commonly seen surgical emer-gencies. 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 bo-wel movement. His anamnesis revealed that he fell off a bicy-cle 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 adi-pose tissue. Abdominal tomography showed that the diameter of appendix was 11 mm. The patient was urgently operated. Du-ring exploration, intense hematoma was seen in the root, wall and mesentery of the edematous appendix. Mesoappendix with hematoma was also resected during appendectomy. After patho-logical examination of the removed specimen, the case was re-ported 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 serio-us 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.