A Case of Laparoscopic Appendectomy and Partial Cystectomy for Vesico-appendiceal Fistula with Appendiceal Diverticulitis

Abstract

A 60-year-old male patient who presented with a one-month history of discomfort/pain in his lower abdomen was admitted to our hospital. He gave a history of having suffered from cystitis for over a decade. The results of urinalysis came back negative, but abdominal CT and cystography at our hospital showed a vesico-appendiceal fistula. MRI showed no diffusion restriction in the pelvis, and cystoscopy showed no bladder tumor, so that neither a tumor of the appendix nor a bladder tumor was suspected. We performed laparoscopic appendectomy and partial cystectomy on the 2nd hospital day and discharged the patient on the 7th postoperative day. The resected specimen showed an appendiceal diverticulum, but no tumor. A diverticulum with inflammatory cell infiltration was observed in the area of the fistula. There were no specific findings in the bladder. The patient was diagnosed as a case of vesico-appendiceal fistula secondary to appendiceal diverticulitis. There was no dysuria or evidence of recurrence at the follow-up examination performed at the follow up 2 years after the surgery, and the patient was relieved of the long-standing cystitis.