A Case of Non-perforating Acute Appendicitis Complicated by Septic Shock

Abstract

Although sepsis occasionally develops as a complication of perforating appendicitis, it is rare in cases of non-perforating appendicitis. In this report, we detail our experience in managing a case of septic shock complicating non-perforating acute appendicitis. The patient was a 51-year-old male who presented to our hospital with abdominal pain and was diagnosed as having phlegmonous appendicitis based on the findings of abdominal CT. We performed laparoscopic appendectomy on the same day. The appendix was dark brown in color and enlarged, but there was no perforation. After emerging from anesthesia, the patient developed shock and findings suggestive of disseminated intravascular coagulation. He was diagnosed as having septic shock caused by the appendicitis, and placed under intensive care. He improved steadily and was discharged on postoperative day 9. A blood culture later grew Enterobacter aerogenes. Postoperative histopathology confirmed the diagnosis of phlegmonous appendicitis. It is important to note that sepsis can occasionally occur even in patients with non-perforating appendicitis without necrosis.