A Case of Laparoscopic Appendicectomy for Perforated Appendiceal Diverticulitis After Ileal Conduit Construction

Abstract

A man in his 50s who had undergone total cystourethrectomy and ileostomy for urethral cancer was admitted to our hospital with the complaint of right lower abdominal pain. Abdominal CT revealed an enlarged appendix and a calcified area at the base of the appendix, which was suspected as an appendiceal diverticulum or a fecal calculus. We diagnosed the patient as having appendiceal diverticulitis and performed laparoscopic appendectomy. As the usual port placement method at our hospital was deemed likely to interfere with the ileal conduit, we modified the port positions accordingly before commencing the operation. Although a perforated diverticulum was identified at the base of the appendix, the laparoscopic surgery was successfully completed. The patient was discharged from the hospital on postoperative day five. Although appendectomy after ileal conduit construction may be difficult because of adhesions or the position of the conduit, laparoscopic surgery can be performed safely if ingenuity is used.