2003 Volume 23 Issue 6 Pages 967-971
A 70-year-old man presented with lower abdominal pain and was referred to our hospital. A fist-sized mass was palpable in the lower right quadrant of the abdomen, suggesting an abscess. His clinical condition indicated the systemic inflammatory response syndrome (SIRS). We drained this mass and removed 15ml of pus. Fistulography showed that the abscess drained into the sigmoid colon. Severe inflammatory changes were found at the apex of the appendix, and the fistula ran through the abscess to the sigmoid colon. We performed an appendectomy and a partial sigmoidectomy, detecting inflammatory cell invasion in the resected appendix and sigmoid colon. We concluded that this appendiceal-sigmoid fistula had been caused by appendicitis.
