A Case Report of Perityphlitic Abscess Endoscopically Observed and Drained Through Biopsy

Abstract

A 71-year-old female was admitted to our hospital because of a palpable egg-sized mass in the right lower quadrant on May 12, 1998. Barium enema disclosed a roundish extraluminal ileocecal mass, 65X50 mm in size, which was shown to be filled with water density material by pelvic CT scan. Colonoscopy revealed a hemispherical elevation of the cecum around the orifice of the appendix, and the biopsy of the reddened orifice led to a sudden drainage of whitish pus into the colonic lumen. The detection of E. coli from the pus indicated diagnosis of perityphlitic abscess probably due to acute appendicitis. After conservative therapy with Fosfomycin, the palpated ileocecal mass gradually decreased in size and disappeared endoscopically. However, subsequent barium enema showed a tumor, 40×30 mm in diameter, at the same site, and so the patient underwent radical operation on May 28, 1998, by which the organized inflammatory mass was resected. A rare case of perityphlitic abscess due to appendicitis, which was endoscopically observed and also diagnosed by the preoperative drained pus to the colonic lumen through biopsy was presented.