Abstract
A 45-year-old man underwent emergency laparotomy under a diagnosis of acute abdomen in July 2008. Ileocecal abscess was identified intraoperatively, but as we were unable to perform ileocecal resection, a drainage tube was placed in the abscess cavity. Postoperative colonoscopic findings revealed only multiple diverticula in the ascending colon and cecum, but no tumor. After discharge from hospital, ileocecal infection developed twice and was improved each time using antibiotics. He was referred to our hospital for right lower abdominal pain in March 2011. Abdominal computed tomography (CT) showed ileocecal infection and abscess of the abdominal wall. Emergency percutaneous drainage was performed and discharge from the drain was identified as intestinal juice. Laparotomy was therefore performed under a diagnosis of ileocecal perforation. At laparotomy, the perforation, stenosis, and penetration of the abdominal wall, was confirmed in the terminal ileum and right colectomy was performed. Postoperative course was good and the patient was discharged on postoperative day 14. Pathological examination revealed the tissue of the appendix by the perforation and marked infiltration of neutrophils around the appendix. The cause of perforation was considered to be recurring inflammation of acute appendicitis.
