A Case of Perforated Acute Appendicitis due to a Metallic Foreign Matter Performed Interval Laparoscopic Appendectomy

Abstract

A 41-year-old man presenting with fever and abdominal pain was found to have perforated acute appendicitis with abscess formation and a metallic foreign matter at the same site. By keeping an avoidance of extended surgery in mind, we decided to employ interval appendectomy (IA) and performed laparoscopic appendectomy after conservative therapy. To ensure the recovery of the foreign matter as well as to treat the appendiceal root, we performed the treatment and transection of the root outside of the peritoneum and under the direct vision by mobilizing the ileocecal region. We recovered the about 7-mm metallic foreign matter. His postoperative course was uneventful. Although we sometimes encounter clinical cases of appendicitis due to a foreign matter, those in which laparoscopic surgery, especially IA, was performed are rare. Ours is of the first domestic case in which IA was successfully done as far as we could review.

Recently a variety of advantages of IA have been advocated for acute appendicitis with locally serious inflammation like our case, and IA is one of promising therapeutic strategies. However, the indication of IA for acute appendicitis caused by a foreign matter has rarely been reported and resultantly its effect is still unknown. As this case appears to be important in terms of the indication and usefulness of IA for acute appendicitis due to a foreign matter, we present the case with a review of the literature.