A Case of Traumatic Appendiceal Transection Diagnosed and Treated by Laparoscopic Surgery

Abstract

A 46-year-old man bruised the lower abdomen by a 70 cm long wood popped out of a wood processing machine during work had severe abdominal pain. He was brought into the Emergency Department in our hospital because of suspected organ damage. On admission, his vital signs were stable, but physical exam revealed tenderness and rebound tenderness in his right lower abdomen. Abdominal computed tomography scan showed mild free fluid around the liver and a small amount of free air in the right lower abdomen. He was suspected of traumatic gastrointestinal perforation and emergency laparoscopic surgery was performed on the same day, which revealed that the appendix had been transected. Appendectomy was performed with a diagnosis of traumatic appendiceal transection. Other organs were intact.

Most gastroenteric injuries due to a blunt abdominal trauma affect the small bowel, and appendiceal transection is extremely rare. Conventionally, laparotomy has been performed for abdominal traumas, but in recent years, the usefulness of laparoscopic surgery has also been reported. Particularly, laparoscopic surgery in the early stage of injuries might be able to avoid delayed diagnosis and excessive laparotomy.