A Case of Interval Appendectomy for Abscess-forming Appendicitis due to a Fishbone

Abstract

A case of abscess-forming appendicitis caused by a fish bone that was treated with interval appendectomy (IA) is presented. The patient, an 80-year-old man, was referred to our hospital with suspected acute appendicitis due to abdominal pain, which had lasted for 2 days, and difficulty swallowing. The right lower abdomen was tender, abdominal computed tomography (CT) showed linear radiopaque images within the abscess, and a diagnosis of abscess-forming appendicitis due to a fishbone was made. The patient was treated conservatively with antibiotics, and laparoscopic IA was performed approximately 6 months later. The appendix was not enlarged, and the tip was only mildly adherent to the retroperitoneum. The patient had an uncomplicated postoperative course and was discharged three days after surgery. Two needle-like substances inside the appendix, which were thought to be fish bones, and an ulcerated scar at the tip of the appendix were discovered. Since there are reports that acute appendicitis due to a fishbone is associated with a high risk of perforation, prompt appendectomy has been considered necessary in cases with no perforation or abscess at the time of diagnosis. However, IA could be a possible treatment strategy in cases where abscess formation is already present.