A Case of Amebic Appendicitis Requiring Re-operation due to Staple Line Rupture following Laparoscopic Appendectomy

Abstract

A 28-year-old man presented to our hospital with diarrhea and abdominal pain. He was diagnosed with acute appendicitis and underwent emergency surgery the same day. Postoperatively, abdominal distension did not improve. On postoperative day 8, small bowel obstruction was diagnosed, and an ileus tube was inserted. Though the small bowel obstruction improved, inflammatory markers worsened, and on postoperative day 15, abdominal contrast-enhanced computed tomography (CT) showed an abscess in the ileocecal region. Conservative treatment was ineffective, and a second surgery was performed on day 24. A perforation at the cecal stump was identified, and lavage drainage and ileocecal resection were performed. The patient was discharged on postoperative day 34, but two days later, he was re-admitted with diarrhea and abdominal pain. Abdominal CT showed extensive edema of the colon, and colonoscopy suggested amebic colitis. Pathology confirmed the presence of amebae, and metronidazole treatment resulted in rapid improvement. Amebae were also detected in the surgical specimen, leading to a diagnosis of amebic appendicitis.