Appendicitis With Abdominal Tumor in a Neonate

Abstract

Although appendicitis is a common disease in children, it is extremely rare in neonates. We experienced a neonatal case of appendicitis with an abdominal tumor. A 22-dayold boy was admitted to our hospital with fever, vomiting and abdominal distention. He was given a diagnosis for infectious enteritis and treated with some antibiotics. His condition, however, was not improved. CT scan revealed abdominal dilatation and an ileocecal tumor was located. We suspected ileus due to intestinal duplication, and performed a laparotomy at the age of 36 days. Laparotomy revealed a retroperitoneal abscess in the ileocecal region, and the appendix had been molten and vanished. We performed a sutural repair of the appendix root, followed by intraperitoneal irrigation and abdominal drainage. The postoperative course was non-eventful. Appendicitis has the potential to occur in neonates, and 41 cases including ours have been reported from 1925 to 2013 in Japan. Because the typical symptoms of appendicitis do not usually appear, preoperative diagnosis is very difficult. Therefore, recognition of neonatal appendicitis is required, and depending on the situation, surgical management should be done before the condition becomes too severe. We need to realize that appendicitis may also occur in neonates. Depending on the situation, surgical management should be done before they become life-threatening.