A Case of Appendicitis With Abscess Formation That Penetrated the Ileum

Abstract

We report a rare case of appendicitis with abscess formation that penetrated the ileum with a review of the literature. The patient was a 9-year-old boy. He was admitted to our hospital on day 8 of onset with recurrent episodes of abdominal pain and fever. We diagnosed him as having appendicitis with abscess formation and planned to performed interval appendectomy. Despite antibiotic therapy, his condition worsened. Therefore, an emergency operation was performed on the third day of hospitalization. An abscess was found to be continuous with the appendix on the right side of the sigmoid colon, and this abscess had penetrated the ileum, so appendectomy and ileal partial resection were carried out. His postoperative course was uneventful. An appendicitis can form a fistula; for example, appendix colon fistula and appendix bladder fistula have been reported. On the other hand, abscesses may penetrate other organs, which is uncommon. For appendicitis with abscess formation, which may take a long time to diagnose and therefore delay the start treatment, we should remember the possibility of abscesses penetrating other organs.