Hepatic abscess: An uncommon complication after laparoscopic appendectomy

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Marco Assenza
Flavia Ciccarone
Sara Santillo
Gennaro Mazzarella
Edoardo De Meis
Greta Bracchetti
Clara Ballanti Storace
Mario Corona

Abstract

AIM: Laparoscopic appendectomy is currently the treatment of choice for acute appendicitis in emergency setting. When appendicitis is clinically suspected, an appendicolith can be found in 30% of the patients. Retained or dropped appendicoliths are an uncommon complication that may occur as a consequence of stone expulsion from the appendix, before or during laparoscopic appendectomies. This is very rare with only 30 reported cases of intra-abdominal abscess secondary to an appendicolith in the literature over the past 40 years. The objective of this case report is to illustrate an intrahepatic localization of a dropped appendicolith causing liver abscess.


CASE PRESENTATION: A 23-year-old female was admitted to the emergency department of our hospital for an acute appendicitis with coprolite obstructing the lumen and periappendicular effusion. Laparoscopic appendectomy was performed.Persistent liver abscess due to appendicolith was a rare complication treated by percutaneous drainage. The appendicolith was successfully removed from the liver parenchyma by Dormia basket recovery system.


DISCUSSION: Treatment options include percutaneous, open, or laparoscopic drainage of the abscess and retrieval of the fecalith, as antibiotics and drainage alone are usually insufficient.


CONCLUSION: Only a handful of cases of hepatic abscess formation as a result of dropped appendicoliths have been reported in literature. Our proposal of treatment was the percutaneous approach. There was no need for a surgical procedure to remove the intrahepatic appendicolith.


 

 


 

Article Details

How to Cite
Assenza, Marco, et al. “Hepatic Abscess: An Uncommon Complication After Laparoscopic Appendectomy”. Annali Italiani Di Chirurgia, vol. 10, no. April, Apr. 2021, pp. 1-5, https://annaliitalianidichirurgia.it/index.php/aic/article/view/1981.
Section
Case Report
Author Biographies

Marco Assenza, Surgical First Aid Unit, Department of Emergency Surgery, Sapienza University of Rome, Rome, Italy

 

 

 

Flavia Ciccarone, Surgical First Aid Unit, Department of Emergency Surgery, Sapienza University of Rome, Rome, Italy

 

 

 

Sara Santillo, Surgical First Aid Unit, Department of Emergency Surgery, Sapienza University of Rome, Rome, Italy

 

 

 

Gennaro Mazzarella, Surgical First Aid Unit, Department of Emergency Surgery, Sapienza University of Rome, Rome, Italy

 

 

 

Edoardo De Meis, Surgical First Aid Unit, Department of Emergency Surgery, Sapienza University of Rome, Rome, Italy

 

 

     

Greta Bracchetti, Surgical First Aid Unit, Department of Emergency Surgery, Sapienza University of Rome, Rome, Italy

 

 

 

Clara Ballanti Storace, Surgical First Aid Unit, Department of Emergency Surgery, Sapienza University of Rome, Rome, Italy

 

 

 

Mario Corona, Vascular and Interventional Unit, Department of Radiological Sciences, Policlinico Umberto I, “Sapienza” University of Rome, Rome, Italy