Asian Journal of Case Reports in Surgery

Acute Appendicitis as a Complication of Severeacute Pancreatitis: Case Report

Bouali Mounir

Department of Visceral Surgical Emergencies, Faculty of Medicine and Pharmacy, University Hospital Center Ibn Rochd, Hassan II University, Casablanca, Morocco.

Azhari Fadwa *

Department of Visceral Surgical Emergencies, Faculty of Medicine and Pharmacy, University Hospital Center Ibn Rochd, Hassan II University, Casablanca, Morocco.

Elbakouri Abdelilah

Department of Visceral Surgical Emergencies, Faculty of Medicine and Pharmacy, University Hospital Center Ibn Rochd, Hassan II University, Casablanca, Morocco.

Elhattabi Khalid

Department of Visceral Surgical Emergencies, Faculty of Medicine and Pharmacy, University Hospital Center Ibn Rochd, Hassan II University, Casablanca, Morocco.

Bensardi Fatimazahra

Department of Visceral Surgical Emergencies, Faculty of Medicine and Pharmacy, University Hospital Center Ibn Rochd, Hassan II University, Casablanca, Morocco.

Fadil Abdelaziz

Department of Visceral Surgical Emergencies, Faculty of Medicine and Pharmacy, University Hospital Center Ibn Rochd, Hassan II University, Casablanca, Morocco.

*Author to whom correspondence should be addressed.

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Abstract

Introduction and Importance: Pancreatitis is a common condition in the general population. Appendicitis is the most common disease and is the first procedure performed in general and digestive surgery. Complication of acute pancreatitis by acute appendicitis is rare. We present a case of acute appendicitis complicating acute pancreatitis.

Case Presentation: A 66-year-old man admitted to the visceral surgical emergency department for epigastralgia and right iliac fossa pain dating back 24 hours. On physical examination, the patient was HD and respiratory stable, apyretic at 36.5°. Epigastric and FID sensitivity, the rest of the examination was unremarkable. CT scan showed a Balthazar stage E acute pancreatitis with acuteappendicitis. After hospitalisation and initiation of antibiotic therapy, the patientunderwent appendectomy with sampling of the peritoneal effusion.

Clinical Discussion: Complications of the large bowel related to pancreatitis do not exceed 7%, including infarction, infection, and transverse colon and splenic flexure fistula and isolated appendix involvement as no complications of pancreatitis have been reported in the literature.

Conclusion: The dangers of misdiagnosis and persistent symptomatology with conservative treatment in patients with appendicitis and pancreatitis are greaterthan those inherent in a correctly performed diagnostic laparotomy.

Keywords: Appendicitis, pancreatitis, pain, surgery

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