Acute appendicitis perforating into the bladder mimicking cystitis

Authors: Papadopoulos, Vasileios N.; Michalopoulos, Antonios; Tzeveleki, Ioanna; Basdanis, George

Source: Surgical Practice, Volume 11, Number 2, May 2007 , pp. 90-95(6)

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Abstract:

Perforation of the appendix can lead to periappendiceal abscess or diffuse peritonitis. The major reason for appendiceal perforation is delay in diagnosis and treatment. We report this rare case of perforated appendix into the bladder, which caused acute abdomen. We also present a review of the literature. The patient underwent an emergency operation in which the appendicitis was found to have perforated into the bladder and produced symptoms that mimicked cystitis. The terminal ileum and the cecum were seriously inflamed. The patient underwent a limited right hemicolectomy, closure of the bladder with a serosal patch, closure of the transverse colon and an end-ileostomy. Differential diagnosis of acute appendicitis especially in women is very difficult because the surgeon must always consider and look for many other conditions that can mimic appendicitis. From a management viewpoint, the various diagnoses can be divided into those that require surgery and those that do not. The present case was an uncommon case of acute appendicitis where, unfortunately, its primary symptoms and laboratory data had led to the wrong diagnosis of cystitis, which did not require surgery.

Keywords: appendicitis; complications; cystitis; mortality

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1744-1633.2007.00347.x

Publication date: 2007-05-01