AN OPERATED CASE OF PRIMARY CUTANEOUS FISTULA OF THE APPENDIX

Abstract

A very rare case of spontaneous cutaneous fistula due to appendicitis in a 48-year-old man is described, with a review of the literature. There was no particular family history nor previous medical history. In September 1977 the patient underwent medical treatment for a right lower quadrant pain. In September 1978 he developed a right flank abscess which could be cured by incision drainage. The patient had been asymptomatic until January 26 1991 when the abscess recurred. Incision drainage was carried out at the outpatient clinic. Recurrence of the abscess was repeated 3 times in December 1991, April and May 1992 which led to a fistula formation. He was admitted to the hospital. Fistulography revealed an abscess cavity in the retroperitoneum. Barium enema showed a diverticulum and polyp in the ascending colon, but did not visualize the appendix vermiformis. On June 26, 1992 right hemicolectomy and fistulectomy were performed. Resected specimen revealed the appendix going around the retroperitoneum to form the abscess cavity with a communication to the cuteneous fistula. Postoperative course was uneventful.