Intra-abdominal hemorrhage from an ileocolic vessel as a complication of acute appendicitis perforation

Abstract

This is an extremely rare complicated presentation of acute appendicitis perforation, which was accompanied by an intra-abdominal hemorrhage from an ileocolic vessel. A 61-year-old man visited an emergency department complaining of abdominal pain. Tenderness & rebound tenderness at the right lower quadrant and muscle guarding were noticed. Computed tomography showed perforated appendicitis with peritonitis. Also, an intra-abdominal hemorrhage of the ileocolic vessel was suggested. An emergent laparoscopic exploration was performed and found a gangrenous retrocecal appendix, peri-lesional adhesion, and substantial hematoma. Finally, a partial cecectomy was performed. A pathologic test confirmed the acute gangrenous appendicitis. Physicians should be aware that appendicitis could complicate an intra-abdominal hemorrhage even though it is extremely rare.ackground.