Traumatic Rupture of the Appendix: A Rare Entity Linked to Blunt Abdominal Trauma
Milos Mirovic *
Department of General Surgery, Clinical Hospital Center Kotor, 85330 Kotor, Montenegro.
Vesna Potkonjak
Department of General Surgery, Clinical Hospital Center Kotor, 85330 Kotor, Montenegro.
Vesna Nisavic
Department of Anestesiology and reanimatology, Clinical Hospital Center Kotor, 85330 Kotor, Montenegro.
Lidija Krtolica Zecevic
Department of Radiology, Clinical Hospital Center Kotor, 85330 Kotor, Montenegro.
*Author to whom correspondence should be addressed.
Abstract
Aim: This study reports a rare case of post-traumatic section of the vermiform appendix by blunt trauma in a 20-year-old male patient following a traffic accident.
Presentation of Case: A 20-year-old male patient was admitted by an ambulance car to the emergency department with complaints of abdominal pain along the seat belt area, after car accident. Upon admission, the patient was hemodynamic stable with pain in lower parts of the abdomen during palpation. On evaluation, contrast-enhanced computed tomography of the abdomen demonstrated: haematoma in the abdominal wall in the right illiac region; a small amount of fluid around the liver and in hepatorenal recess; wall thickening of the small bowell loop posterior to urin bladder and fluid in rectovesical recess. The patient underwent emergency laparoscopic exploration. During exploration, there were found: blood in all peritoneal recesses; transection of the appendix in the middle third and lession of the mesoappendix; a few large lacerration of the omentum with active bleeding; contusion the wall of the terminal ileal loop and the sigmoid colon without signs of deserosation. The surgical team decided to perform laparoscopic appendectomy with lavage and drainage abdominal cavity with one drain. The postoperative course was stable, and the patient was discharged after 5 days of hospitalization.
Conclusions: In this case report we described traumatic transection of the appendix due to blunt abdominal trauma. Early diagnosis and management are essential to prevent associated morbidity and mortality. Laparoscopy for stable patients is feasible and safe.
Keywords: Appendiceal transection, blunt abdominal trauma, laparoscopy