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Case Reports in Surgery
Volume 2015, Article ID 707191, 3 pages
http://dx.doi.org/10.1155/2015/707191
Case Report

Retroperitoneal Perforation of the Appendix Presenting as a Right Thigh Abscess

Department of General Surgery, K. B. Bhabha Hospital, BandraWest, Mumbai 400050, India

Received 4 February 2015; Accepted 23 February 2015

Academic Editor: Steve de Castro

Copyright © 2015 Aditya J. Nanavati et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A rare case of a retroperitoneal rupture of the appendix is being reported here. A 53-year-old male presented to us with a right sided thigh abscess. There were not any abdominal complaints at presentation. There was continuous discharge after incision and drainage from the thigh. Isolation, in culture, of an enteric bacterium from the pus prompted an evaluation of the gastrointestinal tract as a possible source. An MRI scan revealed fluid tracking from the right paracolic gutter over the psoas sheath and paraspinal muscle into the thigh. A CT scan revealed the perforation at the base of the appendix into the retroperitoneum. At laparotomy the above findings were confirmed. A segmental ileocaecal resection was done. The patient made an uneventful recovery. The absence of abdominal symptoms at presentation leads to delay in diagnosis in such cases. Nonresolving thigh and groin abscesses should lead to the evaluation of the gastrointestinal tract as origin. Diagnostic clues may also be provided by culture reports what as happened in this case.