An extremely rare complication after appendectomy in a child: indicators for omental abscess, CRP and Leukocytosis

Abstract

A 14 year-old male child underwent appendectomy, and partial omentectomy with the indication of perforated appendicitis. Despite antibiotic therapy at postoperative sixth day, purulent discharge started to ooze from the incision site. Upon detection of a palpable mass in the lower right abdominal quadrant, ultrasonographic examination was performed on the postoperative 14th day which revealed a non-homogeneous hypoechoic mass measuring 50-45 mm with irregular contours. The case was re-operated and a greater omental abscess was found which resected en-bloc. Any evidence of foreign object or residual appendiceal tissue was not found. Postoperative course was uneventful, and the patient was discharged on the 36th postoperative day.

Herein, we reported an extremely rare case of omental abscess developed following appendectomy

Keywords

• Appendicitis; Appendectomy; Complications; Omental abscess; Child

An extremely rare complication after appendectomy in a child: indicators for omental abscess, CRP and Leukocytosis

Öz

References

1. Shiryajev NY, Glebova VA, Bernstein MA, Kokhaneo NY. A Very Rare Complication After Appendectomy in a Young Adult Patient: Abscess of the Greater Omentum J Med Cases. 2014;5(1):36-9
2. Hung CC, Chou CM, Chen HC. An omental abscess mimicking an intra-abdominal tumor. J Chin Med Assoc. 2012;75(3):136-8.
3. Chukhrienko DP, Bereznitskii IS. Intraabdominal Abscesses and Phlegmons. Kyiv, USSR: Zdorov’ya, 1977:1-136 (in Russian).
4. Odinak VM, Gridina GI. Omentitis in children. Khirurgiia (Mosk). 1987;(8):54-8.
5. Cortesi N, Manenti A, Rossi A, Zanni C, Barberini G, Gibertini G. L’appendicite aigue et ses complications post-operatoires. A propos d’une serie de 8738 cas. J Chir (Paris). 1985;122(10):577-9
6. Bairov GA, Golovanov Ia S. Infiltrative subacute omentitis in children with acute appendicitis. Vestn Khir Im I I Grek. 1988;140(1):116-20.
7. Paliuga NI. Abscess of the greater omentum after appendectomy. Vestn Khir Im I I Grek. 1983;130(4):69- 70.
8. Derzhavin VM, Ivanova MN, Gordeeva IP, Konovalov AK. Secondary acute omentites in children. Vopr Okhr Materin Det. 1986;31(8):29-32 (in Russian).

9. Joshi S, Cuthbert GA, Kerwat R Omental torsion, a rare cause of acute abdomen. BMJ Case Rep. 2016: 5;2016
10. De Brabandere K, Vanpaemel G, Verheyen L. Spontaneous abscesses of the abdominal wall, omentum and abdominal cavity caused by group G streptococci: a case report. Acta Chir Belg. 2008 Nov 1;108(6):765-7.
11. Buckley O, Geoghegan T, Ridgeway P, Colhoun E, Snow A, Torreggiani WC. The usefulness of CT guided drainage of abscesses caused by retained appendicoliths. Eur J Radiol. 2006;60(1):80-3.
12. Lawson GA, 3rd, Castaldo ET, Miller RS. Primary omental abscess caused by Streptococcus constellatus: a case report. Surg Infect (Larchmt). 2010;11(3):339-41.