Acute Appendicitis Post Ureteroneocystostomy for Uretero-Vaginal Fistula Causing Diagnostic Dilemma: A Rare Case Report (original) (raw)
Background: Acute appendicitis is a differential diagnosis of acute abdomen. It poses diagnostic challenge more especially when it occurs postoperatively in women. Postoperative acute appendicitis had been reported following surgical and gynecological interventions. There is no report following urological intervention. The objective of this paper is to report a case of acute appendicitis post ureteroneocystostomy causing diagnostic dilemma. Case report: We report a 39-year-old woman who developed intermittent colicky right flank pain 3 days after ureteroneocystostomy for ureterovaginal fistula. She had hysterectomy due to abnormal uterine bleeding which was complicated by ureteric injury. There was generalized abdominal tenderness and guarding. She had abdominal reexploration, appendectomy and drainage of abscess due to the findings of acute appendicitis and pelvic abscess. The post-operative period was uneventful, and she was discharged home 10 days postoperatively. Conclusion: Acute appendicitis may occur postoperatively after urological intervention. A high index of suspicion is required for diagnosis. Incidental appendicectomy following abdominopelvic exploration in the presence of peritonitis and or suppuration may be helpful.
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