What is Retrocaecal appendix?

What is Retrocaecal appendix?

Patients with a retrocaecal appendix may experience some mild right-sided or right flank tenderness. Long retro-colic inflamed appendix may cause confusions with cholecystitis (sub hepatic). Irritation of the posterior peritoneum may occur in retrocaecal or paracolic appendicitis and give psoas sign positive.

What causes a perforation at the tip of the appendix?

Appendicitis perforations, commonly occur at the tip of the appendix, are associated with the presence of a faecolith on CT scan and not the anatomical location of the appendix (retrocaecal appendix) as previously thought [ 1 ]. Perforation of caecum is an uncommon differential diagnosis for an acute appendicitis.

How is a perforation at the base of the caecum repaired?

Macroscopically, appendix was perforated and gangrenous. Perforation at the base of caecum was repaired with an absorbable suture and the omental patch was used to cover the caecum (Figure 4 ). A thorough washout with warm saline and bethidine solution was carried out to prevent gross peritoneal contamination. A corrugated drain was inserted.

Can a perforated caecum be acute appendicitis?

We report a case of a 46 year old male who was admitted under the surgical service in Mid-Western Regional Hospital, Limerick with suspected appendicitis which turned out to be a perforated caecum, a rare complication of an acute appendicitis.

What is the mortality rate for appendicular perforation?

Perforated appendicitis is associated with a higher mortality rate – as high as five percent and may be particularly more in extreme of age group attributed to delay in clinical presentation or diagnosis in the younger group and multiple co-morbidities in the elderly group.

What is a perforated appendicitis in retrocecal appendix?

Dilated, fluid-filled retrocecal appendix with several appendicoliths. Large area of mucosal discontinuity along the medial aspect, with extraluminal air and fluid. Peritoneal thickening and enhancement in the right paracolic gutter. Few reactive ileocolic lymph nodes.

What to do with an appendicular perforation at the base of caecum?

In the presence of an uncomplicated perforation, absence of severe infection, and well controlled localized haemostasis – a less invasive surgical approach with post operative intravenous antibiotics would be the management of choice.

How is the diagnosis of appendicular perforation made?

Diagnosis is made based on full clinical history and examination as well as supported by a routine blood investigation and urine test. Prompt diagnosis and surgical referral may reduce the risk of perforation and prevent complications. The mortality rate of non-perforated appendicitis is less than 1 percent.

Which is the most common surgery for appendicitis?

Appendectomy is the most frequent surgical procedure performed by general surgeons. This video demonstrates the laparoscopic treatment of a retrocaecal appendicitis performed by a resident in general surgery. The retrocaecal position of the appendix is found in 25% of cases.