AN UNEXPECTED COMPLICATION OF APPENDICITIS

Appendicitis is quite a common pathology and is usually followed by a simple surgical procedure. This was not the case for a 24-year-old patient that initially presented with abdominal pain and diarrhea. The diagnosis of appendicitis was not apparent at first and after a few days of bed rest with malaise and fever, he starts having shortness of breath. The next examination deems his symptoms as a case of pneumonia. He is treated with antibiotics; he shows no signs of improvement and also develops hypoxia and tachycardia. He is referred to our cardiology clinic where the diagnosis of bilateral massive thromboembolism is established, along with the discovery of a large retroperitoneal abscess. Because the patient was septic, the surgery cannot be postponed. A ruptured retroceccal appendix is confirmed as the cause of the abscess. Later, the Doppler examination shows left popliteal vein thrombosis and also the laboratory results confirm that the patient has thrombophilia. This case illustrates an unfortunate association between an unknown thrombophilia, a long standing infection and massive thromboembolism. This combined pathology transformed a simple intervention for appendicitis into a high risk one.