Duodenal perforation by secondary retroperitoneal abscess to a perforated acute appendicitis

Abstract

Introduction: The incidence of perforated or gangrenous appendicitis remains high (28-29%). A delay in diagnosis and surgery leads to increased costs, mortality, and morbidity.

Objective: Describe a clinical case related to inflammation of the appendix

Material and methods: Retrospective descriptive study, clinical case presentation.

Results: A 63-year-old male patient with abdominal pain located in the epigastrium and in the right lower
quadrant of 5 days of evolution, accompanied by diarrheal stools, nausea and vomiting, was diagnosed with a
duodenal perforation due to a retroperitoneal abscess secondary to acute perforated appendicitis. , the same
recognized as a life-threatening condition. Through congenital anatomic communication, the retroperitoneal
abscess has the potential to spread rapidly in the perinephric space, the psoas muscle, the lateral abdominal
wall, and the lower extremities.

Conclusions: The formation of large retroperitoneal abscesses with perforation of the duodenum is a serious
complication of acute perforated appendicitis that should be considered in all patients with an atypical clinical
picture of acute appendicitis.