Complicated retrocaecal appendicitis resulting in mortality in a schizophrenic patient

Complicated retrocaecal appendicitis resulting in mortality in a schizophrenic patient

Acute appendicitis is the most common urgent surgical condition observed in patients over 65 years of age after biliary tract diseases and gastrointestinal obstructions. Ileo-caecal position of the appendix determines the possible clinical condition. The findings forperitonitis in retrocaecal appendicitis are indefinite, and diagnosis would be more difficult if advanced age and psychiatric disorders are also present in addition to these indefinite findings. A 67-year-old female patient with schizophrenia who had percutaneous drainage due to retroperitonal abscess was referred to our clinic. Diffuse retroperitoneal abscess and perforrated retrocaecalappendicitis were detected during laparotomy. The patient lost her life due to multiple organ failure after three weeks. As in the present case, an interrogator approach and an early diagnosis and treatment in old patients with psychiatric disorders would reduce the mortality.

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  • 1.Konan A, Hayran M, Kilic YA, Karakoç D, Kaynaroglu V. Scoring systems in the diagnosis of acute appendicitis in the elderly. Ulus Travma Acil Cerrahi Derg 2011;17(5):396-400.
  • 2. Ong EM, Venkatesh SK. Ascending retrocecal appendicitis presenting with right upper abdominal pain: utility of computed tomography. World J Gastroenterol 2009;15(28):3576-9.
  • 3. Rao PM, Rhea JT, Novelline RA, Mostafavi AA, Lawrason JN, McCabe CJ. Helical CT combined with contrast material adminis- tered only through the colon for imaging of suspected appendi- citis. AJR Am J Roentgenol 1997;169(5):1275-80.
  • 4. Huang SH, Lo WO, Lin CM, Hsieh TS, Wang SF, Tsai SW. Retroperitoneal abscess: 7-year experience of 29 cases in a tertiary care center in Taiwan. Urol Sci, 2015;26(3):218-21.
  • 5. Capitán Manjón C, Tejido Sánchez A, Piedra Lara JD, Martínez Silva V, Cruceyra Betriu G, Rosino Sánchez A, et al. Retroperitoneal abscesses. Scand J Urol Nephrol, 2003;37(2):139-44.
  • 6. Storm-Dickerson TL, Horattas MC. What have we learned over the past 20 years about appendicitis in the elderly? Am J Surg 2003;185(3):198-201.
  • 7. Tsay JH, Lee CH, Hsu YJ, Wang PJ, Bai YM, Chou YJ, et al. Disparities in appendicitis rupture rate among mentally ill patients. BMC Public Health 2007;7(1):331.
  • 8. Cobben LP, Bakker OJ, Puylaert JB, Kingma LM, Blickman JG. Imaging of patients with clinically suspected appendicitis in the Netherlands: conclusions of a survey Br J Radiol 2009;82(978):482-5.
İnönü Üniversitesi Turgut Özal Tıp Merkezi Dergisi-Cover
  • ISSN: 1300-1744
  • Yayın Aralığı: Yılda 4 Sayı
  • Yayıncı: İnönü Üniversitesi Tıp Fakültesi