Complicated appendicitis with scrotal fistula: case report and review of the literature

Appendicitis is the most common emergency abdominal surgery today. Although its common complications are well-known, retroperitoneal abscess and scrotal abscess are rare and less known complications. In this study, we presented our patient who presented with appendicitis complicated with retroperitoneal abscess and scrotal fistula after appendectomy, and the literature review we conducted through PubMed. A 69-year-old man was admitted to the emergency department with complaints of abdominal pain, nausea-vomiting continuing for about 7 days, and fever and mental status change in the last 24 h. He was taken to emergency surgery with the preliminary diagnosis of perforation and retroperitoneal abscess. At laparotomy, perforated appendicitis and associated retroperitoneal abscess were seen. An appendectomy was performed, and the abscess was drained. The patient, who stayed in the intensive care unit for 4 days due to sepsis, was discharged on the 15th postoperative day with full recovery. He was admitted 15 days after his discharge because of an abscess from the scrotum. Percutaneous drainage was performed in the patient, whose tomography revealed an abscess extending from the retroperitoneal area to the left scrotum. The patient, whose abscess regressed, was discharged with recovery 17 days after hospitalization. These rare complications associated with appendicitis should be on the minds of surgeons to make an early diagnosis. Delay in treatment may lead to increased morbidity and mortality.