Intra-abdominal Abscess Due to a Faecalith After Laparoscopic Appendicectomy

A 40-year-old patient, who had undergone laparoscopy for acute appendicitis 72 h before, came to our emergency department because of umbilical pain and fever.

Due to the lack of improvement, an abdominal CT with contrast was performed, which detected a hypodense collection in the mesogastrium, with hyper-intense edges and air bubbles in its interior, measuring approximately 83 mm × 35 mm × 42 mm (CC, T, AP), compatible with intra-abdominal abscess. In the interior, a round hyperdense image measuring 9.5 mm was observed, that was compatible with an appendicolith. The collection was in contact with a distal ileal loop (Fig. 1)

Fig. 1

The patient underwent emergency surgery with supra-umbilical mid-line mini-laparotomy, abdominal cavity lavage and extraction of the fecalith.

Evolution was satisfactory and the patient was discharged ten days after the intervention.