Faecolith migrating from the appendix to produce liver abscess after subhepatic laparoscopic appendectomy

Trop Doct. 2015 Oct;45(4):241-4. doi: 10.1177/0049475515577749. Epub 2015 Mar 29.

Abstract

The subhepatic position of an appendix may lead to difficulty in diagnosis of appendicitis, its surgical management as well as bizarre complications. A 'lost' appendicular faecolith is not an uncommon complication due to spillage during the removal of the appendix or due to perforation. Here we report a case of such a faecolith migrating into the liver parenchyma following intraoperative hepatic injury, and producing a liver abscess. The calcified lesion seen in the liver corresponded to a free-lying faecolith on a preoperative computed tomography scan. Liver abscess was presumed to arise from implantation of this foreign object into the liver parenchyma. Pigtail drainage of abscess was performed with good result.

Keywords: Appendicular faecolith; hepatic injury; laparoscopic appendectomy; liver abscess; subhepatic appendicitis.

Publication types

  • Case Reports

MeSH terms

  • Appendectomy / adverse effects*
  • Appendicitis / surgery*
  • Appendix / abnormalities
  • Drainage
  • Feces
  • Humans
  • Iatrogenic Disease
  • Laparoscopy
  • Liver Abscess / etiology*
  • Male
  • Middle Aged
  • Tomography, X-Ray Computed