Explosion of cecum with melena in a neglected acute appendicitis: A case report

Acute appendicitis is the most common presentation of the acute abdomen in the UK. Although in most cases this is an easily reached diagnosis, presentation is not always typical and there are certain other conditions which may mimic appendicitis. Diagnostic adjuncts usually provide the additional information required to make a confident diagnosis; however, in some circumstances, the safest and most reliable course of action is appropriate surgical intervention. Acute appendicitis is the most common presenting condition of the acute abdomen. In the vast majority of cases, the diagnosis is reached on accurate history taking and thorough clinical examination alone without the need of diagnostic adjuncts. Furthermore, if the diagnosis is proving to be troublesome, repeated clinical examination and monitoring of the patient's condition during a period of observation will usually direct the clinician to the correct diagnosis. However, this is not always the case and particular age groups and the sex of the patient may lead to atypical presentations. Blood tests and radiological imaging may provide further clues, but it is only through surgical intervention that confirmation of the diagnosis can be made confidently. Appendicitis is a common disease, and as we have improved in early diagnosis and management of this disease process, late stage complications have become extremely rare, but can have indolent presentations. Our case was a 22 years male with 7 days abdominal pain and referred to surgery part with peritonitis that we do surgery for him and in laparotomy we find Explosion of cecum with melena in a neglected acute appendicitis and septic shock that we do DCS surgery and discharge him healthy after right hemicolectomty. Acute appendicitis is a common cause of acute abdominal pain requiring urgent surgery. Despite characteristic clinical signs, diagnosis can be challenging, leading to unnecessary appendectomies. However, the source of appendix bleeding is very rare. It is important to distinguish appendiceal bleeding from lower gastrointestinal bleeding and to treat it as soon as possible with less invasiveness.