Retrocecal Abscess Caused by Residual Appendix and Remains of
Appendicolithiasis after Laparoscopic Appendectomy ; Case Report of a Child

Takehito Oshio, Hiroki Ishibashi, Shuichi Takano
Department of Pediatric Surger y, National Kagawa Children's Hospital

Abstract
　A fifteen-year-old boy was referred to our institute because of sever abdominal pain in the right lower quadrant. He had undergone a laparoscopic appendectomy 8 days before his arrival. Findings of plain abdominal X-ray films before appendectomy and on admission to our institute, and of the CT-scan done after operation, revealed a fecalith from the appendix. He was diagnosed as having a retrocecal abscess caused by residual appendicolithiasis. An emergency laparotomy was performed. The appendicolithiasis together with the ligature for the appendicular stump were removed from the abscess. The abscess was drained for 22 days. Five months later, a residual appendix of 3.5Н length was diagnosed by a contrast enema. Ten months after the first operation, an interval appendectomy was performed to avoid a stump appendicitis. The postoperative course was uneventful.
　In conclusion, an appendiular fecalith showing on X-ray films should be carefully considered in the treatment of acute appendicitis. If it remains in the abdomen, an abscess will form and will be difficult to cure except by removal.

Keywords：Stump appendicitis, Laparoscopic appendectomy, Abscess, Fecalith, Appendicolithiasis