Xanthogranulomatous Appendicitis with a Fulminant Course: Report of a Case

• DOI: 10.7860/jcdr/2014/8660.5230
• Publication Date: 2015-01-04T23:22:51Z
• Authors: Gaurav Kochhar
• Keywords: Vermiform; Fulminant; Rare disease

Case RepoRtA 50-year-old male presented with the complaints of pain in right lower abdomen for seven days along history fever and anorexia.On examination, there was approximately 8 x 6 cm lump present iliac fossa.Total leucocyte count 24000/ mm 3 .Ultrasound showed inflamed appendix echogenic mesentery.Clinical diagnosis acute inflammatory appendicular made patient started on expectant management.Despite management his clinical condition did not improve.CECT done which suggested abscess formation [Table /Fig-1].As no window percutaneous aspiration, extra peritoneal drainage fourth day admission.Hundred ml pus drained.Appendicectomy attempted as small intestine, omentum cecum forming a mass.But developed intestinal obstruction resolved conservative management.Patient then taken up exploratory celiotomy eighth admission.Intra-operatively, larger ileo-cecal phlegmon dense interloop adhesions adhered to phlegmon.Small intestine dilated proximal mass.Right hemicolectomy ileostomy mucous fistula.Postoperatively went into septicaemia later multiorgan dysfunction.Despite aggressive he succumbed disease process.The histopathological report suggestive transmural inolvement infiltration by lymphocytes, histiocytes gaint cells.Foamy macrophages plasma cells were also present, xanthogranulomatous appendicitis [Table/Fig-2].