Gangrenous appendicitis caused huge retroperitoneal abscess and scrotal abscess: a case report and literature review

Gangrenous appendicitis caused huge retroperitoneal abscess and scrotal abscess are rarely reported. We presented a case who developed both huge retroperitoneal abscess and scrotal abscess after the surgical treatment of gangrenous appendicitis. A 15-year-old male was admitted to our hospital for right low abdominal pain and fever for 2 days. Physical examination showed mild inflamed right scrotum tenderness, red and swollen. Acute gangrenous appendicitis was diagnosed by emergency laparotomy and pathological examination and the appendix was removed by surgery. The patients still presented fever and scrotal swelling after the surgery. CT scan showed irregular honeycomb pneumatosis accompanied by an abscess of the right scrotum epididymis area and the posterior peritoneum. A second laparotomy was performed for aspiration of the fester. Antibiotic treatment and nutritional support were used and the patient recovered and discharged on the 18th day after the surgery. Preoperative CT scan might contribute to the diagnosis of gangrenous appendicitis caused huge retroperitoneal abscess and scrotal abscess.