Acute gangrenous perforated appendicitis complicated by phlegmon of the anterior abdominal wall (clinical case)

The article considers a clinical case of acute gangrenous perforated appendicitis with the development of a purulent-necrotic process in the anterior abdominal wall, the cause of which was an atypical localization of the appendix – in the projection of the deep inguinal ring. In this case, the purulent-destructive process was localized only in the anterior abdominal wall. This case is unique, since it has not been previously encountered in the clinical practice of the authors, as well as in the literature we studied. The observation turned out to be difficult in terms of differential diagnosis: the patient was suspected of having a strangulated recurrent inguinal hernia with the formation of phlegmon of the hernial sac, acute inguinal lymphadenitis on the right, and, to a lesser extent, acute appendicitis in the stage of appendicular infiltrate. Surgical treatment was performed, after which the patient was discharged in a satisfactory condition on the 17th day.