Acquired appendiceal-cecal fistula as a complication of untreated acute appendicitis in a noncompliant patient: a case report

Abstract Background Appendiceal fistula is a primary appendix perforation into the surrounding hollow viscera or skin and can rarely occur as a complication of appendicitis. To date, only nine cases of appendiceal fistula to the cecum have been reported. Case presentation We present the case of a 30...

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Main Authors: Mohammad AshrafAzimi, Abbas Abdollahi, Amir Rahmanian Sharifabad, Seyed Hassan Seyed Sharifi, Ali Mehri, Seyed Ramin Dabiri
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Journal of Medical Case Reports
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Online Access:https://doi.org/10.1186/s13256-025-05382-0
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author Mohammad AshrafAzimi
Abbas Abdollahi
Amir Rahmanian Sharifabad
Seyed Hassan Seyed Sharifi
Ali Mehri
Seyed Ramin Dabiri
author_facet Mohammad AshrafAzimi
Abbas Abdollahi
Amir Rahmanian Sharifabad
Seyed Hassan Seyed Sharifi
Ali Mehri
Seyed Ramin Dabiri
author_sort Mohammad AshrafAzimi
collection DOAJ
description Abstract Background Appendiceal fistula is a primary appendix perforation into the surrounding hollow viscera or skin and can rarely occur as a complication of appendicitis. To date, only nine cases of appendiceal fistula to the cecum have been reported. Case presentation We present the case of a 30-year-old Persian male who presented with a low-grade fever and lower abdominal pain for 3 days. He had a history of untreated acute appendicitis 3 years prior. During the appendectomy, a fistula between the appendix and cecum, along with a thick cecal wall, was found. The patient underwent a right hemicolectomy and was discharged with a diagnosis of appendiceal-cecal fistula in the context of appendicitis. Conclusion An appendiceal-cecal fistula usually does not cause any specific symptoms and is an accidental finding. Surgeons should thoroughly explore the ileocecal region for the fistula, particularly in patients with a history of untreated appendicitis. Although the appendiceal-cecal fistula is a rare finding, it can change the surgical plan. Therefore, it is important to discuss this complication with the patient and obtain informed consent preoperatively to avoid potential medicolegal issues. On the basis of our experience, right hemicolectomy is associated with a good surgical outcome in managing the fistula, especially when malignancy is suspected.
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spelling doaj-art-8753bb7bb1554892a79b150bd8f30c942025-08-20T03:05:18ZengBMCJournal of Medical Case Reports1752-19472025-07-011911510.1186/s13256-025-05382-0Acquired appendiceal-cecal fistula as a complication of untreated acute appendicitis in a noncompliant patient: a case reportMohammad AshrafAzimi0Abbas Abdollahi1Amir Rahmanian Sharifabad2Seyed Hassan Seyed Sharifi3Ali Mehri4Seyed Ramin Dabiri5Department of General Surgery, Faculty of Medicine, North Khorasan University of Medical SciencesEndoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical SciencesDepartment of Emergency Medicine, Faculty of Medicine, North Khorasan University of Medical SciencesDepartment of General Surgery, Faculty of Medicine, North Khorasan University of Medical SciencesEndoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical SciencesDepartment of General Surgery, Mashhad University of Medical SciencesAbstract Background Appendiceal fistula is a primary appendix perforation into the surrounding hollow viscera or skin and can rarely occur as a complication of appendicitis. To date, only nine cases of appendiceal fistula to the cecum have been reported. Case presentation We present the case of a 30-year-old Persian male who presented with a low-grade fever and lower abdominal pain for 3 days. He had a history of untreated acute appendicitis 3 years prior. During the appendectomy, a fistula between the appendix and cecum, along with a thick cecal wall, was found. The patient underwent a right hemicolectomy and was discharged with a diagnosis of appendiceal-cecal fistula in the context of appendicitis. Conclusion An appendiceal-cecal fistula usually does not cause any specific symptoms and is an accidental finding. Surgeons should thoroughly explore the ileocecal region for the fistula, particularly in patients with a history of untreated appendicitis. Although the appendiceal-cecal fistula is a rare finding, it can change the surgical plan. Therefore, it is important to discuss this complication with the patient and obtain informed consent preoperatively to avoid potential medicolegal issues. On the basis of our experience, right hemicolectomy is associated with a good surgical outcome in managing the fistula, especially when malignancy is suspected.https://doi.org/10.1186/s13256-025-05382-0AppendicitisComplicationFistulaCecumHemicolectomy
spellingShingle Mohammad AshrafAzimi
Abbas Abdollahi
Amir Rahmanian Sharifabad
Seyed Hassan Seyed Sharifi
Ali Mehri
Seyed Ramin Dabiri
Acquired appendiceal-cecal fistula as a complication of untreated acute appendicitis in a noncompliant patient: a case report
Journal of Medical Case Reports
Appendicitis
Complication
Fistula
Cecum
Hemicolectomy
title Acquired appendiceal-cecal fistula as a complication of untreated acute appendicitis in a noncompliant patient: a case report
title_full Acquired appendiceal-cecal fistula as a complication of untreated acute appendicitis in a noncompliant patient: a case report
title_fullStr Acquired appendiceal-cecal fistula as a complication of untreated acute appendicitis in a noncompliant patient: a case report
title_full_unstemmed Acquired appendiceal-cecal fistula as a complication of untreated acute appendicitis in a noncompliant patient: a case report
title_short Acquired appendiceal-cecal fistula as a complication of untreated acute appendicitis in a noncompliant patient: a case report
title_sort acquired appendiceal cecal fistula as a complication of untreated acute appendicitis in a noncompliant patient a case report
topic Appendicitis
Complication
Fistula
Cecum
Hemicolectomy
url https://doi.org/10.1186/s13256-025-05382-0
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