PMC9448879_01
The appendix is not clearly visualized, and a mass can be seen in the left abdomen.
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F1
Imaging examination by abdominal CT showed that the appendix was not clearly visible, and a mass was found in the left lower abdomen (Figure 1).
(A) Laparoscopic exploration reveals an omentum-enclosed mass with pus moss on the surface at the left iliac fossa of the patient. (B) Right hemicolon and cecum, the right iliac fossa is occupied by the ileum and it pushes the cecum and ascending colon to the left iliac fossa.
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F2
It revealed an omentum-enclosed mass with pus moss on the surface at the left iliac fossa of the patient (Figure 2A). Laparoscopic exploration revealed the right iliac fossa occupied by ileum that pushed the cecum and ascending colon to the left iliac fossa, which is an intestinal malrotation with a left-sided appendicitis (Figure 2B), and intestinal malrotation left-sided appendicitis was diagnosed intraoperatively.
Intraoperative appendix.
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F3
The pus on the surface of the mass was aspirated and the omentum was detached by blunt dissection with the aspirator to expose the appendix, which was seen to be swollen, approximately 6 cm in length, approximately 1 cm in diameter, and with pus moss attached to the surface (Figure 3).
Postoperative pathology reveals acute gangrenous appendicitis with periappendicitis (HE x 100).
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F4
Postoperative pathology revealed acute gangrenous appendicitis with periappendicitis (Figure 4), and on telephone follow-up on the seventh postoperative day, the patient reported good recovery without any complications.