# Unusual Acute Appendicitis Complicated by Sepsis, Evisceration, and Ileostomy: A Case Report

## TL;DR

A 59-year-old patient with delayed appendicitis diagnosis developed severe complications requiring multiple surgeries and eventual recovery.

## Contribution

This case report highlights unusual complications from delayed appendicitis treatment in an elderly patient.

## Key findings

- Delayed diagnosis of acute appendicitis led to sepsis and wound dehiscence.
- A single-barrel ileostomy was created after partial small intestine resection.
- The patient recovered fully and underwent successful reconstructive surgery six months later.

## Abstract

Acute appendicitis stands as a prevalent cause necessitating surgical intervention globally, predominantly affecting young adults and children, with notably lower incidence among the elderly. Timely diagnosis facilitates effective management, mitigating the risk of severe complications. In this report, we present the case of a 59-year-old patient whose delayed diagnosis and consequently delayed surgical treatment led to serious complications. After the appendectomy, the patient, due to developing sepsis, was transferred to the intensive care unit. On the seventh postoperative day, complications were found in the form of wound dehiscence along with perforation of the jejunum. The second surgery involved a classic laparotomy, encompassing partial resection of the small intestine, and the creation of a single-barrel ileostomy. Further conservative treatment was implemented, and drainage of the abscess was performed. After treatment in the ICU, the patient was transferred to the surgical ward for further treatment. During the hospital stay, further conservative treatment was implemented, resulting in the improvement of the patient's general condition and resolution of symptoms. The patient was discharged home in optimal general condition with recommendations. After six months, the patient was brought to the surgical ward for reconstructive surgery to reestablish gastrointestinal continuity, which was carried out successfully.