A ten-year-old male, with no relevant personal history, who came to the emergency department of the primary care center for a four-hour history of abdominal pain, fever of 40 °C, vomiting and diarrhea with remnants.
Abdominal examination revealed diffuse abdominal pain, slightly more in the right iliac fossa, with signs of peritoneal irritation.
Laboratory tests showed 12 200 leukocytes/μl (91% neutrophils) and mild elevation of C-reactive protein (CRP).
The patient was referred to the nearest hospital with suspected acute abdomen to complete the study.
Abdominal ultrasound showed a tubular, aperistaltic and incomprehensible image with transducer compatible with acute colitis.
It was decided to perform a surgical intervention, after receiving informed consent from the parents, and performing a cystectomy during which a cecal appendix with mild inflammatory signs is observed.
The postoperative course was torpid, with persistent fever (38.8 °C), generalized abdominal pain without peritonitis, vomiting and diarrhea.
An abdominal ultrasound was performed, which showed dilation of the loops of the small intestine, suggesting an incomplete obstructive picture.
Blood tests continued to show leukocytosis with left shift and elevated C-reactive protein.
Given the lack of awareness, the patients symptoms and operative findings, it was decided to opt for conservative treatment, coprocultive and empirical antibiotic therapy was initiated waiting for the results of the coprojunctivobacter Campi.
Antibiotic treatment with gentamicin was started, with which the evolution of the patient is satisfactory, since the clinical picture is resolved and the patient is discharged ten days after surgery.
The anatomopathological study of the cecal appendix was informed as a cecal appendix with inflammatory signs.
