Acute appendicitis in a child with “artificial” mobile cecum due to neonatal high jejunal atresia surgery

Abstract

Introduction: Acute appendicitis cases with “congenital” mobile cecum due to intestinal malrotation have already been reported. However, cases of acute appendicitis involving “artificial” mobile cecum in which the intestinal tract was made non-rotational by surgery in the neonatal period have not been described, and the degree of adhesion in the ileocecal and ascending colon region has remained unclear.Presentation of the case: An 11-year-old girl with artificial non-rotation of the intestinal tract made at surgery for multiple high jejunal atresia in the neonatal period was diagnosed with acute appendicitis based on contrast-enhanced computed tomography (CT) of the abdomen. Transumbilical laparoscopic-assisted appendectomy (TULAA) revealed the ileocecal region was located in the lower middle abdomen and showed good mobility without adhesions, but the right abdominal wall where the colon was released showed adhesions. Discussion: Acute appendicitis could be diagnosed from CT and appendectomy successfully performed in a patient with “congenital” mobile cecum. As with congenital cases, this “artificial” mobile cecum case could be diagnosed from CT and TULAA performed properly without adhesions on the right colon even after rare neonatal surgery. Conclusion: As diagnostic imaging techniques have improved, appendectomy is not always necessary in surgery for intestinal malrotation in newborns or infants.

Keywords

• Neonatal high jejunal atresia
• Artificial mobile cecum
• Acute appendicitis
• Transumbilical laparoscopic-assisted appendectomy (TULAA)