A Life Threatening Case of Perforated Gangrenous Appendicitis: When the Open Abdomen Technique Can be Safe and Effective In Acute Peritonitis. A Case Report

Background: Acute appendicitis is one of the most common abdominal urgent/emergent conditions worldwide and can occur at every age. It can be simple, in many cases treated conservatively, or complicated which require a surgical intervention. Sometimes is present peritonitis or abscesses which can deal to the creation of laparostomy (in order to oversee bowel inflammation). Diagnosis can be difficult because of a great variety of clinical presentations but many Scores (such as Alvarado Score) can help Surgeons to adopt a correct approach. Objectives: This work aims to describe a possible treatment of complicated perforated appendicitis with diffuse peritonitis and multiple abscesses with the use of the Open Abdomen technique. Case Report: We present a case of perforated gangrenous appendicitis occurred in a young man associated to diffuse peritonitis and septic shock. We also discuss contemporary methods in diagnosis and management of the condition. Conclusions: Appendicitis must never be undervalued because of a large possible series of complications, and, even death. In selected cases, when bowel conditions require, it is possible to use the Open Abdomen technique, in way to resolve intestinal inflammation and help patient in septic resolution.