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Rare case of perforated appendicitis presenting as persistent perineal discharge following laparoscopic abdominoperinal excision of rectum (APER)
  1. Tanmoy Mukherjee,
  2. Shantata Jayant Kudchadkar,
  3. Jayesh Sagar and
  4. Shashank Gurjar
  1. General Surgery, Luton and Dunstable University Hospital NHS Foundation Trust, Luton, UK
  1. Correspondence to Tanmoy Mukherjee; dr.tanmoy09{at}


Abdominoperineal excision of rectum (APER) is one of the widely used surgical procedures to treat low rectal cancer, benign conditions like Crohn’s proctitis with anal involvement and as a salvage procedure for anal cancer. Perineal wound infection is a well-recognised complication following such major surgery. Occurrence of appendicitis in a few weeks’ time following such a major surgery is uncommon. However, here we present a rare case report of perforated appendicitis presenting as persistent perineal discharge in an elderly man, following laparoscopic APER for a low rectal tumour. To our knowledge, this is the first time such a rare clinical presentation of appendicitis is reported in the history of medical literature. Through this case report, we aim to highlight the importance of considering such an uncommon presentation in patients with perineal discharge, following APER.

  • surgery
  • surgical oncology
  • gastrointestinal system
  • radiology

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  • Contributors TM collected patient data and prepared the manuscript. SJK helped in preparing the manuscript. JS and SG edited and reviewed the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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