Serious delayed rectal haemorrhage following uncomplicated appendicetomy. Report of a case.
A 17-year-old girl developed considerable haemorrhage per rectum 7 days after an apparently uncomplicated appendicetomy with ligature and invagination of the appendix stump. The appendix was normal. Persistent haemorrhage and a fall in HB led to a second laparotomy on the 11th post-operative day. The catgut ligature on the appendix stump was found to have slipped off, and it was assumed that there had been bleeding from the appendix stump into the caecum. The appendix stump was re-sutured and re-invaginated. After this there was no more rectal bleeding. Histological examination of the basal section of the appendix showed a small longitudinal extramural branch artery. There was probably a normal variant of the blood supply to the appendix where the basal part receives its blood supply from the caecum.
D000293:Adolescent; D001062:Appendectomy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D008026:Ligation / Q000009:adverse effects; D011183:Postoperative Complications / Q000601:surgery*; D012007:Rectum