title: Appendico-cutaneous fistula presenting as a large wound: a rare phenomenon-brief review.
abstract: Appendicular inflammation can present as a discharging fistula on the abdominal wall. We are reporting a rare case of appendico - cutaneous fistula presenting as a large wound over the right iliac region. A 60 year old female reported to the emergency with a large wound and slough on right side of the abdomen. The thin shinning serous discharge from the wound revealed actinomycosis on microbiology.  Patient was successfully treated conservatively with the help of percutaneous drainage and antibiotics. On follow-up of 3 months, patient is doing well and is asymptomatic. Acute appendicitis is considered one of the elementals of general surgical disease processes, yet its presentation often confounds its diagnosis by most surgeons.  Its presentation as abscess in the abdominal wall and groin is a rare clinical entity. Because of insidious onset and subtle clinical signs of resulting abscess, the diagnosis of such cases is often delayed. USG and Contrast enhanced computed tomography are important part of investigations to make diagnose and helps in the treatment.
authors.affiliation: Department of Surgery, Maharishi Markandeshwer Institute of Medical Sciences and Research, Haryana, India. singalsurgery@yahoo.com
authors.forename: Rikki
authors.initials: R
authors.lastname: Singal
authors.forename: Sunita
authors.initials: S
authors.lastname: Gupta
authors.forename: Amit
authors.initials: A
authors.lastname: Mittal
authors.forename: Samita
authors.initials: S
authors.lastname: Gupta
authors.forename: Mujhail
authors.initials: M
authors.lastname: Singh
authors.forename: Ashwani K
authors.initials: AK
authors.lastname: Dalal
authors.forename: Subhash
authors.initials: S
authors.lastname: Goyal
authors.forename: Bir
authors.initials: B
authors.lastname: Singh
mesh_terms: D018784:Abdominal Abscess / Q000175:diagnosis / Q000209:etiology*; D000196:Actinomycosis / Q000175:diagnosis / Q000209:etiology*; D001064:Appendicitis / Q000150:complications / Q000175:diagnosis*; D017577:Cutaneous Fistula / Q000175:diagnosis / Q000209:etiology*; D016154:Digestive System Fistula / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D008875:Middle Aged