A Rare Case of Fibrosing Obliterative Appendicitis in a Young Patient: Case Report

Authors

  • Mohamed Arsath Shamsudeen Department of Surgery, Faculty of Medicine, MAHSA University, Bandar Saujana Putra, 42610 Jenjarom, Selangor, MALAYSIA.
  • Peh Kiam Heng Department of Surgery, Faculty of Medicine, MAHSA University, Bandar Saujana Putra, 42610 Jenjarom, Selangor, MALAYSIA.
  • G. Krishnaswamy Department of Primary Care Medicine, Faculty of Medicine, MAHSA University, Bandar Saujana Putra, 42610 Jenjarom, Selangor, MALAYSIA. https://orcid.org/0000-0002-6546-977X
  • Mohamad Zahin Hafiz Zulkiple Faculty of Medicine, MAHSA University, Bandar Saujana Putra, 42610 Jenjarom, Selangor, MALAYSIA.
  • Suresh V Chinni Department of Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai 602105, INDIA. https://orcid.org/0000-0002-4697-2994

DOI:

https://doi.org/10.22452/mjs.vol44sp1.10

Keywords:

chronic appendicitis, obstructive appendicitis, appendiceal inflammation, mesenteric lymphadenitis

Abstract

Fibrosing obliterative appendicitis is an uncommon inflammatory condition of the appendix that can lead to significant diagnostic challenges, particularly in younger patients. In a patient presenting with abdominal pain at the emergency department, appendicitis must be considered and ruled out. However, due to various causes of abdominal pain, the diagnosis of appendicitis may be challenging. Therefore, thorough history taking and a careful clinical examination are essential for identifying appendicitis and ensuring prompt treatment. This study describes a young patient who presented with a complaint of right lower abdominal pain for the past 4 days. A 14-year-old male presented to the emergency department with right lower abdominal pain, without associated symptoms. He had a similar episode three months earlier and was treated conservatively. Ultrasound suggested mesenteric lymphadenitis. Diagnostic laparoscopy was initially performed, but was then converted to open surgery due to an invisible appendix. The procedure revealed an inflamed, slender appendix adhering to the cecum with enlarged mesenteric lymph nodes. Appendectomy and lymph node excision were performed. Histopathology confirmed fibrosing obliterative appendicitis with reactive lymphadenitis. The patient was discharged after two days in stable condition. This case highlights the diagnostic challenge of chronic appendicitis in paediatric patients. Diagnostic laparoscopy proved valuable in identifying fibrosing obliterative appendicitis, allowing for effective surgical intervention.

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References

Agha, R. A., Franchi, T., Sohrabi, C., Mathew, G., Kerwan, A., Thoma, A., et al. (2020). The SCARE 2020 guideline: Updating consensus surgical CAse REport (SCARE) guidelines. International Journal of Surgery, 84, 226–230.

Al-Janabi, M. H., Hasan, S., & Issa, R. (2022). Appendiceal neuroma presented as acute appendicitis: A rare case report from Syria. International Journal of Surgery Case Reports, 98, 107532.

Amadea, M. A., & Jurnalis, Y. D. (2022). Diagnosis and management of chronic appendicitis in children: A case report. Bioscientia Medicina: Journal of Biomedicine and Translational Research, 6(12), 2485–2488.

Binchu Kurian, B., Philip, P., & Kommu, P. P. K. (2024). Association of mesenteric lymphadenitis with abdominal pain in children: A case–control study. Asian Journal of Medical Sciences, 15(2), 104–107.

Cabrales-Escobar, I. E., Murcio-Pérez, E., & Albarrán-Sánchez, A. (2021). IgG4-related disease manifesting as symptoms of appendicitis: Case report and literature review. Clinical Journal of Gastroenterology, 14, 626–632.

Choi, S. J., Jang, Y. J., Lee, D., Cho, S. H., Kim, G. C., Bae, J. H., et al. (2014). Two cases of fibrous obliteration of the appendix mimicking acute appendicitis. Journal of the Korean Society of Radiology, 70(6), 430–434.

Greenson, J. K. (2019). Diagnostic pathology: Gastrointestinal (E-book). Elsevier Health Sciences.

Holm, N., Rømer, M. U., Markova, E., Buskov, L. K., Hansen, A. B. E., & Rose, M. V. (2022). Chronic appendicitis: Two case reports. Journal of Medical Case Reports, 16(1), 51.

Jenkins, J. K., Morrow, C. A., Chaudhary, S., Brashear, J. H., & Brashear, J. (2022). A Case of a Rare, Incidental Discovery of Fibrous Obliteration of an Appendiceal Diverticulum. Cureus, 14(7).

Kothadia, J. P., Katz, S., & Ginzburg, L. (2015). Chronic appendicitis: Uncommon cause of chronic abdominal pain. Therapeutic Advances in Gastroenterology, 8(3), 160–162.

Lee, C. K., Pelenyi, S. S., Fleites, O., Velez, V., Alaimo, K. L., Ramcharan, D. N., et al. (2021). Chronic appendicitis, the lesser-known form of appendiceal inflammation: A case report. Cureus, 13(11), e19856.

Ljubas, I., Jurca, I., & Grgić, D. (2024). Chronic appendicitis: Possible differential diagnosis in patients with chronic abdominal pain. Case Reports in Surgery, 2024(1), 6032042.

Molina, G. A., Torres, M. A., Montenegro, M. S., Sánchez, G. D., Arcia, A. C., Enríquez, J. J., et al. (2020). Neuroma of the appendix: A rare cause of appendicitis and an important reason for close follow-up. Journal of Surgical Case Reports, 2020(3), rjaa023.

Scoazec, J. Y. (2010). Appendicular pathology: Mucous neuroma. Annales de Pathologie, 30(2), 130–134.

Shahba, L., Parizi, M. K., & Shafie, M. (2024). Comparison of clinical and laboratory manifestations between acute appendicitis and mesenteric lymphadenitis in children. Cureus, 16(6).

Uchihara, T., Komohara, Y., Yamashita, K., Arima, K., Uemura, S., Hanada, N., & Baba, H. (2022). Chronic appendicitis caused by a perforating fish bone: Case report and brief literature review. In Vivo, 36(4), 1982–1985.

Zarghami, A., Ebrahimi, M., Tajik, A., & Ahmadi, S. (2024). Fibrous obliteration in a middle-aged woman: A case report. Novelty in Biomedicine, 12(2), 86–88.

Zhao, J., Samaan, J. S., Toubat, O., & Samakar, K. (2020). Laparoscopy as a diagnostic and therapeutic modality for chronic abdominal pain of unknown etiology: A literature review. Journal of Surgical Research, 252, 222–230.

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Published

12-12-2025

How to Cite

Mohamed Arsath Shamsudeen, Peh Kiam Heng, G. Krishnaswamy, Mohamad Zahin Hafiz Zulkiple, & Suresh V Chinni. (2025). A Rare Case of Fibrosing Obliterative Appendicitis in a Young Patient: Case Report. Malaysian Journal of Science (MJS), 44(sp1), 61–65. https://doi.org/10.22452/mjs.vol44sp1.10

Issue

Vol. 44 No. sp1 (2025): Special Issue: MAHSA International Medical Sciences and Technology Conference (Mi-Med) 2024

Section

Special Issue - Mi-Med 2024

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