No abstract

Acute appendicitis induced by metastatic disease is uncommon. We present the case of an 82-year-old man with known bony metastases secondary to prostatic cancer who presents with a short history of acute abdominal pain. A CT scan was indicative of acute appendicitis and the patient underwent a laparoscopic appendicectomy; a phlegmonous mass seen intraoperatively was suspicious for malignancy, and histopathology confirmed acute appendicitis as well as metastases of prostate cancer. Metastatic disease should be considered as an important differential in all patients with a known history of malignancy, as this may in turn complicate their presenting surgical complaint.

Laparotomy incisions provide easy and rapid access to the peritoneal cavity in case of emergency surgery. Incisional hernia (IH) is a late manifestation of the failure of abdominal wall closure and represents frequent complication of any abdominal incision: IHs can cause pain and discomfort to the patients but also clinical serious sequelae like bowel obstruction, incarceration, strangulation, and necessity of reoperation. Previous guidelines and indications in the literature consider elective settings and evidence about laparotomy closure in emergency settings is lacking. This paper aims to present the World Society of Emergency Surgery (WSES) project called ECLAPTE (Effective Closure of LAParoTomy in Emergency): the final manuscript includes guidelines on the closure of emergency laparotomy.

No abstract