Appendix bleeding with painless bloody diarrhea: A case report and literature review

Abstract

<jats:title>Abstract</jats:title><jats:p>Appendix bleeding is an uncommon clinical phenomenon. In this article, we reported a case of appendix bleeding with painless bloody diarrhea. With the analysis of clinical features, clinical examination, experimental test and literature review, we diagnosed that the appendix bleeding might be caused by granulomatous appendicitis. This successfully cured case might be a reference for later diagnosis and treatment of appendix bleeding with painless bloody diarrhea.</jats:p>

Appendiceal bleeding: A case report

“…In terms of sex, 5 males and 2 females are reported on herein. Similar to previous reports, the most likely cause of hospitalization was massive hematochezia, rather than melena[ 3 ]. Pathological analyses showed the main vascular factors of appendiceal bleeding to be angiodysplasia and Dieulafoy’s lesion.…”

“…Several modalities, such as colonoscopy, contrast-enhanced abdominal CT, and angiography, can be applied in diagnosing appendiceal bleeding[ 2 , 3 , 9 ]. In our case, colonoscopy directly revealed the active bleeding from the appendiceal orifice.…”

“…However, appendiceal bleeding as the origin is extremely rare. Diverticulum, angiodysplasia, inflammation, and neoplasm are the usual etiologies for appendiceal bleeding[ 2 , 3 ]. Vascular diseases, such as angiodysplasia and Dieulafoy’s lesion, are one of the most common causes of massive bleeding and sometimes can be life-threatening[ 1 , 4 ].…”

Atypical Presentation of Appendicitis Leading to Exploratory Laparotomy

“…It is typically confirmed with elevated inflammatory markers and an ultrasound or CT scan [ 3 , 6 ]. In this case, the atypical manifestation of gastroenteritis symptoms, including persistent nausea, anorexia, and hematochezia, prompted the decision for an exploratory laparotomy and subsequent appendectomy [ 7 , 9 , 10 ]. It is crucial for clinicians to thoroughly explore the absence of typical symptoms of appendicitis to delay progression to more serious complications.…”

“…Neglecting atypical symptoms can lead to severe complications, including perforation, uncontrolled bleeding, or abscess formation, posing life-threatening risks [ 9 , 10 ]. Delays in diagnosis, visualization on imaging, and treatment of appendicitis can also lead to diffuse peritonitis, which may progress to significant morbidity and death [ 11 , 12 ].…”