Empyema Due to Thoracic Migrating Appendicolith

Background

Retained appendicolith following appendicectomy, and can cause recurrent abscess in the abdomen and retroperitoneum.

Case characteristics

11-yr-old boy who presented with subpulmonic abscess and pneumonia following appendicectomy for perforated appendicitis.

Observations

Thoracotomy revealed a thick walled subpulmonic abscess surrounding an appendicolith along with a rent in the posterolateral aspect of the diaphragm.

Message

In children presenting with pus collections and a history of recent appendicectomy, the possibility of a migrating appendicolith should be considered.