2025, Vol. 7, Issue 2, Part D
Acute Gangrenous Appendicitis Following Recent Laparoscopic Cholecystectomy: A Rare Postoperative Diagnostic Challenge
Author(s): Radomir Gelevski, Gorgji Jota, Blagica Krsteska, Vladimir Andreevski, Bojan Trenchikj and Vladimir Joksimovikj
Abstract: Acute appendicitis developing shortly after an elective laparoscopic cholecystectomy is an exceedingly rare clinical occurrence and poses a significant diagnostic challenge. Postoperative right upper or right-sided abdominal pain is often attributed to biliary complications such as bile leak, retained ductal stones, or subhepatic collections, making appendicitis a less likely consideration. The overlap of symptoms between postcholecystectomy syndrome and acute appendicitis further complicates timely recognition.
Hyperbilirubinemia has recently been recognized as a reliable biochemical marker for complicated appendicitis, particularly in gangrenous or perforated cases, due to endotoxin-mediated hepatocellular dysfunction. We present a case of acute gangrenous appendicitis occurring one week after an uneventful laparoscopic cholecystectomy, highlighting the diagnostic difficulties in differentiating biliary from appendiceal pathology in the early postoperative period. The case underscores the importance of maintaining a broad differential diagnosis and considering appendicitis even in patients with recent abdominal surgery presenting with atypical right-sided pain and elevated bilirubin levels.
DOI: 10.22271/27081494.2025.v7.i2d.230Pages: 264-268 | Views: 204 | Downloads: 70Download Full Article: Click Here
How to cite this article:
Radomir Gelevski, Gorgji Jota, Blagica Krsteska, Vladimir Andreevski, Bojan Trenchikj, Vladimir Joksimovikj.
Acute Gangrenous Appendicitis Following Recent Laparoscopic Cholecystectomy: A Rare Postoperative Diagnostic Challenge. Int J Case Rep Surg 2025;7(2):264-268. DOI:
10.22271/27081494.2025.v7.i2d.230
