Clinical Practice and Cases in Emergency Medicine

Introduction: Appendicitis is a common disease, and as we have improved in early diagnosis and management of this disease process, late stage complications have become extremely rare, but can have indolent presentations.

Case Report: A 37-year-old male with no past medical history presented to the emergency department (ED) with vague abdominal pain as well as 12 days of cyclical fever. He had no significant findings on laboratory workup with the exception of a mild aspartate transaminase and alanine transaminase and relative neutrophilia between outpatient, urgent care, and ultimate ED visit. His ED workup included cross-sectional imaging of his abdomen revealing multiple liver abscesses and septic thrombophlebitis secondary to ruptured appendicitis.

Conclusion: Liver abscesses and septic thrombophlebitis are an extremely rare complication of appendicitis that has only been documented twice previously.