Authors: Abdelrahman Issa, Manon Van Seters, Mohamed Shehata, Moustafa Eissa.
This case report discusses a 50-year-old female who developed a pelvic abscess caused by a retained fecalith following an appendectomy. Despite multiple admissions and initial treatment for presumed pelvic inflammatory disease (PID), the diagnosis was delayed until the fifth presentation. Imaging revealed a pelvic abscess and a pathognomonic retained fecalith on CT, although histological confirmation was not obtained due to specimen handling. Similar cases of retained fecaliths have been reported, albeit rarely. This case highlights the importance of considering non-gynecological causes of pelvic infections, detailed surgical history, and multidisciplinary collaboration in management. Postmenopausal women require a lower threshold for intervention due to their higher risk of complications.
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