Case ReportComplicated acute appendicitis presenting as an abscess in the abdominal wall in an elderly patient: A case report

•An abdominal wall abscess without a known cause requires thorough investigation.•We describe a case of right abdominal wall abscess and spontaneous drainage.•Appendicitis necessitatis needs to be considered a cause of abdominal wall abscess.

IntroductionAppendicitis is a common cause of acute abdomen; however, the classic clinical signs are not often present, and it has unusual presentations. Thus, its diagnosis can be challenging. PRESENTATION OF CASE: We describe the case of an elderly man who presented with right abdominal wall abscess with spontaneous drainage in the emergency department. Since we suspected a subjacent abdominal pathology, we performed surgery, and intraoperatively, we observed that the Appendix tip had invaded the abdominal wall.DiscussionThis patient had a challenging diagnostic process and surgical visualization of the appendicular tip invading the abdominal wall was an important characteristic in proving the cause of the abdominal wall abscess.ConclusionThe onset of an abdominal wall abscess without a known cause needs to be thoroughly investigated, with consideration of a subjacent abdominal cause and appendicitis necessitatis.