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Perforated Appendix

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https://www.readbyqxmd.com/read/28279749/how-to-diagnose-an-acutely-inflamed-appendix-a-systematic-review-of-the-latest-evidence
#1
REVIEW
S A Kabir, S I Kabir, R Sun, Sadaf Jafferbhoy, Ahmed Karim
Acute appendicitis is the most common condition that presents with an acute abdomen needing emergency surgery. Despite this common presentation, correctly diagnosing appendicitis remains a challenge as clinical signs or positive blood results can be absent in 55% of the patients. The reported proportion of missed diagnoses of appendicitis ranges between 20% and 40%. A delay or mis-diagnosis of appendicitis can result in severe complications such as perforation, abscess formation, sepsis, and intra-abdominal adhesions...
March 6, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28271679/the-diagnostic-value-of-scube1-in-acute-appendicitis
#2
E Sonmez, A Dursun, B Gulen, H Metin, O F Ozer
BACKGROUND: SCUBE1 has recently been studied as a diagnostic biomarker for acute coronary syndrome, ischemic stroke, and acute mesenteric ischemia. The aim of this study is to evaluate the value of SCUBE1 and routine parameters used in patients diagnosed with acute appendicitis. METHODS: Of the 150 patients admitted to the emergency department whose initial diagnosis were acute appendicitis (AA), 103 patients were excluded from the study for various reasons. Forty-seven patients with a definitive diagnose of AA and 43 volunteers were enrolled in the study...
March 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28262593/de-garengeot-hernia-with-perforated-appendicitis-and-a-groin-subcutaneous-abscess-a-case-report
#3
Hiroaki Mashima, Masataka Banshodani, Masahiro Nishihara, Junko Nambu, Yasuo Kawaguchi, Fumio Shimamoto, Kiyohiko Dohi, Keizo Sugino, Hideki Ohdan
INTRODUCTION: De Garengeot hernia is rare. Although previous reports have suggested various surgical options according to patient condition, comorbidities, surgeon preference, and clinical findings during surgery, a treatment strategy has not been established. PRESENTATION OF CASE: An 81-year-old woman presented with an irreducible tender mass that was subsequently diagnosed as an incarcerated femoral hernia with a subcutaneous abscess in the right groin. Intraoperative findings revealed a necrotic and perforated appendix strangulated by the femoral ring for which an appendectomy and herniorrhaphy was performed concurrently through the hernia sac...
February 20, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28255153/an-unexpected-gangrenous-duplication-of-ileum
#4
C I Chiar, T Elango, L Sivaneswaran, R Umasangar, N Mohan
Alimentary tract duplication is a rare congenital anomaly which may involve any part of the alimentary tract extending from stomach to rectum. Clinical presentation may mimic an inflamed appendix as described in this case. A 9-year-old boy with a clinical diagnosis of perforated appendix was noted to have a normal appendix intra-operatively. On further search for an underlying pathology, a gangrenous ileal duplication was discovered. En-bloc resection with primary bowel anastomosis was done. Histopathology report revealed a gangrenous small bowel duplication...
February 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28247217/retrospective-study-of-24-cases-of-acute-appendiceal-diverticulitis-ct-findings-and-pathological-correlations
#5
Aytul Hande Yardimci, Ceyda Turan Bektas, Esra Pasaoglu, Erdem Kinaci, Cigdem Ozer, Mert Mahsuni Sevinc, Abdullah Soydan Mahmutoglu, Ozgur Kilickesmez
PURPOSE: Appendiceal diverticulitis is relatively rare and is difficult to distinguish clinically and radiologically from acute appendicitis. The aim of this study was to describe the computed tomography (CT) findings of acute appendiceal diverticulitis. MATERIALS AND METHODS: Among the 1329 patients who underwent appendectomy at our institution between January 2010 and July 2015, 28 were diagnosed pathologically with appendiceal diverticulitis, including 24 patients who were evaluated by preoperative CT...
February 28, 2017: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/28194430/mesh-inguinal-hernia-repair-and-appendectomy-in-the-treatment-of-amyand-s-hernia-with-non-inflamed-appendices
#6
Emin Kose, Abdullah Sisik, Mustafa Hasbahceci
Amyand's hernia is defined as protrusion of the vermiform appendix in an inguinal hernia sac. It is a rare entity with variable clinical presentation from normal vermiform appendix to abscess formation due to perforation of acute appendicitis. Although surgical treatment includes appendectomy and hernia repair, appendectomy in the absence of an inflamed appendix and use of a mesh in cases of appendectomy remain to be controversial. The aim of this study was to review the experience of mesh inguinal hernia repair plus appendectomy performed for Amyand's hernia with noninflamed appendices...
2017: Surgery Research and Practice
https://www.readbyqxmd.com/read/28131668/management-of-an-inguinal-hernia-in-patients-with-pseudomyxoma-peritonei
#7
P H Sugarbaker
BACKGROUND: Pseudomyxoma peritonei is a disease that results from a perforated mucinous neoplasm of the appendix so that mucinous ascites and mucin-producing tumor cells are widely disseminated in a characteristic pattern throughout the abdomen and pelvis. The intraabdominal mucus can accumulate in the inguinal canal and by physical examination be indistinguishable from the usual inguinal hernia. METHODS: A database of patients with pseudomyxoma peritonei was used to identify patients who had an inguinal hernia prior to or at the time of cytoreductive surgery (CRS) and perioperative hyperthermic chemotherapy (HIPEC)...
January 6, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28099058/two-site-appendectomy-in-children-description-of-technique-and-outcomes
#8
Bethany J Slater, Steven S Rothenberg
PURPOSE: Laparoscopic appendectomy is one of the most common operations. Single-site appendectomy has been gaining popularity; however, it has certain disadvantages. The purpose of this study was to review the results of an essentially scarless laparoscopic appendectomy technique. METHODS: A retrospective review of all patients who underwent two-site appendectomy for appendicitis between January 2015 and February 2016 was performed. For all cases, a 4 mm trocar and a 5 mm trocar were placed through an infraumbilical incision and a 3 mm trocar was placed in the suprapubic region...
January 18, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28063718/second-date-appendectomy-operating-for-failure-of-nonoperative-treatment-in-perforated-appendicitis
#9
Marco Lotti
BACKGROUND: Nonoperative treatment of acute appendicitis is embraced by many surgical teams, driven by low to moderate quality randomized studies that support noninferiority of antibiotics versus appendectomy for treatment of acute uncomplicated appendicitis. Several flaws of these studies have emerged, especially in the recruitment strategy and in the diagnostic criteria that were used. The growing confidence given to antibiotics, together with the lack of reliable criteria to distinguish between uncomplicated and perforated appendicitis, exposes patients with perforated appendicitis to the likelihood to be treated with antibiotics instead of surgery...
January 2, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27955852/-chronic-appendicitis-due-to-multiple-fecaliths-a-case-report
#10
Álvaro José Montiel-Jarquín, Celso Ramírez-Sánchez, Eugenio García-Cano, Nicolás González-Hernández, Fabiola Rodríguez-Pérez, Ivan Alvarado-Ortega
BACKGROUND: The appendix inflammatory process is the most common cause of chronic abdominal pain in the right lower quadrant. The frequency of appendiceal lumen obstruction by fecalith ranges from 10 to 20%; few cases of obstruction by multiple fecaliths had been reported. CLINICAL CASE: Sixty-nine years old male, diabetic and hypertensive in control, he underwent bowel resection 30 years previously. He completed 6 months with intermittent, mild pain in the right lower quadrant abdomen; 14 days prior to admission with increasing pain, nausea, vomiting, constipation, abdominal distension and absence of peristalsis; 12,750 leukocytes, neutrophils 90%; plain abdominal radiography without specific bowel pattern, TAC with 3 dense images in right lower quadrant; exploratory laparotomy was performed and perforated appendix with 3 free fecaliths was found...
December 9, 2016: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/27938532/a-rare-case-of-perforation-of-the-subhepatic-appendix-by-a-toothpick-in-a-patient-with-intestinal-malrotation-laparoscopic-approach
#11
V Grassi, J Desiderio, A Cacurri, A Gemini, C Renzi, Alessandro Corsi, I Barillaro, A Parisi
Foreign body ingestion is not an uncommon problem in clinical practice. While most ingested foreign bodies pass uneventfully through the gastrointestinal tract, sharp foreign bodies such as toothpicks should cause intestinal perforation. We reported the case of a perforation of the appendix caused by a toothpick, which also pierced the liver without hepatic damages, in a male with an intestinal malrotation and subhepatic appendix. The patient was admitted to our hospital for abdominal pain in the right upper quadrant...
July 2016: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/27922766/diagnostic-value-of-high-mobility-group-box-1-hmgb1-protein-in-acute-and-perforated-appendicitis
#12
Shabanali Alizadeh, Ali Ghazavi, Ali Ganji, Ghasem Mosayebi
AIM: Acute appendicitis is the most common cause of abdominal surgical emergencies. Early diagnosis of appendicitis can reduce perforation and mortality rate. High-mobility group box 1 (HMGB1) protein has been identified as a pro-inflammatory factor and its elevated serum levels have been noted in different diseases. So, the aim of this study was to determine the serum levels of HMGB1 in patients with acute and perforated appendicitis in compare to normal appendix. MATERIAL AND METHODS: For this purpose, serum samples were obtained from 81 patients with primary criteria-based appendicitis 6 hr before and 72 hr after appendectomy, in which serum levels of HMGB1 were analyzed by enzyme-linked immunosorbent assay...
December 6, 2016: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/27913053/intestinal-metaplasia-of-appendiceal-endometriosis-is-not-uncommon-and-may-mimic-appendiceal-mucinous-neoplasm
#13
Monika Vyas, Serena Wong, Xuchen Zhang
Endometriosis of the appendix can be an incidental finding or a cause of appendicitis, intussusception, perforation or retention mucocele. Intestinal metaplasia of appendiceal endometriosis may occur, which can lead to a misdiagnosis of low-grade appendiceal mucinous neoplasm. On a retrospective search of the pathology database from 2001 to 2015, we identified 78 appendiceal endometriosis cases and intestinal metaplasia was present in 10/78 (13%) cases. In most of the cases (90%), the foci of intestinal metaplasia were mainly localized close to the mucosa...
January 2017: Pathology, Research and Practice
https://www.readbyqxmd.com/read/27908462/a-rare-case-of-perforated-sub-hepatic-appendicitis-a-challenging-differential-diagnosis-of-acute-abdomen-based-on-the-combination-of-appendicitis-and-maldescent-of-the-caecum
#14
Costanza Chiapponi, Olof Jannasch, Manuela Petersen, Wiebke Lessel, Christiane Bruns, Frank Meyer
Unusual locations of the appendix vermiformis can result in delay in appropriate diagnosis and treatment of appendicitis. So an inflamed appendix in a sub-hepatic caecum caused by caecal maldescent for example can mimic cholecystitis, the pain being localized in the right upper quadrant. Here, we present a case of perforated sub-hepatic appendicitis with peritonitis, requiring open ileocaecal resection. Review of the existing literature has demonstrated that this pathology is uncommon, yet not so rare as one might presume...
January 2017: Pathology, Research and Practice
https://www.readbyqxmd.com/read/27884613/appendectomy-in-patients-with-human-immunodeficiency-virus-not-as-bad-as-we-once-thought
#15
Michael C Smith, Paul J Chung, Yohannes C Constable, Matthew R Boylan, Antonio E Alfonso, Gainosuke Sugiyama
BACKGROUND: The number of patients living with human immunodeficiency virus and acquired immunodeficiency syndrome is growing due to advances in antiretroviral therapy. Existing literature on appendectomy within this patient population has been limited by small sample sizes. Therefore, we used a large, multiyear, nationwide database to study this topic comprehensively. METHODS: Using the Nationwide Inpatient Sample, we identified 338,805 patients between 2005 and 2012 who underwent laparoscopic or open appendectomy for acute appendicitis...
November 21, 2016: Surgery
https://www.readbyqxmd.com/read/27880929/a-complicated-case-of-amyand-s-hernia-involving-a-perforated-appendix-and-its-management-using-minimally-invasive-laparoscopic-surgery-a-case-report
#16
Wisam Al-Ramli, Yahya Khodear, Muyiwa Aremu, Abdel Basset El-Sayed
INTRODUCTION: Amyand's hernia is a rare condition of inguinal hernia in which the appendix is incarcerated within the hernia sac through the internal ring. Complications include acute appendicitis and perforated appendicitis, which are rare in incidence, accounting for about 0.1% of cases.(1) These complications prove a diagnostic challenge due to their vague clinical presentation and atypical laboratory and radiological findings. Until recently, open appendectomy was the mainstay of treatment...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27873747/atypical-presentation-of-appendicitis
#17
Oliver Beaumont, Robert Miller, Richard Guy
A woman aged 64 years presented as an emergency with a mass in the right iliac fossa, clinically within the abdominal wall, but an otherwise soft abdomen. Systemically, she was quite well with normal vital signs. Blood tests revealed raised inflammatory markers, and an abdominal CT scan demonstrated a perforated appendix with associated large subcutaneous abscess. This represents a rare presentation of a common condition, demonstrating how appendicitis can still be a challenging problem for the clinician...
November 10, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27863342/a-case-report-describing-diverticulosis-of-the-appendix-presenting-as-acute-appendicitis
#18
Sarah L Khan, Madhu Siddeswarappa, Mohammad Farrukh Khan
INTRODUCTION: Diverticulosis of the appendix (DA) is a rare clinical finding which is often confused with acute or chronic appendicitis and is usually only identified during or after appendectomy. The symptoms of DA can last for up to two weeks and laboratory studies tend to reflect a more chronic inflammation. Distinguishing the two entities is important as DA has a higher risk for perforation and may be associated with an underlying malignancy. PRESENTATION OF CASE: A 54--year old African--American male presented with three--days of right sided abdominal pain, nausea, and vomiting...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27857807/transanal-protrusion-of-ventriculoperitoneal-shunt-via-appendicular-perforation-a-rare-case-report
#19
Shaam Bodeliwala, Atul Agrawal, Amit Mittal, Daljit Singh, B G Vageesh, Hukum Singh
Perforation of abdominal viscera and protrusion of the distal end of ventriculoperitoneal shunt (VPS) through natural orifice is well known but rare complication. We report a case of a transanal protrusion of distal end of VPS through appendix perforation without any symptomatology of prior appendicitis. To the best of our knowledge, no case of such kind has been reported in literature yet. The management plan of these patients should be looked in a different way because they may have underlying inflammation of the appendix and distal end of shunt removal should be done by proper surgical exploration followed by added appendicectomy...
July 2016: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/27849324/pre-operative-stool-analysis-for-intestinal-parasites-and-fecal-occult-blood-in-patients-with-acute-appendicitis
#20
Sinan Hatipoğlu, Uğur Lök, Umut Gülaçtı, Tuncay Çelik
BACKGROUND: Etiology of acute appendicitis (AA) rarely involves parasitic infections of gastrointestinal (GI) tract. Preoperative diagnosis of parasitic infections in appendix remains difficult, although parasites can sometimes be observed inside the lumen during histopathological examination. The aim of the present study was to prospectively screen prevalence and species of intestinal parasites and adherence of fecal occult blood (FOB) in patients admitted to emergency department (ED) with clinical symptoms of AA who underwent appendectomy...
September 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
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