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Perforated Appendix

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https://www.readbyqxmd.com/read/29145325/perforated-appendicitis-after-colonoscopy-cause-or-coincidence-a-rare-case-report-and-literature-review
#1
Xiao-Cong Zhou, Chun-Wei Huang, Yan-Yan Dai, Zhi-Yang Huang, Zheng Lou
RATIONALE: Colonoscopy is a relatively safe and common procedure with low risks of complications, and acute appendicitis with perforation is an extremely rare complication of colonoscopy. The current study presents an unusual case of acute gangrenous appendicitis with perforation following a screening colonoscopy. PATIENT CONCERNS: A 73-year-old man presented to our emergency department with lower right abdominal pain 3 days after a routine screening colonoscopy...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29123444/imaging-findings-of-the-unusual-presentations-associations-and-clinical-mimics-of-acute-appendicitis
#2
REVIEW
Mustafa Kemal Demir, Yildiray Savas, Yavuz Furuncuoglu, Tarik Cevher, Serdar Demiral, Babek Tabandeh, Melisa Aslan
There are many kinds of unusual presentations or associations and clinical mimics of acute appendicitis, and definitive diagnosis requires knowledge of the imaging findings in some cases. The unusual presentations and associations of acute appendicitis included in this study are perforated appendicitis, acute appendicitis occurring in hernias, acute appendicitis with cystic endosalpingiosis, intussusception of appendix, and acute appendicitis with pregnancy. We also present uncommon gastrointestinal, urinary and gynecologic clinical mimics of acute appendicitis including anomalous congenital band, duplication cysts, giant Meckel's diverticulitis, inflammatory fibroid polyp, renal artery thrombosis, spontaneous urinary extravasation and OHVIRA syndrome...
October 2017: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/29100501/trends-in-diagnostic-approaches-for-pediatric-appendicitis-nationwide-population-based-study
#3
Chih-Cheng Luo, Wen-Kuei Chien, Chen-Sheng Huang, Hung-Chieh Lo, Sheng-Mao Wu, Hung-Chang Huang, Ray-Jade Chen, Hsun-Chin Chao
BACKGROUND: To define the benefits of different methods for diagnosis of pediatric appendicitis in Taiwan, a nationwide cohort study was used for analysis. METHODS: We identified 44,529 patients under 18 years old who had been hospitalized with a diagnosis of acute appendicitis between 2003 and 2012. We analyzed the percentages of cases in which ultrasound (US) and/or computed tomography (CT) were performed and non-perforated and perforated appendicitis were diagnosed for each year...
November 3, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/29075545/amyand-s-hernia-state-of-the-art-and-new-points-of-view
#4
Guido Mantovani, Michela De Angelis, Francesco Di Lecce, Annalisa Pascariello, Domenico Risio, Luigi Boccia
BACKGROUND: Amyand's hernia (AH) is an inguinal hernia containing the vermiform appendix, with an incidence between 0.4% and 1% of all inguinal hernias. Acute or perforated appendicitis can complicate AH. CASE PRESENTATION: A 75-year-old Caucasian man presented with incarceration of vermiform appendix in inguinal hernia sac. Diagnosis was posed preoperatively with computed tomography (CT) scan. Patient underwent urgent surgery and simultaneous appendectomy and hernia repair by Bassini's technique were performed...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/29073546/jejunal-perforation-as-an-unusual-presentation-of-total-colonic-aganglionosis-in-a-neonate-a-case-report
#5
Sang Beom Han, Jiha Kim, Suk-Bae Moon
INTRODUCTION: Neonatal intestinal perforation usually occurs at distal small bowel secondary to distal bowel obstruction. The aim of this report is to describe an unusual case of total colonic aganglionosis with an initial presentation of proximal jejunal perforation. PRESENTATION OF CASE: A male newborn presented with jejunal perforation on the fifth day of life and was treated by laparoscopic primary repair. Abdominal distention persisted postoperatively, and radiological examination revealed an obstruction near the terminal ileum...
October 18, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29059610/diagnosis-and-operative-management-of-a-perforated-de-garengeot-hernia
#6
Alexi Bloom, Flavio E Baio, Keemberly Kim, Joseph S Fernandez-Moure, Michael Reader
INTRODUCTION: A de Garengeot hernia, a femoral hernia containing the appendix, is a difficult diagnosis often made intra-operatively when the hernia sac is opened. It is a rare finding, and complications are more frequent with a de Garengeot hernia. PRESENTATION OF CASE: A 92 year-old female presented to the emergency department (ED) complaining of abdominal pain. A computed tomographic (CT) scan of the abdomen and pelvis demonstrated a hernia anterior to the inguinal ligament without strangulation...
October 10, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29044790/acute-appendicitis
#7
REVIEW
Mark D Stringer
Acute appendicitis is the most common reason for abdominal surgery in children. Luminal obstruction of the appendix progresses to suppurative inflammation and perforation, which causes generalised peritonitis or an appendix mass/abscess. Classical features include periumbilical pain that migrates to the right iliac fossa, anorexia, fever, and tenderness and guarding in the right iliac fossa. Atypical presentations are particularly common in preschool children. A clinical diagnosis is possible in most cases, after a period of active observation if necessary; inflammatory markers and an ultrasound scan are useful investigations when the diagnosis is uncertain...
October 17, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28958279/an-analysis-of-factors-that-predict-hospital-readmission-after-surgery-for-perforated-appendicitis
#8
Jeffanne E Millien, Michael Townsend, Joshua Goldberg, George M Fuhrman
We performed this study to develop an understanding of why patients were readmitted after appendectomy for perforated appendicitis. Patients who required surgery for perforated appendicitis during a recent five-year period were identified. We recorded the demographic data, length of symptoms, length of stay, vital signs, laboratory findings, surgical approach, length of surgery, time to readmission, length of readmission, and intervention required after readmission. We divided the cohort into two groups depending on whether the patient was readmitted...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28920020/neonatal-perforated-appendicitis-attributed-to-localized-necrotizing-enterocolitis-of-the-appendix-a-review
#9
Andrew Tumen, Pranit N Chotai, John Matthew Williams, Adrianne Myers-Webb, Ramesh Krishnan, James W Eubanks Iii
Neonatal appendicitis is a rare clinical entity associated with remarkable morbidity and mortality. Appendicular perforation is common and the diagnosis is usually made intra-operatively. The causative etiology of neonatal perforated appendicitis (NPA) is a subject of debate and has not been elucidated. Although many etiologic theories exist, increasing evidence suggests a subset of NPA cases may represent a form of necrotizing enterocolitis (NEC) localized to the appendix. We herein present a review of the current literature to include cases of NPA attributed to localized NEC...
July 2017: Journal of Neonatal Surgery
https://www.readbyqxmd.com/read/28900551/appendicitis-caused-by-primary-varicella-zoster-virus-infection-in-a-child-with-digeorge-syndrome
#10
Lotte Møller Smedegaard, Claus Bohn Christiansen, Linea Cecilie Melchior, Anja Poulsen
INTRODUCTION: Chickenpox is caused by varicella zoster virus (VZV). Although predominantly a mild disease, it can cause considerable morbidity and in rare occasions even mortality in healthy children as well as increased morbidity and mortality in immunocompromised patients. The aetiology of appendicitis is largely unknown but is thought to be multifactorial. Appendicitis is a suspected, but not well documented, complication from varicella zoster virus infection. CASE PRESENTATION: A five-year-old girl diagnosed with DiGeorge syndrome and a prolonged primary VZV infection was admitted due to abdominal pain, increasing diarrhoea, vomiting, and poor general condition...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28882933/caecal-cancer-presenting-as-leg-erythema-and-a-lung-opacity
#11
Archik Das, Khalid Hureibi, Muhammad Tayyab, Peter McCullough
Necrotising infection of the lower limb is a rare presentation for colorectal malignancy. We report a case of a perforated caecal adenocarcinoma presenting with right leg erythema, pain and swelling in the presence of a right lower lobe lung opacity. Following initial debridement and washout, CT imaging demonstrated a thickened terminal ileum, caecum and appendix, in keeping with primary malignancy. This fed the right-sided lower limb sepsis tracking down from the medial aspect of the psoas muscle to give rise to the multiloculated collection seen in the adductor compartment...
September 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28876658/laparoscopic-lavage-versus-suction-only-in-complicated-acute-appendicitis-a-prospective-randomised-control-study
#12
I I Sardiwalla, M Z Koto
BACKGROUND: The role of laparoscopy in complicated appendicitis is increasing. It is unclear in the adult population whether lavage of the pus versus suction only impacts in decreasing postoperative collections. In children there appears to be no difference whether the pus is lavaged or suctioned only. This study will be the first of its kind in the adult population. METHOD: A prospective single blinded randomised control trial was conducted. Ethics clearance was obtained from the review board...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876652/unusual-histopathologies-of-the-appendix
#13
L Jonas, I Bombil, A Mannell
BACKGROUND: Acute appendicitis is a very common surgical emergency. Most commonly, the histopathological findings of the appendix reflect the normal pathophysiology of appendicitis that starts with the luminal obstruction and culminates in florid suppurative, gangrenous or perforated appendix. The treatment is usually straightforward and consists of surgery and antibiotics. Uncommonly, unusual pathologies are identified and require specific management. The literature is scanty about the unusual findings...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876618/c-reactive-protein-as-a-predictor-of-severity-of-appendicitis
#14
L Van den Worm, E Georgiou, M De Klerk
BACKGROUND: Complex (perforated or gangrenous) appendicitis has a high rate of morbidity in South Africa. METHOD: The study retrospectively reviewed results from January 2013 to December 2015 at Paarl Hospital in the Western Cape province. All patients who had their appendices surgically removed due to suspected appendicitis and who had preoperative results for CRP and WCC were included. Using the area under the Receiver Operated Characteristics curve we compared the inflammatory markers of 2 groups with histologically proven appendicitis: those with complex (perforated or gangrenous appendix) and those with uncomplicated appendicitis (inflamed appendix)...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28827431/tubo-ovarian-abscess-infected-by-salmonella-typhi
#15
Paban Sharma, Abhusani Bhuju, Ruhee Tuladhar, Christopher M Parry, Buddha Basnyat
We report a case of a tubo-ovarian abscess infected with Salmonella enterica serotype typhi A 19-year-old Nepalese woman presented to a hospital in Kathmandu with lower abdominal pain, constipation, fever and a non-healing, suppurative surgical wound from an emergency caesarian section performed 2 months previously at 37 weeks of pregnancy. She also had an exploratory laparotomy for an appendix perforation with peritonitis at 25 weeks of gestation. Her wound infection did not respond to cloxacillin and she had an exploratory laparotomy, and a tubo-ovarian abscess was found from which S...
August 20, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28826614/diagnostic-performance-of-ultrasonography-for-pediatric-appendicitis-a-night-and-day-difference
#16
Kate Louise M Mangona, R Paul Guillerman, Victor S Mangona, Jennifer Carpenter, Wei Zhang, Monica Lopez, Robert C Orth
RATIONALE AND OBJECTIVES: For imaging pediatric appendicitis, ultrasonography (US) is preferred because of its lack of ionizing radiation, but is limited by operator dependence. This study investigates the US diagnostic performance during night shifts covered by radiology trainees compared to day shifts covered by attending radiologists. MATERIALS AND METHODS: Appy-Scores (1 = completely visualized normal appendix; 2 = partially visualized normal appendix; 3 = nonvisualized appendix with no inflammatory changes in the expected region of the appendix; 4 = equivocal; 5a = nonperforated appendicitis; 5b = perforated appendicitis) from 2935 US examinations (2161:774, day-to-night) from July 2013 to 2014 were correlated with the intraoperative diagnoses and the clinical follow-up...
August 18, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28794884/unusual-presentations-of-comamonas-kerstersii-infection
#17
M Almuzara, C Barberis, F Veiga, R Bakai, R Cittadini, C Vera Ocampo, M Alonso Serena, E Cohen, M S Ramirez, A Famiglietti, D Stecher, M Del Castillo, C Vay
The association of Comamonas kerstersii with peritonitis resulting from the presence of perforated appendix has previously been described by our research team. In the present study, we describe the isolation of this microorganism from two forms of unusual presentations of C. kerstersii infection not previously described in the literature: localized intra-abdominal infection (psoas abscess) and pelvic peritonitis.
September 2017: New Microbes and New Infections
https://www.readbyqxmd.com/read/28770136/neonatal-perforated-appendicitis-masquerading-as-necrotizing-enterocolitis
#18
Andrew Tumen, Pranit N Chotai, John Matthew Williams, Adrianne Myers-Webb, Jie Zhang, Ramesh Krishnan, James W Eubanks Iii
A preterm neonate underwent emergent laparotomy for presumed necrotizing enterocolitis (NEC). Intra-operatively, neonatal perforated appendicitis (NPA) was encountered. This may represent a form of NEC localized to the appendix. A high index of clinical suspicion and early laparotomy are recommended.
April 2017: Journal of Neonatal Surgery
https://www.readbyqxmd.com/read/28762291/water-permeability-is-a-measure-of-severity-in-acute-appendicitis
#19
Nicola Pini, Viktoria A Pfeifle, Urs Kym, Simone Keck, Virginie Galati, Stefan Holland-Cunz, Stephanie J Gros
Acute appendicitis is the most common indication for pediatric abdominal emergency surgery. Determination of the severity of appendicitis on clinical grounds is challenging. Complicated appendicitis presenting with perforation, abscess or diffuse peritonitis is not uncommon. The question remains why and when acute appendicitis progresses to perforation. The aim of this study was to assess the impact of water permeability on the severity of appendicitis. We show that AQP1 expression and water permeability in appendicitis correlate with the stage of inflammation and systemic infection parameters, leading eventually to perforation of the appendix...
December 2017: Journal of Enzyme Inhibition and Medicinal Chemistry
https://www.readbyqxmd.com/read/28736163/robotic-assisted-laparoscopic-mace
#20
Rebecca S Zee, Nora G Kern, C D A Herndon
INTRODUCTION: The creation of a Malone antegrade continence enema (MACE) channel is an option to treat patients with neurologic conditions that result in fecal soiling or intractable constipation. It is typically performed in an open fashion through a midline incision or laparoscopically. The laparoscopic technique typically involves bringing the tip of the appendix to the skin whereas the open technique allows for imbrication of the cecum around the channel, which may improve continence and decrease the risk of perforation...
October 2017: Journal of Pediatric Urology
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