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Perforated Appendix

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https://www.readbyqxmd.com/read/27913053/intestinal-metaplasia-of-appendiceal-endometriosis-is-not-uncommon-and-may-mimic-appendiceal-mucinous-neoplasm
#1
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...
October 25, 2016: 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
#2
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...
November 21, 2016: Pathology, Research and Practice
https://www.readbyqxmd.com/read/27884613/appendectomy-in-patients-with-human-immunodeficiency-virus-not-as-bad-as-we-once-thought
#3
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
#4
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...
November 10, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27873747/atypical-presentation-of-appendicitis
#5
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
#6
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...
November 15, 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
#7
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
#8
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
https://www.readbyqxmd.com/read/27847377/underestimated-amoebic-appendicitis-among-hiv-1-infected-individuals-in-japan
#9
Taiichiro Kobayashi, Koji Watanabe, Hideaki Yano, Yukinori Murata, Toru Igari, Kumiko Nakada-Tsukui, Kenji Yagita, Tomoyoshi Nozaki, Mitsuo Kaku, Kunihisa Tsukada, Hiroyuki Gatanaga, Yoshimi Kikuchi, Shinichi Oka
Entamoeba histolytica is not a common causative agent of acute appendicitis. However, amoebic appendicitis could sometimes be severe and life-threatening, mainly due to lack of awareness. Also, its frequency, clinical features and pathogenesis remain unclear. The study subjects were HIV-1-infected individuals who presented with acute appendicitis and later underwent appendectomy at our hospital between 1996 and 2014. Formalin-fixed paraffin-embedded preserved appendix specimens were re-examined by Periodic acid-Schiff (PAS) staining and PCR to identify undiagnosed amoebic appendicitis...
November 9, 2016: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/27797677/diagnostic-performance-of-us-for-differentiating-perforated-from-nonperforated-pediatric-appendicitis-a-prospective-cohort-study
#10
Jennifer L Carpenter, Robert C Orth, Wei Zhang, Monica E Lopez, Kate L Mangona, R Paul Guillerman
Purpose To prospectively evaluate the diagnostic performance of ultrasonography (US) for differentiating perforated from nonperforated pediatric appendicitis and to investigate the association between specific US findings and perforation. Materials and Methods This HIPAA-compliant study had institutional review board approval, and the need for informed consent was waived. All abdominal US studies performed for suspected pediatric appendicitis at one institution from July 1, 2013, to July 9, 2014, were examined prospectively...
October 31, 2016: Radiology
https://www.readbyqxmd.com/read/27784975/limited-local-extracolonic-spread-of-mucinous-appendiceal-adenocarcinoma-after-perforation-with-formation-of-a-malignant-appendix-to-sigmoid-fistula-case-report-and-literature-review
#11
Seifeldin Hakim, Mitual Amin, Mitchell S Cappell
A 68-year-old man presented with progressive right lower quadrant abdominal pain and tenderness without rebound tenderness, and with constipation during the prior 9 mo. Abdomino-pelvic computed tomography and magnetic resonance imaging demonstrated a dilated appendix forming a fistula to the sigmoid colon. Open laparotomy revealed a bulky abdominal tumor involving appendix, cecum, and sigmoid, and extending up to adjacent viscera, without ascites or peritoneal implants. The abdominal mass was removed en bloc, including resection of sigmoid colon, cecum (with preservation of ileocecal valve), appendix, right vas deferens, testicular vessels, and minimal amounts of anterior abdominal wall; and shaving off of small parts of the walls of the urinary bladder and small bowel...
October 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27761185/fishbone-perforated-appendicitis
#12
Joey Chan Yiing Beh, Anandswaroop Srinivas Uppaluri, Beatrice Fang Ju Koh, Peng-Chung Cheow
Ingested foreign bodies tend to pass through the gastrointestinal tract without incidence, and vast majority of cases do not need intervention. Rarely, these foreign bodies drop into the appendix and not likely to re-enter the normal digestive tract. We describe a case of a 72-year-old male patient who presented with right iliac fossa pain of 3-day duration. Clinical examination suggested classic acute appendicitis. Blood test results revealed leukocytosis. Computed tomography of the abdomen and pelvis showed evidence of acute appendicitis and a linear hyperdensity (foreign body) perforating the appendix...
July 2016: Journal of Radiology Case Reports
https://www.readbyqxmd.com/read/27743898/could-an-abdominal-drainage-be-avoided-in-complicated-acute-appendicitis-lessons-learned-after-1300-laparoscopic-appendectomies
#13
Francisco Schlottmann, Romina Reino, Emmanuel E Sadava, Ana Campos Arbulú, Nicolás A Rotholtz
INTRODUCTION: Complicated appendicitis (CA) may be a risk factor for postoperative intra-abdominal abscess formation (IAA). In addition, several publications have shown an increased risk of postoperative collection after laparoscopic appendectomy. Most surgeons prefer to place a drain to collect contaminated abdominal fluid to prevent consequent abscess formation. We aimed to evaluate the utility of placing an intra-abdominal drain in laparoscopic appendectomy for complicated acute appendicitis...
October 12, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27721929/barium-appendicitis-a-single-institution-review-in-japan
#14
Hideki Katagiri, Alan Kawarai Lefor, Tadao Kubota, Ken Mizokami
AIM: To review clinical experience with barium appendicitis at a single institution. METHODS: A retrospective review of patients admitted with a diagnosis of acute appendicitis, from January 1, 2013 to December 31, 2015 was performed. Age, gender, computed tomography (CT) scan findings if available, past history of barium studies, pathology, and the presence of perforation or the development of complications were reviewed. If the CT scan revealed high density material in the appendix, the maximum CT scan radiodensity of the material is measured in Hounsfield units (HU)...
September 27, 2016: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27717707/evaluation-of-procedural-simulation-as-a-training-and-assessment-tool-in-general-surgery-simulating-a-laparoscopic-appendectomy
#15
Flemming Bjerrum, Jeanett Strandbygaard, Susanne Rosthøj, Teodor Grantcharov, Bent Ottesen, Jette Led Sorensen
BACKGROUND: Laparoscopic appendectomy is a commonly performed surgical procedure, but few training models have been described for it. We examined a virtual reality module for practising a laparoscopic appendectomy. METHODS: A prospective cohort study with the following 3 groups of surgeons (n = 45): novices (0 procedures), intermediates (10-50 procedures), and experienced (>100 procedures). After being introduced to the simulator and 1 familiarization attempt on the procedural module, the participants practiced the module 20 times...
October 4, 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27708690/validity-of-predictive-factors-of-acute-complicated-appendicitis
#16
Yuki Imaoka, Toshiyuki Itamoto, Yuji Takakura, Takahisa Suzuki, Satoshi Ikeda, Takashi Urushihara
BACKGROUND: Our previous retrospective study revealed the three preoperative predictors of complicated appendicitis (perforated or gangrenous appendicitis), which are body temperature ≥37.4 °C, C-reactive protein ≥4.7 mg/dl, and fluid collection surrounding the appendix on computed tomography. We reported here an additional prospective study to verify our ability to predict complicated appendicitis using the three preoperative predictors and thus facilitate better informed decisions regarding emergency surgery during night or holiday shifts...
2016: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/27658707/amyand-s-hernia-with-appendicitis-masquerading-as-fournier-s-gangrene-a-case-report-and-review-of-the-literature
#17
Kishore Rajaguru, Daniel Tan Ee Lee
BACKGROUND: The incarceration of an appendix within an inguinal hernia sac is known as Amyand's hernia. Appendicitis in Amyand's hernia accounts for 0.1 % of the cases. An aggressive necrotizing infection of the genitalia and perineum, called Fournier's gangrene, can rapidly progress to sepsis and death. We describe a rare case of Fournier's gangrene complicating Amyand's inguinal hernia which has rarely been reported in the literature. CASE PRESENTATION: This case report describes the presentation and management of a 47-year-old Chinese man who presented with pus discharge from his right inguinoscrotal region and lower abdominal pain with clinical signs of Fournier's gangrene...
September 22, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27613729/evaluation-of-the-microbiome-in-children-s-appendicitis
#18
Martin Salö, Nittaya Marungruang, Bodil Roth, Tiia Sundberg, Pernilla Stenström, Einar Arnbjörnsson, Frida Fåk, Bodil Ohlsson
BACKGROUND/AIM: The role of the microbiome has been widely discussed in the etiology of appendicitis. The primary aim was to evaluate the microbiome in the normal appendix and in appendicitis specifically divided into the three clinically and histopathologically defined grades of inflammation. Secondary aims were to examine whether there were any microbiome differences between proximal and distal appendices, and relate the microbiome with histopathological findings. METHODS: A prospective pilot study was conducted of children undergoing appendectomy for appendicitis...
September 9, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27612947/the-evolving-management-of-the-appendix-mass-in-the-era-of-laparoscopy-and-interventional-radiology
#19
James Forsyth, Konstantinos Lasithiotakis, Mark Peter
AIM: An appendix mass is the result of a walled-off perforation of the appendix which localises, resulting in a mass and it is encountered in up to 7% of patients presenting with acute appendicitis. However, its management is controversial due to the lack of high level evidence. This review article sets out a rationale diagnostic and therapeutic strategy for the appendix mass based upon up-to-date available evidence. METHODS: A literature review of the investigation and management of appendix mass/complicated appendicitis was undertaken using PubMed, EMBASE and Google Scholar...
September 6, 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27535664/mortality-related-to-appendectomy-a-population-based-analysis-over-two-decades-in-finland
#20
Sannamari Kotaluoto, Mika Ukkonen, Satu-Liisa Pauniaho, Mika Helminen, Juhani Sand, Tuomo Rantanen
OBJECT: To define the mortality rate of appendectomy patients and appendectomy-related risk factors. BACKGROUND: Appendectomy has been considered as a safe operation and negative appendectomies acceptable in order to avoid perforations. There are few publications on appendectomy-related mortality. Removal of a normal appendix has been suggested to be related to a higher mortality rate versus removal of an inflamed appendix. METHODS: Data on all appendectomy patients between 1990 and 2010 in Finland were retrieved from the Discharge Register of the National Institute for Health and Welfare and combined with data from the Death Certificate Register of Statistics Finland...
August 17, 2016: World Journal of Surgery
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