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Perforated Appendix

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
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
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
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
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
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...
2016: Journal of Medical Case Reports
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
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
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
Cheryl K Zogg, John W Scott, Wei Jiang, Lindsey L Wolf, Adil H Haider
BACKGROUND: Differences in perforated appendix admission rates (PAAR) are an ambulatory-sensitive measure of access to care. While pediatric studies report disparities in PAAR, initial adult investigations suggest a lack of racial/ethnic inequity. The objectives of this study were to (1) assess for risk-adjusted, racial/ethnic differences in PAAR among adults on a national scale, (2) consider the extent to which variations (or lack thereof) are explained by age, insurance, and income, and (3) compare results within the United States population to a national segment of the population who are completely insured...
July 30, 2016: Surgery
Cornelis G Vos, Robbert Mollema, Milan C Richir
We present a case of a 78-year-old female patient with an uncommon presentation of acute appendicitis. She was found to have a perforated appendicitis which developed in a femoral hernia sack. An appendix present in a femoral hernia is called a De Garengeot Hernia, which is a rare form of femoral hernia. Clinical presentation, diagnosis and management are discussed.
August 1, 2016: Acta Chirurgica Belgica
Harold Jacob, Takashi Toyonaga, Yoshiko Ohara, Eiji Tsubouchi, Hiroshi Takihara, Shinichi Baba, Tetsuya Yoshizaki, Fumiaki Kawara, Shinwa Tanaka, Tsukasa Ishida, Namiko Hoshi, Yoshinori Morita, Eiji Umegaki, Takeshi Azuma
BACKGROUND AND STUDY AIMS: Endoscopic submucosal dissection (ESD) is performed for treatment of various gastrointestinal lesions; however, the cecum in proximity to the appendiceal orifice remains a challenging area. We reviewed our experience with cecal ESD near the appendiceal orifice in order to clarify whether this procedure is a safe and effective therapeutic option. PATIENTS AND METHODS: We retrospectively reviewed ESD for lesions within approximately 12 mm of the appendiceal orifice at Kobe University Hospital and an affiliated hospital between January 2003 and December 2014...
September 2016: Endoscopy
Ana Bosak Versic, Nedeljka Glavan, Nado Bukvic, Zlatko Tomasic, Harry Nikolic
BACKGROUND: Acute appendicitis is the most common abdominal surgical emergency in children, and appendectomy is the most frequent acute abdominal operation. Prompt diagnosis and surgical treatment are required to reduce the risk of perforation and prevent complications, especially in small children. Enterochromaffin cells that contain large amounts of serotonin are mostly located in the distal appendix. Serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) could therefore be a marker for acute appendicitis...
July 27, 2016: Emergency Medicine Journal: EMJ
Turgut Donmez, Oguzhan Sunamak, Sina Ferahman, Server Sezgin Uludag, Dogan Yildirim, Adnan Hut
INTRODUCTION: The two-port laparoscopic appendectomy technique (TPLA) lays between the conventional three-port trocar procedure and single-port laparoscopic appendectomy surgery. During TPLA, the appendix is suspended with stitches, resulting in perforation risk and difficulty in exploration. AIM: We used a needle grasper in TPLA to hang and manipulate the appendix. MATERIAL AND METHODS: Thirty-four patients (10 female, 24 male) who underwent TPLA between February 2015 and November 2015 were analyzed retrospectively for patient demographics, duration of operation, laparotomy or conventional laparoscopy necessity, drain use, complications, and hospital stay periods...
2016: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Samantha Mc Kenzie Stancu, Bogdan Aurelian Popescu, Mircea Beuran
Meckel's Diverticulum is the most common congenital malformation of the gastrointestinal tract with a prevalence of 2 % in the general population, being twice as common and symptomatic in males. Not seldom is the diagnosis made incidentally, upon laparotomy for other intra-abdominal conditions, namely acute appendicitis. Simple Diverticulectomy is the surgical treatment of choice. We present the case of S.M., a 38 year-old male who was admitted to the Surgery Department of the Bucharest Clinical Emergency Hospital for sudden onset of initially periumbilical pain, which later migrated and localized in the right iliac fossa (RIF) accompanied by vomiting after the onset of pain, approximately 24 hours prior to admission...
May 2016: Chirurgia
Kenichi Ogata, Hiroshi Takamori, Naoki Umezaki, Taisuke Yagi, Katsuhiro Ogawa, Nobuyuki Ozaki, Hiromitsu Hayashi, Hideyuki Tanaka, Yoshiaki Ikuta, Koichi Doi
Although common side effects of regorafenib include hand-and-foot syndrome and diarrhoea, the incidence of gastrointestinal perforation is reportedly unknown. We describe our experience with the case of a 65-year-old woman treated with regorafenib as a third-line therapy for progressive caecal cancer with multiple hepatic metastases after 4 and 6 courses of systemic mFOLFOX6 + bevacizumab (BV) and FOLFIRI + BV chemotherapy, respectively. The patient used regorafenib for 32 days but visited our hospital with abdominal pain during the second course...
July 20, 2016: Journal of Chemotherapy
Candaş Erçetin, Ahmet Cem Dural, Yaşar Özdenkaya, Özlem Dural, Huriye Gözde Muhafız Dada, Gülçin Yeğen, Yersu Kapran, Yeşim Erbil
We report a 32-year-old patient who underwent laparoscopy with classical symptoms and signs of acute appendicitis. An inflamed, edematous and non-perforated appendix, also a large amount gelatinous ascites, omental and peritoneal implants were seen. Appendectomy was performed and multiple biopsies were taken from omentum and peritoneum for definitive diagnosis. Histopathologic diagnosis was a metastatic gastric signet-ring cell carcinoma (GSRCC) involving appendix and other specimens. A flat lesion involving corpus to antrum was diagnosed by gastroscopy and GSRCC was verified histopathologically in a tertiary centre and the case evaluated as stage IV gastric carcinoma...
2016: Ulusal Cerrahi Dergisi
Serap Pamak Bulut, Neslihan Cabıoğlu, Muzaffer Akıncı
Appendix vermiformis duplex is an infrequent malformation. However if it is missed out, there might be some complications and medicolegal troubles. A surgeon must be aware of any other appendix during appendectomy. Therefore, the possible locations and shapes described in the Cave-Wallbridge classification should be considered by the surgeon. In this case report, we present a patient with a horseshoe-type dupplication of appendix in a perforated appendicitis diagnosed during an emergency laparotomy.
2016: Ulusal Cerrahi Dergisi
Yalçın Sönmez, Zülfü Bayhan, Faik Yaylak, Mehmet Fatih Ekici, Ayşe Nur Değer
Appendiceal malignancies are rare clinic entities. The clinical presentation of appendiceal malignancies is often atypical. Acute abdominal pain and acute appendicitis, which requires early surgical intervention, are the most common clinical presentations of appendiceal malignancies. In this case report, an adenocarcinoma of the appendix in a 64-year-old male from a nursing home has been presented. He had right lower quadrant pain for the last 5 days. On physical examination, he had significant guarding. Intravenous contrast-enhanced abdominopelvic tomography revealed no pathological features...
2016: Ulusal Cerrahi Dergisi
Katarzyna Zbierska, Jakub Kenig, Anna Lasek, Mateusz Rubinkiewicz, Piotr Wałęga
UNLABELLED: Acute appendicitis (AA) still remains the most common acute surgical abdominal emergency. Although 90% of cases occur in children and young adults, the incidence in the elderly amounts up to 10% and is constantly rising. The aim of the study was to assess the differences between clinical presentation in the elderly patients with AA compared to the younger patients. Additional aim was to assess the correlation between in-hospital time delays and patients' outcomes. MATERIAL AND METHODS: We conducted a retrospective analysis of medical data of 274 patients admitted to 3rd Department of General Surgery in Cracow between January 2011 and December 2013 due to AA...
May 1, 2016: Polski Przeglad Chirurgiczny
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