appendicular phlegmon

The aetiology of acute appendicitis (AA), the most frequent abdominal surgical emergency, is still unclarified. Recent epidemiologic, clinical and laboratorial data point to an allergic component in the pathophysiology of AA. Mastocytes participate in the Th2 immune response, releasing inflammatory mediators from their granules upon stimulation by IgE-specific antigens. Among the well-known mediators are histamine, serotonin and tryptase, which are responsible for the clinical manifestations of allergies. We conducted a prospective single-centre study to measure histamine and serotonin (commercial ELISA kit) and tryptase (ImmunoCAP System) concentrations in appendicular lavage fluid (ALF) and serum...

Intestinal intussusception is a condition determined as the telescoping of one portion of the bowel loops into the approximate distal portion. Intestinal intussusception is a fairly rare condition in the adult population and almost always secondary to the underlying pathology; the most common leading causes of intussusception in adults are neoplasms, accounting for up to two-thirds of the causes. However, appendicular pathology is an extremely rare leading cause. The clinical picture of an adult patient with bowel intussusception (BI) is uncertain and nonspecific; it varies from vague abdominal pain to clinical presentation of complications, such as signs of bowel obstruction or bowel perforation...

Background: Amyand's hernia (AH) is a rare type of inguinal hernia, containing the appendix in the hernia sac irrespective of the presence of appendicitis. Appendiceal mucocele represents a dilation of the appendix with an accumulation of mucinous material and could be either a benign or a malignant process. Herein we report an exceptionally rare case of a perforated appendiceal mucocele within an AH. Case report: A 77-year-old male patient, underwent surgery for right incarcerated inguinoscrotal hernia. He was found to have a perforated, phlegmonous, and dilated appendix dislocated from the caecum, with peri-appendicular purulent content with fibrin deposits within the hernia sac...

Several pieces of evidence point to an allergic component as a trigger of acute appendicitis. As the Th2 immune response is characterized by eosinophil mobilization to the target organ and release of their cationic granule proteins, it is reasonable to investigate if the degranulation of eosinophils could be associated with the local injury. The primary aim of this study is to evaluate the participation of eosinophils granules proteins in acute appendicitis, both at local and systemic levels and the secondary aim is to evaluate the diagnostic accuracy of eosinophils granules proteins for the detection of acute appendicitis, as well as for distinguishing between complicated and uncomplicated acute appendicitis...

Appendicitis is the most common abdominal surgical emergency, but its aetiology is not fully understood. We and others have proposed that allergic responses play significant roles in its pathophysiology. Eosinophils and Interleukin (IL)-5 are involved in a hypersensitivity type I reaction. Eosinophil infiltration is common in the allergic target organ and is dependent on IL-5. In the presence of an allergic component, it is expected that the eosinophil count and IL-5 local and systemic concentrations become elevated...

Background Appendicitis is a common reason for hospitalization. Rarely do people with acute appendicitis have an appendiceal mass called an abscesses or inflamed phlegmon. The goal of this study was to determine the prevalence of different appendiceal tumors including neuroendocrine tumors, adenocarcinoma, carcinoid, and mucinous and evaluate patient demographic data (e.g., age and gender) at a major tertiary care center in Riyadh, Saudi Arabia. Materials and methods We conducted a cross-sectional analytical review of patient records of 1513 patients who received an appendectomy and were diagnosed with acute appendicitis from 2015 to 2020 at King Abdulaziz Medical City, Riyadh, Saudi Arabia...

Purpose: Bacteriological sample in the presence of intraabdominal free fluid is necessary to adapt the antibiotherapy and to prevent the development of resistance. The aim was to evaluate the differences between uncomplicated (UAA) and complicated acute appendicitis (CAA) in terms of bacterial culture results and antibiotic resistance, and to evaluate the factors linked with CAA. Methods: We performed a single-center, retrospective observational study of all consecutive patients who presented with appendicular peritonitis and underwent emergent surgery in a tertiary referral hospital in Brussels, Belgium, between January 2013 and December 2020...

BACKGROUND: A pseudoaneurysm of the splanchnic vessels is considered to be rare, and in particular, very few cases of pseudoaneurysm in the ileocolic artery are reported. Here, we report a case of rupture of a pseudoaneurysm of the appendicular branch of the ileocolic artery after laparoscopic appendectomy. CASE PRESENTATION: A 52-year-old man was diagnosed as having phlegmonous appendicitis, and an emergency laparoscopic appendectomy was performed. Bleeding from the inter-appendicular ligament during detachment of adhesions was stopped by white coagulation and Z-suture, and the inter-appendicular ligament was treated...

Background: IgE mediates type I hypersensitivity reaction and can be found in the mucosa of organs affected by allergy. Acute appendicitis (AA) is a common disease, but its etiology remains poorly understood. Here, we investigated IgE deposition in histological sections of AA samples to test the hypothesis that an allergic reaction may substantially contribute to the pathophysiology of AA. Materials and Methods: In a retrospective study, we assessed the presence of IgE in appendicular specimens of histologically confirmed appendicitis and in the control group, comprised of negative appendicitis and incidental appendectomies, using a monoclonal antibody against human IgE...

INTRODUCTION: Subhepatic appendix is most often due to an anomaly of rotation of the primary intestine occurring during embryogenesis. This ectopic topography associated with advanced age can be a serious diagnosis problem at the stage of appendicitis or appendicular peritonitis. CASE PRESENTATION: We report the case of a 60-year-old melanoderm man, with a history of urinary pathology and peptic ulcer, referred from a health district for abdominal pain of the right hypochondrium evolving for about 5 days, secondarily generalized, in whom we suspected peritonitis, the etiology of which remains to be determined...

OBJECTIVE: The safety and role of emergency (EA) versus interval appendicectomy (IA) for appendicular abscess and phlegmon remains debatable with no optimal strategy identified. The aim of this systematic review and meta-analysis is to evaluate outcomes of managing appendicular abscesses and phlegmon with emergency or interval appendicectomy. METHODS: We conducted a systematic search of electronic databases using key terms including 'appendicular abscess', 'appendicular phlegmon' and 'interval appendicectomy'...

Acute appendicitis is the most frequent surgical abdominal emergency, but its etiology remains poorly understood. Histological examination of the appendix, following its removal due to acute appendicitis, consistently shows features in common with bronchial asthma, suggesting an allergic reaction as a candidate etiologic factor. Here, we propose the concept of appendicular lavage and use it to study the levels of the Th2 cytokines IL-4, IL-5, and IL-9 in patients with a clinical diagnosis of acute appendicitis...

Aim: To assess the reliability of a standardized reporting system of acute appendicitis at low-dose 320-rows CT. Subjects and Methods: Retrospective analysis CT of 78 patients with pathologically proven acute appendicitis. The study was performed at a low-dose 320-rows CT. The image analysis was performed by 2 radiologists according to a standardized reporting system of acute appendicitis. Results: There was an excellent overall of the inter-observer agreement of both observers for the standardized reporting system of acute appendicitis ( K = 0...

BACKGROUND: No consensus exists among surgeons regarding the optimal treatment of complicated acute appendicitis in children (CAA). Existing studies present heterogeneity of data and only few studies analyzed free perforated appendicitis (FPA) separately from appendicular abscess (AAb) and appendicular phlegmon (AP). METHOD: Studies which have been judged eligible for this systematic review and consequent meta-analysis are those comparing non-operative management (NOM) with operative management (OM) in children with CAA...

AIM: To study the possibility of antibacterial therapy for acute appendicitis as an alternative to surgical treatment. MATERIAL AND METHODS: For the period 1985-2010 diagnostic laparoscopy was performed in 5548 patients with suspected acute appendicitis. Acute phlegmonous or gangrenous appendicitis was observed in 2275 (41.0%) patients who underwent laparoscopic appendectomy. Other acute diseases occurred in 2458 (44.3%) patients. Acute catarrhal appendicitis or secondary inflammation of the appendix were diagnosed in 815 (14...

PRINCIPLES: Optimal management of perforated appendicitis with perityphlitic phlegmon or abscess formation is controversial. The aim of the study was to assess the outcome after a two-step procedure to treat patients with perityphlitic abscess formation. METHODS: We retrospectively assessed prospectively collected data from a single-centre database that included adult patients who had appendicitis and perityphlitic abscess (>=3 cm) but no generalised peritonitis, and were treated in 2007-2015...

BACKGROUND: Unexpected inflammatory cecal masses of uncertain etiology, encountered in the emergency surgical departments can be indistinguishable, and appropriate operative management of these cases is a dilemma for the surgeons. METHODS: Over a 30-months period between January 2009 and June 2011, a series of 3032 patients who live in sub-urban underwent emergency surgery for clinical diagnosis of acute appendicitis and ileocecal resection or right hemicolectomy for inflammatory cecal mass were performed in 48 patients...

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The objective of this study was to analyze the clinical benefit of histopathologic analysis of appendectomy specimens from patients with an initial diagnosis of acute appendicitis. We retrospectively analyzed the demographic and histopathologic data of 1255 patients (712 males, 543 females; age range, 17-85 years) who underwent appendectomy to treat an initial diagnosis of acute appendicitis. Patients who underwent incidental appendectomy during other surgeries were excluded from the study. Histopathologic findings of the appendectomy specimens were used to confirm the initial diagnosis...

This was a prospective randomized controlled study designed to compare laparoscopic and open interval appendectomy and involved 100 patients of appendicular phlegmon. After initial conservative management, patients were divided into 2 groups of 50 each and interval appendectomy was performed by laparoscopy in one of the groups and by open method in the other. Mean operative time in open surgery was 33.9 minutes and that in laparoscopic surgery was 57.64 minutes (P < 0.05). Concomitant pathology was observed in 16% and 2% of patients in the laparoscopic and open groups, respectively...