scholarly journals SARS-CoV-2 identification in an acute appendicitis case: Acute abdomen as manifestation of Multisystem Inflammatory Syndrome in a child with COVID-19

Author(s):  
Amanda Munhoz Serra ◽  
Andréa Maria Cordeiro Ventura ◽  
Lucas Freitas Xavier ◽  
Angélica Braz Simões ◽  
Amaro Nunes Duarte-Neto
Author(s):  
LORAINE ENTRINGER FALQUETO ◽  
CAROLINA MARTINS VISSOCI ◽  
ISABELLA CRISTINA BONETTO FERREIRA ◽  
AMANDA GINANI ANTUNES ◽  
FERNANDO ANTÔNIO BERSANI AMADO ◽  
...  

ABSTRACT Introduction: the new coronavirus pandemic has been a reality throughout 2020, and it has brought great challenges. The virus predominantly manifests in the pediatric population with mild symptoms. However, an increase in the incidence of Multisystemic Inflammatory Syndrome in Children (MIS-C) associated with COVID-19 has been described in the literature. MIS-C manifests mainly with fever and gastrointestinal symptoms and may mimic acute abdomen due to acute appendicitis. The objective of this study is to propose a care flowchart for suspected cases of acute appendicitis in the initial phase in pandemic times, considering the possibility of MIS-C. This situation was brought up by a patient treated in a pediatric hospital in Brazil. Discussion: It was possible to identify common signs and symptoms in the reported patient and those published cases that may serve as alerts for early identification of MIS-C cases. Based on the literature review and on the similarities between the syndrome and the inflammatory acute abdomen in children, we elaborated an initial approach for these cases to facilitate the identification, early diagnosis, and management. The flowchart considers details of the clinical history, physical examination, and complementary exams prior to the indication of appendectomy in patients with initial phase symptoms. Conclusion: MIS-C, although rare and of poorly known pathophysiology, is most often severe and has a high mortality risk. The use of the proposed flowchart can help in the diagnosis and early treatment of MIS-C.


2008 ◽  
Vol 2 (2) ◽  
pp. 165
Author(s):  
Ana Lucia De Faria ◽  
Silvana Novaes ◽  
Monica Silva Gonçalves ◽  
Regina Celia C Peres

ABSTRACTAcute abdomen refers to a not traumatic disorder located in the bowels of the abdominal cavity and classifies itself in five syndromes named, inflammatory perforating, obstructive, hemorrhagic and vascular. The signs and symptoms are: abdominal pain that is installed of quick and sudden form, vomiting, fever, interruption of the elimination of gases and evacuation. The aim was identify the syndromes and the causes of surgeries resulting on acute abdomen in patients interned and submitted to a surgical intervention in a General Hospital of the Taubaté - SP. The research was the type retrospective, documentary, descriptive and quantitative, in the period 2004 to 2006. The results showed that the 91 (100%) cases studied prevailing male in the 55 (60,44%); the surgery occurred more in the age group of 40-49 years in 16 (17,58%); among the signs and symptoms abdominal pain was present in (100%) and vomiting in 41 (29,50%); due to the higher incidence of surgery was acute appendicitis with 45 (49,45%); the predominant syndrome was the inflammatory in 49 (53,85%), but perforating appeared in 23 (25,27%) to be obstructive in 18 (19,78%), vascular in 1 (1,10%) of the cases; the most frequent cause of death was septic shock in 10 (38,46%); the mortality prevailed in the age group between 80 to 89 years old with 5 (45,46%), with perforating syndrome in 6 (54,55%). It is concluded that the inflammatory syndrome and the cause appendicitis were the most frequent. Descriptors: acute abdomen; surgery; mortality.RESUMOAbdome agudo refere-se a uma afecção não traumática, localizada nas vísceras da cavidade abdominal, e classifica-se em cinco síndromes, nomeadas de: inflamatória, perfurativa, obstrutiva, hemorrágica e vascular. Os sinais e sintomas são: dor abdominal que se instala de forma súbita e rápida, vômito, febre, interrupção da eliminação de gases e fezes. O objetivo da pesquisa foi identificar as síndromes e as causas de cirurgias decorrentes do quadro de abdome agudo em pacientes internados e submetidos a uma intervenção cirúrgica em um Hospital Geral de Taubaté - SP. A pesquisa foi do tipo retrospectiva, documental, descritiva e quantitativa, no período de 2004 a 2006. Os resultados mostraram que, dos 91 (100%) casos estudados, o sexo masculino predominou em 55 (60,44%); as cirurgias ocorreram mais na faixa etária de 40-49 anos de idade, em 16 (17,58%); dentre os sinais e sintomas, a dor abdominal esteve presente em 100%, e o vômito, em 41 (29,50%); a causa cirúrgica de maior incidência foi a apendicite aguda, em 45 (49,45%); a síndrome predominante foi a inflamatória, em 49 (53,85%), a perfurativa apareceu em 23 (25.27%), a obstrutiva em 18 (19,78%),e a vascular, em 1 (1,10 %) dos casos; a causa de morte mais frequente foi o choque séptico, em 10 (38,46%); a mortalidade prevaleceu na faixa etária entre 80 e 89 anos de idade, em 5 (45,46%), com síndrome perfurativa em 6 (54,55%). Concluiu-se que a síndrome inflamatória foi predominante e que a apendicite foi a causa mais freqüente de cirurgia. Descritores: abdome agudo; cirurgia; mortalidade.RESUMENAbdomen agudo se refiere a un trastorno no traumático que se  encuentra en las vísceras de la cavidad abdominal y se clasifica en cinco síndromes nombrados de inflamatorio, perforativa, obstructiva, hemorrágica y vasculares. Las señales y síntomas son: dolor abdominal que se instalan de forma repentina y rápida, vómitos, fiebre, interrupción en la eliminación de gases y heces. El objetivo era determinar los síndromes y las causas de cirugías derivadas del cuadro de abdomen agudo en pacientes hospitalizados y sometidos a un procedimiento quirúrgico en el Hospital General del Taubate - SP. La investigación es del tipo retrospectivo, documental, descriptivo y cuantitativo, en el período de 2004 a 2006. Los resultados mostraron que de los 91 (100%) casos estudiados predominó el sexo masculino en 55 (60,44%); La cirugía ocurrieron en más frecuencia en el grupo de edad de 40 -49 años en 16 (17,58%); entre las señales y síntomas el dolor  abdominal estuvo presente en el (100%) y los vómitos en 41 (29,50%) la causa de cirugía de mayor incidencia fue apendicitis aguda con 45 (49,45%); El síndrome predominante  fue la inflamatoria en 49 (53, 85% ), Pero  perforativa apareció en 23 (25,27%), la obstructiva en 18 (19,78%), vasculares en 1 (1,10%) de los casos; la causa más frecuente de muerte fue el  choque séptico, 10 (38,46%); Prevaleció la mortalidad en el grupo de edad entre 80 a 89 años con 5 (45,46%), con síndrome  perforativa en 6 (54,55%). Se concluye que la síndrome inflamatoria y la causa apendicitis fueron las más frecuentes. Descriptores: abdomen agudo; cirurgía; mortalidad. 


2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Yu-Ting Wang ◽  
Yi-Ru Li ◽  
Tuan-Ying Ke

Adenocarcinoma ex goblet cell carcinoid is a rare tumor incidentally found in specimens of appendicitis. Most patients present with acute abdomen, similar to acute appendicitis. Here we present two cases, which were found incidentally after operation. We give a brief summary about clinical and biological behavior of this entity.


Author(s):  
Aydin Hakan Kupeli ◽  
Murat Ozdemir ◽  
Sezgin Topuz ◽  
Alper Sozutek ◽  
Tugba Paksoy

Author(s):  
Riccardo Guanà ◽  
Camilla Pagliara ◽  
Angelo Giovanni Delmonaco ◽  
Federico Scottoni ◽  
Roberto Bordese ◽  
...  

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Selahattin Koray Okur ◽  
Yavuz Savaş Koca ◽  
İhsan Yıldız ◽  
İbrahim Barut

Introduction. Acute appendicitis is the most common cause of acute abdomen, but atypical appendicitis may lead to delayed diagnosis and related complications. In this report, we present a very rare case of acute appendicitis causing right hydronephrosis.Case Report. A 54-year-old male patient who had been receiving antibiotic therapy due to the diagnosis of urinary tract infection for the last one week but had no clinical improvement was admitted to the emergency service. Abdominal computed tomography (CT) showed right hydronephrosis and a pelvic abscess. After appendectomy and abscess drainage had been performed, hydronephrosis was completely recovered.Discussion. The use of appendicitis scoring systems, abdominal ultrasonography (USG), abdominal CT, and diagnostic laparoscopy can be useful for the diagnostic process in patients presenting with acute abdomen. In our patient, we considered that the surgical treatment was delayed since the symptoms of acute appendicitis were suppressed by the antibiotic therapy that was being administered due to the complaints including symptoms of urinary tract infections.Conclusion. Atypical appendicitis may cause a delay in the diagnosis of acute appendicitis and thus may lead to serious complications such as right hydronephrosis, prolonged hospital stay, increased morbidity and mortality, and increased antibiotic resistance.


2019 ◽  
Vol 6 (5) ◽  
pp. 1710
Author(s):  
M. Srujan Kumar ◽  
Bharath B. ◽  
K. S. Balasubramanya ◽  
K. Thinagaran

Background: Acute abdomen poses a big challenge to the general surgeons in terms of both diagnosis and management. The aim of this study was to know in detail the clinical and postoperative outcome in non traumatic acute abdomen.Methods: Prospectively collected data of 326 patients with non traumatic acute abdomen admitted in PES institute of medical sciences and research, Kuppam from November 2016 to June 2018. All patients were subjected to clinical examination, relevant blood and imaging investigations, Intra and postoperative findings events were recorded.Results: Non traumatic acute abdominal pain was more common in 2nd to 5th decade of life. Males are more affected than females with a male to female ratio of 3.4:1. Acute appendicitis forms the commonest cause of acute abdomen (n=160=49%) followed by perforative peritonitis (n=85=26%). Most common surgical procedures done were laparoscopic/open appendectomy for acute appendicitis, exploratory laparotomy with Graham’s omentoplasty for perforative peritonitis.Conclusions: Systematic approach in history taking and a proper clinical examination with supportive imaging findings are most important in making an accurate diagnosis and need of appropriate surgical intervention in patients with non traumatic acute abdomen.


Author(s):  
Emrah Gün ◽  
Tanıl Kendirli ◽  
Edin Botan ◽  
Berrin Demir ◽  
Ergun Ergün ◽  
...  

Abstract Objective Multisystemic inflammatory syndrome in children (MIS-C) is characterized by persistent fever, systemic hyperinflammation, and multiple-organ dysfunction. There are a few reports about MIS-C presenting with acute abdomen. The aim of this study is to demonstrate the clinical characteristics and treatment options for MIS-C-related acute abdomen and appendicitis. Methods This was a retrospective study conducted between April 2020 and October 2020 in our pediatric intensive care unit in Turkey. Patients between the ages of 1 month and 18 years who presented with acute abdomen and were ultimately diagnosed with MIS-C were included. Results Seven patients with a median age of 12.5 (interquartile range 10.5–13) years were enrolled. Four were females. The most frequent symptoms were fever, abdominal pain, and vomiting. Three patients had involvement of the appendix that required surgical intervention. All pathology reports were compatible with appendicitis. The other patients also had an acute abdomen. One patient had malignant hyperthermia during induction of anesthesia, so surgery was postponed and medical management was commenced. The clinical picture regressed with immunomodulation. All patients were treated with intravenous immunoglobulin and steroids. Four patients with acute abdomens improved with immunomodulation, and surgery was not needed. Conclusion MIS-C may present with an acute abdomen. Immunomodulation should be considered instead of surgery if the clinical course is not complicated.


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