Twisted "appendix epiploica" as extraordinary cause of discomfort at the right lower abdomen and rare differential diagnosis of acute appendicitis - a representative case

2017 ◽  
Vol 2 (0) ◽  
pp. 34
Author(s):  
Stefan Schäfer ◽  
Benjamin Garlipp ◽  
Cora Wex ◽  
Inken Häusler ◽  
Stephan Arndt ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Acute Appendicitis ◽  
Lower Abdomen ◽  
Representative Case ◽  
Rare Differential Diagnosis ◽  
The Right

scholarly journals Uncommon Differential Diagnosis of Acute Right-sided Abdominal Pain – Case Report

2019 ◽  
Vol 4 (1) ◽  
pp. 33-36
Author(s):  
Cédric Kwizera ◽  
Benedikt Wagner ◽  
Johannes B. Wagner ◽  
Călin Molnar
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Fragile X ◽  
Pleural Empyema ◽  
Blind Ending ◽  
Rare Differential Diagnosis ◽  
Mentally Impaired ◽  
The Right ◽  
Tract Infections

Abstract The appendix is a worm-like, blind-ending tube, with its base on the caecum and its tip in multiple locations. Against all odds, it plays a key role in the digestive immune system and appendectomy should therefore be cautiously considered and indicated. We report the case of a 45-year-old male with a known history of Fragile-X syndrome who presented to the emergency department with intense abdominal pain and was suspected of acute appendicitis, after a positive Dieulafoy’s triad was confirmed. The laparoscopic exploration showed no signs of inflammation of the appendix; nonetheless, its removal was carried out. Rising inflammatory laboratory parameters led to a focused identification of a pleural empyema due to a tooth inlay aspiration. Our objective is to emphasize the importance of a thorough anamnesis, even in cases of mentally impaired patients, as well as to highlight a rare differential diagnosis for appendicitis. Acute appendicitis is an emergency condition that requires a thorough assessment and appropriate therapy. Clinical examinations are important, but in this particular case, imaging methods had a much more important role in establishing the right treatment approach. Furthermore, the signs of acute appendicitis are mimicked by several medical conditions including respiratory tract infections.

APPENDECTOMY IN CHILDREN WITH ACUTE RHEUMATIC FEVER

PEDIATRICS ◽  
1969 ◽  
Vol 43 (4) ◽  
pp. 573-577
Author(s):  
Jer-Shoung Lin ◽  
Ramon Rodriguez-Torres
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
Laboratory Data ◽  
Initial Symptom ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
The Right

Clinical and laboratory data on five patients with appendectomy, later proved to have acute rheumatic fever, are presented in detail. The findings indicate that abdominal pain simulating acute appendicitis can be presented as the only initial symptom in acute rheumatic fever. Awareness and knowledge of the presence of clues-high fever, rapid sedimentation rate, prolonged P-R interval, and 4 plus C-reactive protein-usually help to make the differential diagnosis. However, if doubt remains, the right approach is to go ahead with surgery since these patients tolerate anesthesia and laparotomy very well.

scholarly journals Omental infarction in an obese 10-year-old boy

2011 ◽  
Vol 3 (3) ◽  
pp. 22 ◽  
Author(s):  
Katerina Kambouri ◽  
Stefanos Gardikis ◽  
Alexandra Giatromanolaki ◽  
Aggelos Tsalkidis ◽  
Efthimios Sivridis ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Preoperative Diagnosis ◽  
Acute Abdominal Pain ◽  
Accurate Diagnosis ◽  
Lower Abdomen ◽  
Omental Infarction ◽  
Appropriate Treatment ◽  
Low Incidence ◽  
The Right

Primary omental infarction (POI) has a low incidence worldwide, with most cases occurring in adults. This condition is rarely considered in the differential diagnosis of acute abdominal pain in childhood. Herein, we present a case of omental infarction in an obese 10-year-old boy who presented with acute abdominal pain in the right lower abdomen. The ultrasound (US) examination did not reveal the appendix but showed secondary signs suggesting acute appendicitis. The child was thus operated on under the preoperative diagnosis of acute appendicitis but the intraoperative finding was omental infarct. Since the omental infarct as etiology of acute abdominal pain is uncommon, we highlight some of the possible etiologies and emphasize the importance of accurate diagnosis and appropriate treatment of omental infarction.

scholarly journals A rare differential diagnosis of acute appendicitis: Appendiceal endometriosis

2012 ◽  
Vol 28 (3) ◽  
pp. 159-161
Author(s):  
Semra Dogan ◽  
Asiye Safak Bulut ◽  
Burcu Saygan Karamursel
Keyword(s):  
Differential Diagnosis ◽  
Acute Appendicitis ◽  
Rare Differential Diagnosis

scholarly journals Case Report. Appendiceal Recurrent Colic Due to Enterobius Vermicularis Infection in a 14-Year-Old Female Patient

2016 ◽  
Vol 9 (2) ◽  
pp. 159-162
Author(s):  
Toni I. Stoyanov ◽  
Emilio Corral-Fernadez ◽  
Antonio Melero-Abellan ◽  
Pablo Sarduy-Fernandez ◽  
Paloma Casado-Santamaria ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Young Female ◽  
Lower Abdomen ◽  
Enterobius Vermicularis ◽  
Laboratory Findings ◽  
Rebound Tenderness ◽  
Radiologic Findings ◽  
The Right ◽  
Oral Doses

Summary Acute appendicitis due to Enterobius vermicularis, usually known as pinworm, is very rare and affects mostly children.According to different authors, it is controversial whether pinworms cause inflammation of the appendix or appendiceal colic only.We presentacase ofa14-year-old female with three subsequent hospitalizations in 1 month due to abdominal pain in the right lower abdomen, with rebound tenderness, normal CTscan and laboratory findings. During the last hospitalization, laparoscopic appendectomy was performed. Intraoperatively multiple pinworms were found in the appendix. These were trapped byastercolith in the appendicular base inanoninflamed and histologically normal appendix. Two oral doses of mebendazole were administered postoperatively. Uneventful postoperative period and postoperative follow-up showed lack of symptoms six months after the operation. Despite the widespread idea that acute appendicitis due to Enterobius vermicularis is very rare, it should always be considered in young female patients with repeated abdominal pain in the right lower abdomen with normal laboratory and radiologic findings.

Acute renal artery aneurysm rupture – a rare differential diagnosis of acute appendicitis

2011 ◽  
Vol 161 (17-18) ◽  
pp. 445-447 ◽  
Author(s):  
Thomas von Ahnen ◽  
Martin von Ahnen ◽  
Markus Landinger ◽  
Stefan K. Schopf ◽  
Hans Martin Schardey ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Acute Appendicitis ◽  
Renal Artery ◽  
Artery Aneurysm ◽  
Aneurysm Rupture ◽  
Renal Artery Aneurysm ◽  
Rare Differential Diagnosis

Acute Appendicitis Remains a Great Mimicker – The Pitfalls in the Differential Diagnosis and Tactics - A Case Report

2020 ◽  
Vol 13 (1) ◽  
pp. 54-58
Author(s):  
Georgi I. Popivanov ◽  
Marina N. Konaktchieva ◽  
Vladimir V. Vasilev ◽  
Kirien Ts. Kjossev ◽  
Marin B. Penkov ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Acute Appendicitis ◽  
Neuroendocrine Tumour ◽  
Iliac Fossa ◽  
Femoral Vein ◽  
Vascular Complications ◽  
Final Diagnosis ◽  
Linear Stapler ◽  
Chronic Appendicitis ◽  
The Right

Summary Acute appendicitis (AA) is the most common non-traumatic abdominal emergency. Despite the improved knowledge, experience, and technological advance, its diagnosis remains a challenge. Herein we report an example of a difficult diagnosis of acute appendicitis and comment on the possible pitfalls in the differential diagnosis and surgical tactics. We present the case of a 41-year-old man who had been admitted to another hospital with an initial diagnosis of acute appendicitis and changed to Crohn’s disease (CD). Because of a pelvic abscess, percutaneous drainage had been performed. Thrombosis of the right femoral vein had been diagnosed and treated accordingly. In an improved condition, he was referred for elective operation with a final diagnosis of neuroendocrine tumour based on cytology. At laparotomy, the appendix was found densely adherent to the right external iliac vein with a well-demarcated tumour (1 cm) at the base. Appendectomy with partial resection of the caecum with a linear stapler was performed. The histological examination revealed acute to chronic appendicitis with lymphoid follicle hyperplasia at the base. The case illustrates the necessity for broad differential diagnosis in AA and the possibility of severe vascular complications in complicated AA. Taking a detailed history and CT are of paramount importance for an accurate preoperative diagnosis, especially of CD. All emergency surgeons should also be familiar with the scenario of unexpected findings at laparotomy, especially with the management of CD and the algorithms for treatment of appendiceal malignancies. The mini-invasive drainage of right iliac fossa abscess allows for optimizing the patient’s condition and may help to avoid unnecessary extensive resections.

scholarly journals Perforated Acute Appendicitis in a Six-Day-Old Neonate: A Rare Differential Diagnosis of Neonatal Peritonitis

2021 ◽  
pp. 188-194
Author(s):  
Thanh Xuan Nguyen ◽  
Nhu Thanh Dang ◽  
Hai Thanh Phan ◽  
Nhu Hien Pham ◽  
Hoai Anh Vu
Keyword(s):  
Differential Diagnosis ◽  
Critical Care ◽  
Acute Appendicitis ◽  
Septal Defect ◽  
Pulmonary Atresia ◽  
Hemodynamic Instability ◽  
Term Infant ◽  
Rare Differential Diagnosis ◽  
Rare Diagnosis ◽  
Neonatal Peritonitis

Acute appendicitis is a rare diagnosis of acute abdomen in neonates which is associated with high mortality due to late diagnosis. Here, we presented a case of acute neonatal appendicitis in a 6-year-old full-term infant with Down syndrome and pulmonary atresia with ventricular septal defect. The patient underwent surgery and postoperative critical care. However, he died on postoperative day 5 due to worsening sepsis and decompensated hemodynamic instability.

scholarly journals A case of mucinous cystadenoma of appendix

2017 ◽  
Vol 4 (11) ◽  
pp. 3768
Author(s):  
Tharun Ganapathy C. ◽  
Shruthi Chandrasekar ◽  
Jeyakumar S.
Keyword(s):  
Chronic Pain ◽  
Acute Appendicitis ◽  
Mucinous Cystadenoma ◽  
Unusual Presentation ◽  
Histopathological Study ◽  
Lower Abdomen ◽  
Primary Tumors ◽  
The Right

Mucocoele of the appendix is the term used to describe an appendix dilated with mucous collections due to benign or malignant causes. Primary tumors of the appendix are rare. Many a time, a mucocoele of the appendix is reported through histopathological study of the appendix removed in a scenario of acute appendicitis. 25% of the patients with mucocoele of appendix are asymptomatic, however patients may present with acute appendicitis or other obstructive symptoms. Here we report an unusual presentation of mucocoele of appendix who presented with chronic pain and mass in the right lower abdomen.

scholarly journals Difficult cases of differential diagnosis of acute appendicitis

2021 ◽  
Vol 8 (3) ◽  
pp. 133-139
Author(s):  
L. A. Otdelnov ◽  
A. M. Mastukova
Keyword(s):  
Differential Diagnosis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Acute Appendicitis ◽  
Young Patient ◽  
Right Hemicolectomy ◽  
Greater Omentum ◽  
Intestinal Fistula ◽  
First Case ◽  
The Right

Despite the results of technological progress in medicine, which has made high-resolution methods of medical imaging available, the problem of differential diagnosis of acute appendicitis does not lose its’ relevance. This can be explained by the fact that the symptoms of acute appendicitis are variable, non-specific, and can mimic other diseases with similar symptoms.Three cases of rare diseases of the gastrointestinal tract that simulates acute appendicitis were presented. Those are primary torsion of the greater omentum with necrosis, caecum cancer with lengthy necrosis in a young patient and Crohn's disease that simulates appendicular infiltrate. All patients underwent surgery. Signs of acute appendicitis were indications for surgery. Laparoscopic resection of greater omentum was performed in the first case. In the second case caecum necrosis with peritonitis was revealed by laparoscopy. Conversion laparoscopy to laparotomy was performed. Caecum necrosis with caecum wall perforation and necrosis of terminal part of the ileum was diagnosed. right hemicolectomy with ileo-transverso anastomosis was carried out. Complicated case of Crohn’s disease was suspected. Nevertheless, the diagnosis of colorectal cancer is established by pathomorphology only. This case is interesting because of rare complication of colon cancer – the caecum and the ileum wall necrosis that was manifestation of the disease. In the third case of Crohn’s disease in a young patient the diagnosis of appendicular infiltrate and surgical policy were wrong. At the first laparotomy by McBurney was performed. A dense infiltrate was found in the right iliac fossa. The intervention was finished by local abdominal package. In the early postoperative period an intestinal fistula was formed. The patient underwent relaparotomy and right hemicolectomy with ileo-transversal anastomosis was carried out. Despite the diagnosis of Crohn's disease was questionable patomorphology and was established after half a year only by colonoscopy. The presented cases illustrate the complexity of acute appendicitis and the importance of modern approaches to diagnosis: irreplaceability of laparoscopy and the feasibility of using diagnostic scales. When the right diagnosis is not clear the intervention might be late for using methods of instrumental diagnostics.

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