scholarly journals TP10.2.13Outcome of Acute appendicitis management during COVID-19 pandemic in a tertiary hospital

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Su Kwan Lim
Keyword(s):  
Acute Appendicitis ◽  
Readmission Rate ◽  
Best Practice ◽  
Tertiary Hospital ◽  
Inclusion Criteria ◽  
Computed Tomography Scan ◽  
Intravenous Antibiotics ◽  
The Uk ◽  
Surgical Unit ◽  
Tomography Scan

Abstract Aim Coronavirus (COVID) has influenced the management of acute appendicitis. The Royal Colleges of Surgeons recommend best practice depending on local circumstances. The aim of this project is to assess the 30-day outcome of patients managed operatively and conservatively for acute appendicitis during the first wave of the pandemic in the UK. Method Patient data were collected prospectively at the end of March 2020, when Covid-19 became prevalent in the UK and lockdown started. Data was collected for patients admitted to the acute surgical unit for the admission dates of 20/03/2020 to 15/05/2020. At 30 days after admission, a search was done on the electronic clinical portal to check if the patient was readmitted for operation. The inclusion criteria are any patients above 16-year-old admitted through acute surgical unit with a clinical diagnosis of acute appendicitis or computed tomography scan findings of proven acute appendicitis. Result A total of 34 patients (median age, 33; range, 17-74) were identified from March 2020 to May 2020. All patients have covid-19 status as negative and were given intravenous antibiotics at point of admission. All patients received a course of seven-day of antibiotic. 17 patients underwent operation and 17 patients were managed conservatively. Only one patient who was treated conservatively for acute appendicitis, was re-admitted within 30 days of admission date. Discussion The readmission rate of patients treated conservatively for acute appendicitis after 30 days were low during the first wave of the pandemic.

scholarly journals Appendiceal diverticulitis presenting as acute appendicitis diagnosed postoperatively

2019 ◽  
Vol 2019 (12) ◽  
Author(s):  
Majid Z Albeeshi ◽  
Abdullah A Alwanyan ◽  
Alaa A Salim ◽  
Ibrahim T Albabtain
Keyword(s):  
Computed Tomography ◽  
Acute Appendicitis ◽  
Diverticular Disease ◽  
Laparoscopic Appendectomy ◽  
Rare Entity ◽  
Computed Tomography Scan ◽  
History Of ◽  
Appendiceal Diverticulitis ◽  
Tomography Scan

Abstract Appendiceal diverticular disease is a rare entity. We report a case of appendiceal diverticulitis mimicking acute appendicitis and diagnosed postoperatively on histopathology. A 28-year-old female presented with a 2-day history of shifting periumbilical pain associated with nausea and anorexia. A computed tomography scan of the abdomen demonstrated acute appendicitis. She was taken to laparoscopic appendectomy. Histopathology showed appendiceal diverticulitis, and perforation of an inflamed diverticulum with periappendicitis. Diverticulosis of the appendix is classified as congenital and acquired. Diagnosis can be made preoperatively by imaging. In this case, diverticulosis was not radiologically evident, and was interpreted as acute appendicitis. Gross appearance of the resected appendix was not suggestive of diverticulitis. Other cases reported that the gross specimen had evidence of diverticular disease. Surgeons should be aware that inflamed appendixes may harbor different pathologies warranting further management.

scholarly journals P.031 A Rare Canadian Case of Cervical Pyomyosistis Presenting as Occipital Neuralgia

2021 ◽  
Vol 48 (s3) ◽  
pp. S29-S29
Author(s):  
H Girgis ◽  
M Ziller
Keyword(s):  
Source Control ◽  
Review Of The Literature ◽  
Computed Tomography Scan ◽  
Tropical Regions ◽  
Lower Limb Muscles ◽  
Nuchal Rigidity ◽  
Intravenous Antibiotics ◽  
Local Destruction ◽  
Immunocompromised Hosts ◽  
Tomography Scan

Background: Pyomyositis is an infectious disease usually encountered in tropical regions. It typically occurs in immunocompromised hosts and most commonly affects lower limb muscles. Our patient was a healthy Canadian with an atypical presentation of cervical pyomyositis. Methods: We report a case of a healthy 22-year old woman presenting to the emergency department with unprovoked severe bilateral cervico-occipital pain and nuchal rigidity. She remained afebrile. Review of the literature was conducted to search for similar presentations. Results: A Computed Tomography scan of the head and neck demonstrated the presence of a ring enhancing lesion in the semispinalis capitis muscle extending from the occiput to the C4 level. The abscess was surgically drained and cultures grew staphylococcus aureus. The patient rapidly improved on intravenous antibiotics. Literature review revealed this to be the first Canadian case of cervical pyomyositis. Conclusions: Cervical pyomyositis can be complicated by local destruction of the vertebrae, septic shock, endocarditis, septic emboli, brain abscess or rhabdomyolysis. Early diagnosis and source control is necessary to reduce the risk of morbidity. Therefore, it is important to consider this rare disease in the differential diagnosis of cervicalgia even in healthy immunocompetent patients.

scholarly journals Role of Computed Tomography Scan in Non-Localized Headache in Tertiary Hospital of Mid Western Region of Nepal

2017 ◽  
Vol 13 (1) ◽  
pp. 2-4 ◽  
Author(s):  
Prasanna Ghimire ◽  
B. P. Singh ◽  
S. K. Chaturvedi
Keyword(s):  
Computed Tomography ◽  
Tertiary Hospital ◽  
Neurological Deficits ◽  
Computed Tomography Scan ◽  
Medical College ◽  
Health Related ◽  
History Of ◽  
Detailed Assessment ◽  
Age Range ◽  
Tomography Scan

Objective: To investigate the implication of a computed tomography scan for headache with non-localizing sign.Materials and methods: One hundred and thirty six patients with headache having non-localizing signs were included in this prospective study. Patients with age > 11 years, incomplete radiological or clinical data, recent/new onset headache, any immunosuppressive state, neurological deficits at the time of presentation, history of fever, trauma, any previous surgical intervention and any malignancy were excluded from the study.Results: Among the 136 patients, 73% were females and 27% were males with age range of 11- 76 years. Negative computed tomography scan was present in 91 (66.9 %) cases. Positive findings that significantly influenced the management were present in only 6 (4.4%) cases. Conclusion: Computed tomography in headache with non-localizing signs has a poor yield for a significant intracranial pathology. A careful and detailed assessment curtails the need for inadvertent imaging thus reducing the economic burden and health related hazards.Journal of Nepalgunj Medical College Vol.13(1) 2015: 2-4

scholarly journals The Best Strategy for Nasogastric Tube Removal in Patients with Acute Appendicitis Complicated with Ileus: A Case Report and Review.

2020 ◽  
Author(s):  
Yu-Ju Tseng ◽  
Pei-Yin Huang ◽  
Po-Chu Lee ◽  
Tzu-Hsin Lin ◽  
Rey-Heng Hu
Keyword(s):  
Acute Appendicitis ◽  
Nasogastric Tube ◽  
Lower Abdominal Pain ◽  
Computed Tomography Scan ◽  
Case Presentation ◽  
Nasogastric Tubes ◽  
Tube Removal ◽  
Common Causes ◽  
Periappendiceal Abscess ◽  
Tomography Scan

Abstract BackgroundAcute appendicitis is one of the most common causes of the acute abdomen. However, acute appendicitis complicated with ileus is uncommon. By presenting this case, we aim to give some suggestions on the postoperative care, especially an algorithm for the insertion and removal of nasogastric tube.Case presentation A 20-year-old man presenting with left lower abdominal pain and symptoms of ileus was diagnosed with acute appendicitis complicated with ileus by computed tomography scan. A nasogastric tube was inserted for the ileus preoperatively. He underwent laparoscopic appendectomy, during which periappendiceal abscess with local peritonitis was noted. The nasogastric tube was removed on the first postoperative day, but symptoms of ileus developed again. Urografin study revealed contrast media retaining in the small bowel, so nasogastric tube reinsertion was performed. The nasogastric tube was removed on the ninth postoperative day after the recovery from ileus. The patient was discharged on the thirteenth postoperative day.ConclusionPatients of acute appendicitis with ileus should be assessed carefully. Nasogastric tubes shouldn’t be removed until the following requirements are satisfied: Firstly, symptoms of abdominal distention and nausea relieve. Secondly, no more hypoactive bowel sounds are found. And finally, nasogastric tube drainage becomes less than 200mL per day, or the passage of flatus or stool presents.

scholarly journals Computed tomography scan usage when US results are non-diagnostic for suspected acute appendicitis in children

Medicine ◽  
2020 ◽  
Vol 99 (36) ◽  
pp. e21961
Author(s):  
Injoon Kim ◽  
Hyuksool Kwon ◽  
Yoo Jin Choi ◽  
Young Ho Kwak ◽  
Jin Hee Lee ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Appendicitis ◽  
Computed Tomography Scan ◽  
Suspected Acute Appendicitis ◽  
Tomography Scan

scholarly journals Pierce the ear and stab the spleen

2020 ◽  
Vol 14 (2) ◽  
pp. 95-99
Author(s):  
Thomas Matteazzi ◽  
Italo Balzani ◽  
Michele Alberghini ◽  
Federica Beretta ◽  
Claudia Bon ◽  
...  
Keyword(s):  
Splenic Abscess ◽  
Invasive Procedure ◽  
Computed Tomography Scan ◽  
Unique Case ◽  
Ear Piercing ◽  
Left Hypochondrium ◽  
Intravenous Antibiotics ◽  
Focus Of Infection ◽  
Dangerous Condition ◽  
Tomography Scan

Splenic abscess is a rare but extremely dangerous condition generally spreading from a local, or systemic, focus of infection. We present the case of a young immunocompetent female admitted with sepsis and multiple splenic abscesses. The patient had a recent left ear piercing on the tragus complicated by an ear infection. The presence of a solitary parotid abscess, the absence of other infectious foci on computed tomography scan, the negativity of blood cultures and the absence of endocarditis vegetations led us to think that the most likely culprit was a hematogenous dissemination from the left tragus. The patient was successfully treated with intravenous antibiotics. There had been no need of splenectomy or any other procedure. This rather unique case underscores that splenic abscess should be suspected when a long-lasting fever and pain in the left hypochondrium are present, even when an apparently innocuous invasive procedure, such as a body piercing, is performed.

scholarly journals Assessment of the Size of Sella Turcica among Nepalese Population by Computed Tomography

2019 ◽  
Vol 9 (2) ◽  
pp. 40-47
Author(s):  
Gourav Makaju ◽  
Birendra Raj Joshi ◽  
Ram Bahadur Chand
Keyword(s):  
Computed Tomography ◽  
Prospective Study ◽  
Sella Turcica ◽  
Tertiary Hospital ◽  
Age Group ◽  
Computed Tomography Scan ◽  
Age And Gender ◽  
Radiological Appearance ◽  
And Gender ◽  
Tomography Scan

Introduction: The deformity of the sella turcica is often a major clue that an abnormality exists within the cranium, hence a familiarity with the sella turcica anatomy and radiological appearance is important. The aim of this study was to assess the dimension of sella turcica of normal Nepalese people by using computed tomography scan of head and to correlate the dimension with the patient’s age and gender. Methods: This prospective study was performed in a tertiary hospital in Kathmandu. Data were collected over the period of 4 months from June to September 2018 with the total of 73 patients who underwent CT of head. The age and gender of the patients were noted. The dimensions of sella turcica were measured at the predefined three directions: length, depth and antero-posterior diameter of the sella turcica. Results: The sella turcica had a mean length of 8.375mm, AP diameter of 7.029mm, and depth of 10.13mm.The dimensions of the sella turcica increased with age till the age of 80 years and then decreased. Conclusions: This study concluded that the length, AP diameter and depth of the sella turcica vary with respect to age group. The length and depth of sella turcica were higher in males while AP diameter in females.

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