scholarly journals Solitary Cecal Diverticulitis: An Unusual Cause of Acute Right Iliac Fossa Pain—A Case Report and Review of the Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Nikolaos Mudatsakis ◽  
Marinos Nikolaou ◽  
Konstantinos Krithinakis ◽  
Michail Matalliotakis ◽  
Nikolaos Politis ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Acute Abdominal Pain ◽  
Iliac Fossa ◽  
Clinical Signs ◽  
Uneventful Recovery ◽  
Western World ◽  
Management Options ◽  
Alternative Therapeutic Approach ◽  
Cecal Diverticulitis ◽  
Right Iliac Fossa Pain

Solitary cecal diverticulitis is a rare cause of acute abdominal pain in the Western world. Its clinical presentation, in most cases, mimics acute appendicitis. A 38-year-old Caucasian man presented with acute abdomen and clinical signs of acute appendicitis. Laparotomy was performed and revealed an inflammatory, solitary diverticulum of the cecum. A typical appendectomy was performed and a catheter was inserted for draining percutaneously the inflamed diverticulum of the cecum. The patient had an uneventful recovery and was discharged on the 4th postoperative day. This frequently misdiagnosed condition, in most cases, is being suspected and identified intraoperatively as acute appendicitis. The aim of this study is to review the available different surgical management options and to present an alternative therapeutic approach that may be valuable under specific circumstances.

scholarly journals Role of C-Reactive Protein, White Blood Cell Counts, Bilirubin Levels, and Imaging in the Diagnosis of Acute Appendicitis as a Cause of Right Iliac Fossa Pain

Cureus ◽  
2018 ◽  
Author(s):  
Shetty Sushruth ◽  
Chellappa Vijayakumar ◽  
Krishnamachari Srinivasan ◽  
Nagarajan Raj Kumar ◽  
Gopal Balasubramaniyan ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Blood Cell ◽  
Iliac Fossa ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Cell Counts ◽  
Blood Cell Counts ◽  
Right Iliac Fossa Pain ◽  
White Blood Cell Counts

scholarly journals Acute right iliofemoral deep vein thrombosis mimicking acute appendicitis in the postpartum period: a case report

2020 ◽  
Vol 102 (9) ◽  
pp. e1-e4
Author(s):  
S Karaisli ◽  
E Selcuk
Keyword(s):  
Deep Vein Thrombosis ◽  
Acute Appendicitis ◽  
Postpartum Period ◽  
Iliac Fossa ◽  
Correct Diagnosis ◽  
Uneventful Recovery ◽  
Surgical Interventions ◽  
Vein Thrombosis ◽  
Pregnancy And Postpartum ◽  
Deep Vein

The risk of venous thromboembolism increases during pregnancy and postpartum. The incidence in the first six weeks following delivery is approximately 0.15%. Deep vein thrombosis may present with acute appendicitis-like symptoms such as right iliac fossa pain, nausea and vomiting. A 22-year-old woman was admitted with complaints of abdominal pain and vomiting 20 days after spontaneous vaginal delivery. Physical examination and radiological findings were compatible with acute appendicitis. Preoperative re-examination and re-evaluation of computed tomography revealed concomitant deep vein thrombosis on the right side. The patient underwent laparotomy and a normal appendix and ovaries were found. She had an uneventful recovery. Anticoagulant treatment was administered for six months. Early and correct diagnosis should be established to avoid complications of deep vein thrombosis and prevent unnecessary surgical interventions. Physicians should be aware of deep vein thrombosis in women who present acute appendicitis-like symptoms, especially during pregnancy and in the postpartum period.

Appendicoliths: the neglected stones

2017 ◽  
Vol 4 (1) ◽  
pp. 3-6
Author(s):  
Saroj Dhital ◽  
Udaya Koirala ◽  
Birendra Dhoj Joshi ◽  
Amit Mani Upadhyaya ◽  
Arbin Joshi
Keyword(s):  
Acute Appendicitis ◽  
Iliac Fossa ◽  
Vermiform Appendix ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Recurrent Appendicitis ◽  
Right Iliac Fossa Pain

Introductions: Cases of colic of the vermiform appendix have been rarely described or diagnosed. Appendicoliths cause acute appendicitis and appendicular perforation. It is still not clear whether appendicoliths cause appendicular colic in the absence of acute appendicitis. Methods: A cross sectional study that included appendectomy done for recurrent appendicitis or chronic right iliac fossa pain. Histology reports were reviewed. The presence of an appendicolith in the report was noted. Results: Thirty-two cases of recurrent appendicitis and chronic right iliac fossa pain were included. Twenty-four patients (75%) had fecoliths in the histology specimens. Eight patients (25%) who presented with appendicular colic without signs of appendicitis were further evaluated. Conclusions: Majority of patients with chronic or colicky right iliac fossa pain had appendicoliths.

scholarly journals A study of correlation between clinical, radiological and pathological diagnosis of appendicitis: a retrospective analytic study

2018 ◽  
Vol 5 (9) ◽  
pp. 3011
Author(s):  
Prabhu R. ◽  
Vijayakumar C. ◽  
Balagurunathan K. ◽  
Senthil Velan M. ◽  
Kalaiarasi R. ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Scoring System ◽  
Acute Abdominal Pain ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Radiological Finding ◽  
Clinical Signs ◽  
Emergency Setting ◽  
Alvarado Score

Background: Acute appendicitis is the most common cause of acute abdominal pain in young adults requiring emergency surgery. Appendicectomy is the most frequently performed surgery. The diagnosis is often challenging and the decision to operate in an emergency setting is always debatable. A combination of clinical signs and symptoms with laboratory findings in many scoring systems are suggesting the probability of appendicitis and the possible subsequent management pathway. The aim was to evaluate accuracy of the clinical Alvarado scoring system, radiological finding and histopathological examination for the diagnosis of acute appendicitis.Methods: A retrospective study was conducted in the department of general surgery in a tertiary care centre in South India. Total of 237 patients with acute abdominal pain were included and evaluated with the clinical Alvarado scoring system, radiological finding with (USG/CT abdomen) and histopathological examination for the diagnosis of acute appendicitis. The data was collected and analyzed retrospectively.Results: Of the 237 patients, 164 patients were male (69.1%) and rest is female. The correlation of the Alvaroda score with histopathological findings in groups with score > 7 and ≤7 the correlation of Alvarado score and the ultrasound findings were comparable between the study groups. The sensitivity of ultrasound in diagnosing acute appendicitis in patients with Alvarado score >7 was 72.99%. The sensitivity of ultrasound in diagnosing acute appendicitis in patients with Alvarado score ≤7 was decreased to 27%.Conclusions: The diagnostic accuracy of clinical features is far better than radiological investigations in the diagnosis of acute appendicitis. Therefore, it is concluded that it is better to use radiological investigations only to confirm the diagnosis of acute appendicitis rather to diagnose it.

scholarly journals ACUTE APPENDICITIS

2016 ◽  
Vol 23 (03) ◽  
pp. 241-245
Author(s):  
Javeria Farid ◽  
Rizwanullah Junaid Bhambhro ◽  
Sohail Soomro
Keyword(s):  
Abdominal Pain ◽  
Postoperative Complications ◽  
Acute Appendicitis ◽  
Epigastric Pain ◽  
Iliac Fossa ◽  
University Hospital ◽  
Cross Sectional ◽  
Clinical Pattern ◽  
Rebound Tenderness ◽  
Right Iliac Fossa Pain

Objectives: To determine the clinical presenting pattern and postoperativecomplications of acute appendicitis. Study design: Observational and cross-sectional study.Setting: Isra university hospital Hyderabad. Period: 7 months. Methodology: All the patientsabove 12 years of age and both genders male/female after diagnosis of acute appendicitishad integrated in the study. Complete clinical pattern and postoperative complications hadrecorded. Results: Symptoms/sign nausea, vomiting, anorexia, rebound tenderness, fever,constipation, diarrhea and leukocytosis were noted with the percentage 98.0%, 65.0%, 95.0%,90.0%, 85.0%, 58.0%, 30.0% and 89.0% respectively. Paraumblical pain was noted in 50.0%of the cases, right iliac fossa pain was in the 99.0%, epigastric pain was seen in 61.0% and theother abdominal pain was noted in the 39.0%. Postoperative complications found in 33.0% ofthe cases and majority was seen wound infection. Conclusion: In the conclusion of this studyclinical features nausea, vomiting, anorexia, rebound tenderness, fever, and leukocytosis wereseen as most common and the most important postoperative complication is infection whichprobably created with the uncompleted sterilization.

scholarly journals Clinicopathological correlation of acute appendicitis undergoing emergency appendicectomy in a tertiary care hospital of Gujarat: a retrospective study

2019 ◽  
Vol 6 (9) ◽  
pp. 3201
Author(s):  
Mrugesh Chudasama ◽  
Pallav Patel
Keyword(s):  
Retrospective Study ◽  
Acute Appendicitis ◽  
Iliac Fossa ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Vermiform Appendix ◽  
Study Patient ◽  
Care Hospital ◽  
Delayed Presentation ◽  
Operative Findings

Background: Acute appendicitis is acute inflammation and infection of the vermiform appendix, which is most commonly referred to simply as the appendix. The aim of this study was to determine the presenting pattern of acute appendicitis and to review the pathological diagnosis.Methods: This retrospective study was conducted in the general surgery department at tertiary care institute of Gujarat for the period of one year. One hundred patients who were attending department of surgery diagnosed as acute appendicitis were selected for the study. Patient demographics, clinical features, operative findings and histology results were recorded on a special patient proforma.Results: The most common presenting complaints were abdominal pain (n=100), nausea (n=54), vomiting (n=80) and diarrhoea (n=7). As for clinical signs 100% of the patients in this study had some degree of right iliac fossa tenderness. Open appendicectomy was performed in 62% of the patients and laparoscopic appendicectomy in 38% of the patients. 66% of the patients presented within 24 hours of the onset of symptoms whereas 28% presented 24-48 hours after the onset of symptoms.Conclusions: Diagnosis of acute appendicitis obvious based on strongly positive clinical presentation. Present study shows that acute appendicitis in India is a disease of young males. On further sub-classification of acute appendicitis, uncomplicated acute appendicitis seems to be the most common. Delayed presentation is associated with greater morbidity. 

scholarly journals EP.WE.641Spectrum of Right Iliac Fossa Pain Presentation and Management During the First COVID-19 Lockdown: A Single Institution Experience

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Ahmed Salman Bodla ◽  
Chinedu Ndegbu
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Imaging ◽  
Imaging Modality ◽  
Iliac Fossa ◽  
Management Approach ◽  
Conservative Approach ◽  
Diagnosis Rate ◽  
Right Iliac Fossa Pain ◽  
Management Approaches ◽  
Surgical Unit

Abstract Aims Acute surgical presentations and management approaches have witnessed a changing pattern occasioned by COVID-19 pandemic and attendant lockdown. We report the spectrum of right iliac fossa (RIF) pain referrals and management trend within an acute surgical unit before and during the National lockdown. Methods A retrospective review of all patients referred to the acute surgical unit with RIF pain before and during first National lockdown was undertaken. Patients managed during these periods were segregated into Pre-Lockdown (January-2020) and Lockdown (April/May-2020) cohorts. Relevant data were obtained from patients’ electronic medical records and main outcome measures compared between both arms were definitive diagnosis, rate of acute appendicitis, diagnostic imaging modality utilised, management approach and post-operative 30-day complications. Results RIF pain referrals were fewer (17% vs. 23%, P = 0.045) but more likely to be related to acute appendicitis during the lockdown (52% vs. 28%, P = 0.002). However, the risk of presenting with complicated appendicitis did not alter significantly (26% vs. 19%, RR = 1.34, P = 0.56). Diagnostic imaging was increasingly deployed (for RIF pain: 91% vs. 74%, P = 0.07; for appendicitis: 77% vs. 42%, P = 0.007) especially computerised tomography scan (45% vs. 31%). Increased adoption of conservative approach in the management of acute appendicitis was significant (61% vs 23%, RR 2.65, P = 0.01) although other outcomes such as length of stay, post-operative complication and 30-day re-presentation rates were comparable to pre-lockdown phase. Conclusion Fewer RIF pain but more likelihood of acute appendicitis, increased use of radiological imaging and conservative approach to management reflect an evolving pattern during the lockdown phase.

scholarly journals A comparative study of RIPASA and Alvarado score for the diagnosis of acute appendicitis

2020 ◽  
Vol 7 (12) ◽  
pp. 4006
Author(s):  
Praveena Suresh ◽  
Rajan Janardhanan ◽  
Deepak Paul
Keyword(s):  
Acute Appendicitis ◽  
Scoring System ◽  
Prospective Observational Study ◽  
Iliac Fossa ◽  
Scoring Systems ◽  
Alvarado Score ◽  
Medical College ◽  
Right Iliac Fossa Pain ◽  
Sensitivity Specificity ◽  
Ripasa Score

Background: Acute appendicitis is a common problem and can be difficult to diagnose at time. There are many scoring systems to predict the diagnosis of acute appendicitis. The most commonly used scoring system is Alvarado scoring system but, it is far from perfect. In this study we compare Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) scoring system to Alvarado scoring system in correctly diagnosing acute appendicitis.Methods: This prospective observational study was conducted in the department of general surgery, Sree Gokulam Medical College and Research Foundation. It comprised of 60 consecutive patients who were admitted with suspicion of appendicitis who had right iliac fossa pain. RIPASA and Alvarado scoring was done and compared to histopathology after surgery. Sensitivity, specificity and accuracy was calculated.Results: Majority of the patients were below 30 years of age majority were males 36 (60%). When Alvarado score predicted appendicitis in 31 (51.77%) and RIPASA in 54 (90%). When the RIPASA score was >7.5 the sensitivity was 100%, specificity 67% and accuracy was 95%.Conclusions: RIPASA scoring system is more accurate to diagnose acute appendicitis especially when RIPASA score is >7.5. literatures.

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