scholarly journals Perforated Meckel’s Diverticulitis in a Patient with Unknown Intestinal Malrotation: Clinical Pitfall

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Marie Burgard ◽  
Floryn Cherbanyk ◽  
François Pugin ◽  
Bernhard Egger
Keyword(s):  
Acute Appendicitis ◽  
Clinical Presentation ◽  
Final Diagnosis ◽  
Intestinal Malrotation ◽  
Radiological Imaging ◽  
Atypical Clinical Presentation ◽  
Lower Abdominal Quadrant ◽  
Meckel’S Diverticulitis ◽  
The Right ◽  
Abdominal Quadrant

Symptomatic Meckel’s diverticulum is rare in adults. The most frequent complications are intestinal obstruction and diverticulitis. Diagnosis of Meckel’s diverticulitis can be challenging due to nonspecific clinical manifestation of pain in the right lower abdominal quadrant, mimicking acute appendicitis. If associated with congenital malformation, such as intestinal malrotation, the anomalous anatomy makes the diagnosis even more challenging. In such cases, radiological imaging is essential to guide further management. We present a case of Meckel’s diverticulitis in which physicians were initially misguided because of the atypical clinical presentation. Yet, anamnestic details directed to a potential underlying malformation, leading to supplementary radiological examination and the final diagnosis.

Appendiceal Diverticulitis

2006 ◽  
Vol 72 (3) ◽  
pp. 221-223 ◽  
Author(s):  
Hamed Kabiri ◽  
Leon E. Clarke ◽  
Chris D. Tzarnas
Keyword(s):  
Acute Appendicitis ◽  
Clinical Presentation ◽  
Correct Diagnosis ◽  
Younger Patients ◽  
Clinical Process ◽  
Lower Abdominal Quadrant ◽  
Appendiceal Diverticulitis ◽  
The Right ◽  
Time Of Operation ◽  
Abdominal Quadrant

The incidence of appendiceal diverticulitis in pathologic specimens is 0.004 to 2.1 per cent and is unusual in younger patients. Despite being first described in 1893, this condition is commonly dismissed by surgeons and pathologists as a variant of true appendicitis. However, appendiceal diverticulitis is a discrete clinical process that must be considered in the appropriate setting because of the much higher risk of perforation. The average age is older, the pain is often intermittent, and although it can be localized in the right lower abdominal quadrant, it is of longer duration. Although no further treatment in addition to appendectomy is needed, it is important that surgeons be aware of this condition, as the clinical presentation can be different from the classical acute appendicitis picture. Patients often seek medical treatment much later than those with classic appendicitis, and if there is a delay in establishing the correct diagnosis, perforation within the mesentery is found at the time of operation. Also, it is often mistakenly identified as carcinoma and it has higher rate of perforation and a longer convaslescence. We describe a case of a 42-year-old man and review the literature.

Acute abdomen in pregnancy: a retrospective study of pregnant patients hospitalised for abdominal pain

2020 ◽  
Vol 99 (3) ◽  
pp. 131-135
Keyword(s):  
Abdominal Pain ◽  
Clinical Signs ◽  
University Hospital ◽  
Diagnostic Process ◽  
Abdominal Emergency ◽  
Lower Abdominal Quadrant ◽  
Abdominal Emergencies ◽  
The Right ◽  
Abdominal Quadrant ◽  
In Pregnancy

Introduction: Abdominal emergencies occur in pregnant women with the rate of 1:500−635 pregnancies. Such conditions usually develop from full health and worsen rapidly. Symptoms are often similar to those in physiological pregnancy (abdominal pain, vomiting, constipation). The diagnostic process is thus difficult and both the mother and her child are at risk. Our aim was to evaluate the frequency of abdominal emergencies in the Department of Surgery, University Hospital in Pilsen and to consider their impact on pregnancy and on the newborn. Methods: We acquired a set of patients by retrograde collection of data. We searched for pregnant patients suspected of developing an abdominal emergency admitted to the Department of Surgery, Faculty of Medicine, Pilsen between 2004 and 2015. We evaluated a number of clinical signs to statistically describe the set. Results: The set included 121 patients; 42 of the patients underwent a surgical procedure and 79 received conservative treatment. 38 patients underwent appendectomy; 6 appendixes were with no pathologies. McBurney’s incision was an approach of choice in most cases. The most frequent symptom was pain in the right lower abdominal quadrant. The foetus has been lost in none of the cases. Conclusion: Acute appendicitis was the most frequent abdominal emergency in our set and also the most frequent reason for surgical intervention. The most specific sign was pain in the right lower abdominal quadrant. No impact of appendicitis or appendectomy on the health of the newborn has been observed. Even though abdominal emergencies in pregnancy are relatively rare, the results of the department are very good.

scholarly journals Acute appendicitis: a 2- year review of clinical presentation and histopathology

1970 ◽  
Vol 1 (2) ◽  
pp. 104-107 ◽  
Author(s):  
N Subedi ◽  
US Dangol ◽  
MB Adhikary ◽  
S Pudasaini ◽  
R Baral
Keyword(s):  
Acute Appendicitis ◽  
Clinical Diagnosis ◽  
Clinical Presentation ◽  
Histopathological Examination ◽  
Iliac Fossa ◽  
Operative Procedure ◽  
Lymphoid Hyperplasia ◽  
Negative Appendectomy ◽  
Histopathological Correlation ◽  
The Right

Background: Acute appendicitis is the most common surgical emergency. Obstruction of the lumen by fecolith is the usual cause of acute appendicitis.The aim of the study was to analyze clinical presentation of acute appendicitis and its histopathological correlation. Materials and Methods: A retrospective study of acute appendicitis was done in the Department of Surgery of Helping Hands Community Hospital from January 2009 to December 2010. Three hundred forty five patients out of 415 patients with clinical diagnosis of appendicitis underwent operative treatment. The histopathological reports were reviewed and correlated with clinical diagnosis. Results: Out of 345 patients who underwent operative procedure 98% (n= 338) came with chief complaint of pain in the periumbilical region migrating to the right iliac fossa. The mean age of presentation was 42 years. Increased leucocyte count was seen in only 65% cases. Acute appendicitis was more commonly seen in male patients (214 cases, 62%). The most common per operative finding was acutely inflammed appendix (84%) followed by perforated appendix (7.5%), gangrenous appendix (3.5%) and appendicular lump (1.5%). However, histopathological diagnoses were acute appendicitis (91.9%), resolving appendicitis (3.5%), lymphoid hyperplasia (2.6%), mucocele (0.3%) and carcinoid (0.3%). Normal histology was seen in 1.4% cases. Conclusion: Though there are other causes of acute abdomen, acute appendicitis still stands first amongst all the emergencies. Histopathological examination of appendectomy specimen should not be omitted in order to see the incidence negative appendectomy rate and to avoid complications relating to malignant conditions. Keywords: Acute appendicitis; Appendectomy; Appendicular perforation; Histopathology DOI: http://dx.doi.org/10.3126/jpn.v1i2.5402 JPN 2011; 1(2): 104-107

scholarly journals Melanoma of the Right Foot Simulating Kaposi’s Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
K. A. Kouassi ◽  
K. Kassi ◽  
K. Kouamé ◽  
M. A. Oussou ◽  
I. Kouassi ◽  
...  
Keyword(s):  
Malignant Tumor ◽  
Clinical Presentation ◽  
Histopathological Examination ◽  
Partial Resection ◽  
Sub Saharan Africa ◽  
Visceral Metastasis ◽  
Atypical Clinical Presentation ◽  
Sub Saharan ◽  
The Right ◽  
Lack Of Knowledge

Melanoma is a malignant tumor rarely being described in sub-Saharan Africa. We reported an unusual and atypical clinical presentation. It was a 59-year-old patient who was hospitalized for a monomelic black tumor evolving for 10 years. Histopathological examination confirmed the melanocytic origin of this tumor. Paraclinical assessment did not find any visceral metastasis. A partial resection of the tumor was performed. The patient left the hospital against medical consent due to lack of technical facilities. The delay in the consultation and the lack of knowledge of melanoma by doctors and patients might contribute to the severity and the difficulties of its management.

An atypical clinical presentation of acute appendicitis in a young man with midgut malrotation

Radiography ◽  
2007 ◽  
Vol 13 (2) ◽  
pp. 164-168 ◽  
Author(s):  
Antonio Pinto ◽  
Domenico Di Raimondo ◽  
Antonino Tuttolomondo ◽  
Paola Fernandez ◽  
Aurelio Caronia ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Clinical Presentation ◽  
Midgut Malrotation ◽  
Atypical Clinical Presentation

scholarly journals Left sided acute appendicitis with intestinal malrotation in an adult, a diagnostic challenge

2018 ◽  
Vol 8 (1) ◽  
pp. 68-70
Author(s):  
Rupesh Gautam, ◽  
Deepak Adhikari ◽  
Gemma U. De Lima ◽  
Bhawana Adhikari
Keyword(s):  
Acute Appendicitis ◽  
Ct Scan ◽  
Lower Abdominal Pain ◽  
Sudden Onset ◽  
Intestinal Malrotation ◽  
Diagnostic Challenge ◽  
Diagnostic Modality ◽  
Operative Findings ◽  
The Right ◽  
Ct Features

A 28-yr-old male presented with sudden onset pain at the epigastric region followed by left lower abdominal pain. CT scan of the abdomen revealed reverse relation of the superior mesenteric artery and superior mesenteric vein with large bowel loops including the cecum on left side and small bowel loops on the right. An inflamed appendix arising from the base of left sided cecum was identified. The intra operative findings were consistent with CT features. This is a rare case of left sided acute appendicitis with intestinal malrotation in an adult patient. CT scan is diagnostic modality of choice and excludes other possible disease presenting with similar clinical features.  

A Woman With Painless Swelling in the Right Lower Abdominal Quadrant

2012 ◽  
Vol 59 (5) ◽  
pp. e9-e10
Author(s):  
Ahmet Pergel ◽  
Ahmet Fikret Yucel ◽  
Ibrahim Aydin ◽  
Dursun Ali Sahin
Keyword(s):  
Lower Abdominal Quadrant ◽  
The Right ◽  
Abdominal Quadrant

scholarly journals Primary yolk sac tumour of liver with unusual clinical presentation mimicking acute appendicitis

2014 ◽  
Vol 13 (3) ◽  
pp. 33-37 ◽  
Author(s):  
M Hosala ◽  
L Laca ◽  
J Hosalova Matisova ◽  
J Janik ◽  
M Adamik ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Clinical Presentation ◽  
Right Hemicolectomy ◽  
Yolk Sac ◽  
Rare Tumour ◽  
Regional Lymph Nodes ◽  
Right Hemihepatectomy ◽  
Exact Etiology ◽  
Yolk Sac Tumour ◽  
The Right

Abstract Primary hepatic yolk sac tumour (YST) is an extremely rare tumour of the liver. The exact etiology of primary hepatic YST is still unclear. This tumour is very aggressive with ability to spread into distant sites, where it can lead to the first clinical presentation. The authors present a case of a 20-year-old woman with fever and pain in the epigastrium, which later on moved to the right hypogastrium clinically resembling acute appendicitis. Ultrasound revealed tumorous mass in the liver and hypoechogenous tumorous mass in the area of right adnexes and terminal ileum. Tumorous mass in the liver was confirmed on the CT scan. Markedly raised levels of serum α-fetoprotein concentration were detected. Laparoscopic appendectomy was performed and there was bioptically verified a diagnosis of YST. Afterwards, patient underwent right hemihepatectomy, right hemicolectomy and right adnexectomy. There was found no evidence of the gonadal, mediastinal, retroperitoneal and central nervous system origin of the YST. Histological findings from the liver proved primary yolk sac tumour of the liver with the metastatic spread into the appendix, caecum and regional lymph nodes.

scholarly journals Hip pain in children dilemmas in diagnosis and management a case report

2020 ◽  
Vol 8 (8) ◽  
pp. 3098
Author(s):  
Lakshmipriya Baskaran ◽  
Ashok Thudukuchi Ramanathan
Keyword(s):  
Clinical Presentation ◽  
Chronic Osteomyelitis ◽  
Final Diagnosis ◽  
Blood Parameters ◽  
Hip Pain ◽  
Lytic Lesion ◽  
Benign Bone Tumor ◽  
Radiological Imaging ◽  
Ct Guided ◽  
Ct Guided Biopsy

Atraumatic hip pain in growing children is of varied etiology from developmental to infection and tumor. Differential clinical presentation of symptoms and investigation modalities like blood parameters and radiological imaging remains inconclusive at times with differential diagnosis. Biopsy remains the final say in conclusive of establishing final diagnosis unless proved otherwise. Bony lytic lesion of proximal femur in children without systemic illness mimicking benign bone tumor initially (osteiod osteoma) turned out to be chronic osteomyelitis on histopathologically following CT guided biopsy of the lesion which alters the course of management.

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