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.

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.

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.

Role of laparoscopic in diagnosis and treatment of undescended testis in children at Viet Duc Hospital

2018 ◽  
Vol 8 (4) ◽  
Author(s):  
Viet Hoa Nguyen
Keyword(s):  
Laparoscopic Surgery ◽  
Undescended Testis ◽  
Correct Diagnosis ◽  
Diagnosis And Treatment ◽  
Highly Sensitive ◽  
The Mean ◽  
The Right ◽  
Time Of Operation

Abstract Introduction: Evaluating the role of laparoscopic for diagnosis and treatment of undescended testis in children. Material and Methods: Restrospective study, between 6/ 2014 and 6/2017. All the patients are aged from 1 to 16 years with undescended testis underwent laparoscopic surgery for diagnosis and treatment in Deparment of pediatric surgery – Viet Duc hospital enrolled. Results: Of 95 patiens in total had 106 undescended testis diagnosed and treated by laparoscopy. The mean age of patients was 7,5 ± 3,8 years. 44,2% undescended were on the left side, 44,2% were on the right and 11,6% were undescended bilateral. The correct diagnosis by ultrasound accounted in 79,4%. The locations of testis diagnosed by laparoscopic are : intra abdomen in 45,3%, deep inguinal orifice in 16,9%, extra inguinal orifice in 26,4%, no testicle found in 11,4%. The mean time of operation were 67,33± 28,01 pht. Scrotal positions were achieved 74,5%, remove atrophic testis accounted in 7,6%. Stephen- Flowler technique including step I were in 4,7%, step II in 1,9%. The outcome evaluated by testicular positions following 3 months after operation are : good in 79,2%, moderate 13,2%, poor in 7,6%; By classification of Aubert are : good in 81,1%, moderate in 11,3% and poor in 7,6 %. Conclusion: Laparoscopic surgery is not only a highly sensitive diagnostic method to find accurately the location and size of the testes, but also the most effective method to treat impalpable undescended testes.

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

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 A Rare Case of De Garengeot Hernia: A Challenging Diagnosis and a New Approach

2021 ◽  
pp. 1-3
Author(s):  
Sleiman Marwan Julien ◽  
Sleiman Marwan Julien ◽  
Litchinko Alexis ◽  
Toso Christian ◽  
Ris Frédéric ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Hernia Repair ◽  
Femoral Hernia ◽  
Clinical Presentation ◽  
Emergency Setting ◽  
Rare Presentation ◽  
Hernia Sac ◽  
Double Approach ◽  
The Right ◽  
De Garengeot Hernia

De Garengeot’s hernia is a rare entity in which the appendix is located within a femoral hernia and is almost invariably encountered incarcerated in an emergency setting. The clinical presentation is usually that of an incarcerated femoral hernia and is indistinguishable from other incarcerated femoral hernias. Here, we report on a 48-year-old female patient, known for a post-operative chronic seroma in the right groin since childhood, with a rare clinical presentation of a De Garengeot hernia. An abdominal CT-scan was performed, revealing an appendicitis with a stercolith in a femoral hernia. Generally, an inguinal approach alone (McVay procedure) is chosen and provides access for both appendectomy and hernia repair. In the absence of concomitant acute appendicitis, trans-abdominal pro-peritoneal laparoscopy (TAPP) could also be used as a single approach. In case of a rare presentation of acute appendicitis with probable contamination of the groin, we propose the double approach of laparoscopic appendectomy and hernia repair either with (if hernia sac is not opened during surgery) or without mesh. This approach is not yet described in the literature, and we think it the best technique to perform the appendectomy and hernia repair with little contamination of the groin.

An Imaging Diagnostic Protocol in Children with Clinically Suspected Acute Appendicitis

2016 ◽  
Vol 82 (5) ◽  
pp. 390-396 ◽  
Author(s):  
Matias Epifanio ◽  
Marco Antonio De Medeiros Lima ◽  
Patricia Corrêa ◽  
Matteo Baldisserotto
Keyword(s):  
Acute Appendicitis ◽  
Predictive Value ◽  
Iliac Fossa ◽  
Correct Diagnosis ◽  
Signs And Symptoms ◽  
Clinical Findings ◽  
The Other ◽  
Free Fluid ◽  
Diagnostic Strategy ◽  
The Right

The objective of the present study is to evaluate a new diagnostic strategy using clinical findings followed by ultrasound (US) and, in selected cases, MRI. This study included 166 children presenting signs and symptoms suggesting acute appendicitis. Cases classified as suggesting appendicitis according to clinical exams had to be referred to surgery, whereas the other cases were discharged. Unclear cases were evaluated using US. If the US results were considered inconclusive, patients underwent MRI. Of the 166 patients, 78 (47%) had acute appendicitis and 88 (53%) had other diseases. The strategy under study had a sensitivity of 96 per cent, specificity of 100 per cent, positive predictive value of 100 per cent, negative predictive value of 97 per cent, and accuracy of 98 per cent. Eight patients remained undiagnosed and underwent MRI. After MRI two girls presented normal appendixes and were discharged. One girl had an enlarged appendix on MRI and appendicitis could have been confirmed by surgery. In the other five patients, no other sign of the disease was detected by MRI such as an inflammatory mass, free fluid or an abscess in the right iliac fossa. All of them were discharged after clinical observation. In the vast majority of cases the correct diagnosis was reached by clinical and US examinations. When clinical assessment and US findings were inconclusive, MRI was useful to detect normal and abnormal appendixes and valuable to rule out other abdominal pathologies that mimic appendicitis.

scholarly journals An Unusual Cause of Abdominal Pain: Three Lead Pellets within the Appendix Vermiformis

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Orhan Veli Ozkan ◽  
Vecdi Muderris ◽  
Fatih Altintoprak ◽  
Orhan Yagmurkaya ◽  
Omer Yalkin ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
High Risk ◽  
Foreign Bodies ◽  
Fluoroscopic Guidance ◽  
Appendix Vermiformis ◽  
Lower Abdominal Quadrant ◽  
History Of ◽  
Rabbit Meat ◽  
The Right ◽  
Abdominal Quadrant

Most ingested foreign bodies usually pass out in the feces uneventfully. Complications such as intestinal perforation and bleeding usually occur with sharp, thin, stiff, long, and pointed objects. This case describes the management of three lead pellets within the appendix vermiformis. A 45-year-old male visited our clinic complaining of a 4-month history of abdominal pain. The patient inquiry revealed that he had eaten hunted rabbit meat on numerous occasions and had unintentionally ingested three lead pellets. Plain abdominal films and a barium enema showed foreign bodies in the right lower abdominal quadrant. Since the lead pellets were thought to have migrated extraluminally, they were removed through laparotomy under fluoroscopic guidance. An appendectomy was performed. Pathologically, three lead pellets were embedded in the appendix, which showed signs of intramucosal inflammation. Foreign bodies causing appendicitis are rare. However, if stiff or pointed objects enter the appendicular lumen, there is a high risk of appendicitis, perforation, or abdominal pain. An appendectomy was required to remove the ingested lead pellets in the appendix.

scholarly journals A Case of Postpartum Thrombophlebitis of a Retroperitoneal Varix Mimicking Acute Appendicitis

2019 ◽  
Vol 35 (5) ◽  
pp. 432-437
Author(s):  
Paula Glackin ◽  
Lars G. Crabo
Keyword(s):  
Acute Appendicitis ◽  
Correct Diagnosis ◽  
Ovarian Vein ◽  
Quadrant Pain ◽  
Sonographic Examination ◽  
Lower Quadrant Pain ◽  
Lower Quadrant ◽  
Right Lower Quadrant Pain ◽  
The Right ◽  
Right Lower Quadrant

A case of thrombophlebitis of a retroperitoneal varix in a postpartum patient with right lower quadrant pain is presented. The sonographic examination was falsely positive for appendicitis, but the correct diagnosis was made with a subsequent computed tomogram. The thrombosed varix was likely a collateral of the right ovarian vein, analogous to postpartum ovarian vein thrombophlebitis (POVT), an uncommon potentially fatal disorder. POVT is reviewed, emphasizing features useful for distinguishing it from appendicitis at sonography. Sonographers should be aware of the possibility of thrombophlebitis when examining postpartum patients with right lower quadrant pain.

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