Abdominal Tuberculosis in Ahmadi, Kuwait: A Clinico-Pathological Review

For studying abdominal tuberculosis (TB) in Ahmadi, files of all patients admitted to our hospital with abdominal TB over 15 years (1981–1996) were reviewed. Nineteen patients are reported here. Young adults were predominant in our study. The non-Arab Asians were the most frequently affected group in relation to their population in Ahmadi, and Kuwaitis were the least frequently affected group. Abdominal pain, sweating, anorexia and fever were the most frequent presenting symptoms. Ascites and intestinal obstruction were the most frequent clinical presentations. Two patients presented with acute appendicitis and one patient had tuberculous pancreatitis. Abdominal lymph nodes, peritoneum, ileum and caecum were the most frequently affected abdominal structures. We found laparoscopy very helpful in the diagnosis of abdominal TB and we recommend it as the diagnostic method of choice. All our patients responded well to antituberculous chemotherapy. It should be kept in mind that abdominal TB still affects the indigenous and expatriate population of Kuwait.

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Abdominal tuberculosis: a clinicopathologic study in Kashmir valley

International Surgery Journal ◽

10.18203/2349-2902.isj20173104 ◽

2017 ◽

Vol 4 (8) ◽

pp. 2470

Author(s):

Ravinder Kumar ◽

Madhu Digra ◽

Dinesh Kumar

Keyword(s):

Health Hazard ◽

Signs And Symptoms ◽

Abdominal Tuberculosis ◽

Medical College ◽

Presenting Symptoms ◽

Clinicopathologic Study ◽

Igm Elisa ◽

Clinical Presentations ◽

Laboratory Investigations ◽

Study Association

Background: Tuberculosis is a major health hazard in India. Because of its diverse manifestations, difficult diagnosis, widespread complications, prolonged morbidity and increased mortality the study of this disease becomes even more important. The objectives of the study were to study age and sex distribution of abdominal tuberculosis, to study association of abdominal tuberculosis with pulmonary tuberculosis, to study various clinical presentations of abdominal tuberculosis, to study various modalities for diagnosis of abdominal tuberculosis and to study the surgical management in relevant patients of abdominal tuberculosis.Methods: This study was carried out in 50 patients of abdominal tuberculosis of different age group and sex admitted in Department of Surgery, SMHS Hospital, Govt. Medical College, Srinagar during the period from 2002 to 2004. The patients of abdominal tuberculosis fell into two broad categories - those presenting with acute/sub-acute intestinal obstruction and those without obstruction. All patients were worked up with the elicitation of proper history, clinical examination, laboratory investigation, etc. The diagnosis was confirmed by IgM ELISA for tuberculosis, peritoneocentesis, FNAC, laparotomy and biopsy of the specimen obtained at the time of surgery.Results: Maximum incidence of abdominal tuberculosis was noted in third and fourth decades followed by second decade of life. Males constituted 60% and females constituted 40% of total patients. 23 patients presented with acute and 27 patients with chronic onset of signs and symptoms respectively. Abdominal pain, anorexia, weight loss, weakness, vomiting and constipation were the main presenting symptoms. No haemoglobin and raised ESR were the commonest finding on routine laboratory investigations in majority of the patients. IgM ELISA for tuberculosis was positive in 41 patients (95.34%). Surgical intervention was required in 50% of the patients.Conclusions: Good clinicopathological workup in patients of abdominal tuberculosis results in earlier diagnosis and timely management of this curable disease.

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Surgery

Oxford Handbook of Emergency Medicine ◽

10.1093/med/9780199589562.003.0010 ◽

2012 ◽

pp. 503-532

Author(s):

Jonathan P. Wyatt ◽

Robin N. Illingworth ◽

Colin A. Graham ◽

Kerstin Hogg ◽

Michael J. Clancy ◽

...

Keyword(s):

Acute Pancreatitis ◽

Peptic Ulcer ◽

Abdominal Pain ◽

Acute Appendicitis ◽

Intestinal Obstruction ◽

Peptic Ulcer Disease ◽

Biliary Tract ◽

Large Bowel ◽

Ulcer Disease ◽

P Retention

Approach to abdominal pain 504 Causes of acute abdominal pain 506 Acute appendicitis 507 Acute pancreatitis 508 Biliary tract problems 510 Peptic ulcer disease 511 Intestinal obstruction 512 Mesenteric ischaemia/infarction 514 Large bowel emergencies 516 Anorectal problems 518 Retention of urine 520 Testicular problems 522...

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Acute Appendicitis Masquerading Distal Intestinal Obstruction Syndrome in Adult Cystic Fibrosis

Case Reports in Gastrointestinal Medicine ◽

10.1155/2018/8475060 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3

Author(s):

Sushant M. Nanavati ◽

Hiren Patel ◽

Gabriel Melki ◽

Vinod Kumar ◽

Edward Milman ◽

...

Keyword(s):

Cystic Fibrosis ◽

Abdominal Pain ◽

Acute Appendicitis ◽

Intestinal Obstruction ◽

Care Program ◽

Lower Quadrant ◽

Quadrant Abdominal Pain ◽

Distal Intestinal Obstruction Syndrome ◽

Right Lower Quadrant ◽

Distal Intestinal Obstruction

Overshadowed by Sino-pulmonary infections, Cystic Fibrosis (CF) commonly affects gastrointestinal organs because of secretory and motility dysfunction. Infrequently, these changes result in Distal Intestinal Obstruction Syndrome (DIOS), an increasingly diagnosed gastrointestinal entity in adult Cystic Fibrosis patients. We present a case 22-year-old male who presented to our hospital with right lower quadrant abdominal pain with suspicion of acute appendicitis and was subsequently diagnosed as DIOS. Our case highlights the importance of DIOS as one of the differential diagnosis of right lower quadrant abdominal pain in a patient with a CF, especially for physicians working at community hospitals which may not have a Cystic Fibrosis care program available.

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Vólvulo y necrosis de divertículo de Meckel gigante: reporte de un caso. [Title: Volvulus and necrosis of giant Meckel's diverticulum: a case report]

Revista Médica de Panamá - ISSN 2412-642X ◽

10.37980/im.journal.rmdp.2020831 ◽

2020 ◽

Vol 40 (1) ◽

Author(s):

Germán - Brito Sosa ◽

Ana María Iraizoz Barrios

Keyword(s):

Abdominal Pain ◽

Case Report ◽

Acute Appendicitis ◽

Intestinal Obstruction ◽

Terminal Ileum ◽

Meckel’S Diverticulum ◽

Exploratory Laparotomy ◽

Meckel's Diverticulum ◽

Meckel Diverticulum

ResumenEl divertículo de Meckel complicado es poco frecuente en el adulto. Presentamos un paciente de 19 años de edad, con dolor abdominal de 11 horas de evolución, encontrando al realizar la laparotomía exploradora un divertículo de Meckel gigante, necrosado y volvulado. Las presentaciones más frecuentes del divertículo de Meckel son la obstrucción intestinal y la diverticulitis, esta última da una sintomatología similar a la apendicitis aguda,por lo que al realizar la exploración quirúrgica y encontrar el apéndice cecal normal, se debe visualizar los últimos 180 cm de íleo terminal.Abstract Meckel's diverticulum is rare in adults. We present a 19-year-old patient with abdominal pain of 11 hours of evolution, finding a giant Meckel diverticulum, necrotic and volvulated, when performing the exploratory laparotomy. The most frequent presentations of Meckel's diverticulum are intestinal obstruction and diverticulitis, the latter being a symptomatology similar to acute appendicitis, surgical surgery and the normal cecal appendix, the last 180 cm of terminal ileum should be visualized.

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VALIDAÇÃO DO ESCORE DE ALVARADO NO DIAGNÓSTICO DE APENDICITE AGUDA NOS PACIENTES DO HOSPITAL GERAL DE PALMAS: ANÁLISE RETROSPECTIVA DE 100 CASOS

Revista de Patologia do Tocantins ◽

10.20873/uft.2446-6492.2018v5n2p25 ◽

2018 ◽

Vol 5 (2) ◽

pp. 25-28

Author(s):

Luisa Coelho Milhomem ◽

Luiz Antônio Gomes Amorim ◽

Pedro Manuel González Cuellar

Keyword(s):

Abdominal Pain ◽

Acute Appendicitis ◽

Emergency Room ◽

Sensitivity And Specificity ◽

Diagnostic Method ◽

Clinical Laboratory ◽

Noninvasive Method ◽

Alvarado Score ◽

Cutoff Value ◽

Suspected Diagnosis

RESUMO Objetivos: determinar a sensibilidade e especificidade do escore de Alvarado para o diagnóstico de apendicite aguda nos pacientes admitidos na emergência do Hospital Geral de Palmas. Métodos: o estudo foi realizado com a validação de método diagnóstico através do escore clínico-laboratorial para diagnóstico de apendicite aguda. A amostra estudada consistiu de 100 pacientes admitidos na emergência do HGP com dor abdominal e suspeita de apendicite aguda, no período de março a outubro de 2017. Os pacientes foram atendidos na emergência e avaliados quanto ao escore de Alvarado pelo cirurgião responsável, o residente de cirurgia e os internos. Resultados: tomando como ponto de corte o valor >7 pontos, encontramos uma sensibilidade de 71,05 % e especificidade de 84,93 %. Conclusões: o escore de Alvarado é um método pouco invasivo para diagnóstico, simples, rápido, que utilizando o ponto de corte >7 pontos, apresentou-se como um instrumento de alto valor na triagem dos nossos pacientes com suspeita diagnóstica de apendicite aguda. Palavras-chave: apendicite, diagnóstico, emergência. ABSTRACT Objectives: to determine the sensitivity and specificity of the Alvarado score for the diagnosis of acute appendicitis in patients admitted to the Emergency Hospital of Palmas. Methods: The study was performed with the validation of the diagnostic method through the clinical-laboratory score for the diagnosis of acute appendicitis. The sample consisted of 100 patients admitted to the emergency room of the HGP with abdominal pain and suspected of acute appendicitis, from March to October 2017. The patients were treated in the emergency room and evaluated for the Alvarado score by the surgeon in charge, the resident of surgery and the inmates. Results: taking as a cutoff value> 7 points, we found a sensitivity of 71.05% and specificity of 84.93%. Conclusions: The Alvarado score is a simple, fast, noninvasive method for diagnosis, which, using the cutoff point> 7 points was presented as a high-value instrument for the screening of our patients with suspected diagnosis of acute appendicitis. Keywords: appendicitis, diagnosis, emergency.

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Challenges in the Diagnosis of Leak After Sleeve Gastrectomy: Clinical Presentation, Laboratory, and Radiological Findings

Obesity Surgery ◽

10.1007/s11695-020-05008-y ◽

2020 ◽

Author(s):

Mohammad Al Zoubi ◽

Nesreen Khidir ◽

Moataz Bashah

Keyword(s):

Abdominal Pain ◽

Sleeve Gastrectomy ◽

White Blood Cells ◽

Delayed Diagnosis ◽

Contrast Study ◽

Radiological Findings ◽

Reactive Protein ◽

Presenting Symptoms ◽

Clinical Presentations ◽

The Mean

Abstract Background The presentation of leak after laparoscopic sleeve gastrectomy (LSG) is variable. A missed or delayed diagnosis can lead to severe consequences. This study presents our experience: the clinical presentations, laboratory, and radiological findings in patients with leak after LSG. Methods A retrospective review of patients who were diagnosed and treated as leak after LSG at our center (January 2012–November 2019). Results Eighty patients developed leak: 68 (85%) after primary LSG, 6 (7.5%) after Re-LSG and 6 (7.5%) after band removal to revisional LSG. Mean age 35.9 ± 10 years. The diagnosis was within 18 ± 14 days after surgery. Five (6.3%) patients were diagnosed during the same admission. Only 29.3% of patients were diagnosed correctly from the first visit to the ER. Most were misdiagnosed as gastritis (49%) and pneumonia (22.6%). Thirty-four patients (45.3%) were diagnosed correctly at the third visit. The most common presenting symptoms were abdominal pain (90%), tachycardia (71.3%), and fever (61.3%). The mean white blood cells (WBCs) count was 14700 ± 5900 (cells/mm3), c-reactive protein (CRP) 270 ± 133 mg/L, lactic acid 1.6 ± 0.85 mmol/L, and albumin 30.3 ± 6.6 g/L. The abdominal CT scans revealed intraabdominal collection in 93.7% of patients, extravasation of contrast in 75%, and pleural effusion in 52.5%. Upper gastrointestinal contrast study (UGIC) showed extravasation of contrast in 77.5% of patients. Conclusion Abdominal pain, tachycardia, or fever after LSG should raise the suspicion of a leak. CT scan of the abdomen and UGIC study detected leaks in 75% and 77.5% consecutively. Only 29.3% of patients were diagnosed correctly as a leak from the first visit to the ER.

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Early Catheter Removal Improves Patient Survival in Peritoneal Dialysis Patients with Fungal Peritonitis: Results of Ninety-Four Episodes of Fungal Peritonitis at a Single Center

Peritoneal Dialysis International ◽

10.3747/pdi.2009.00057 ◽

2011 ◽

Vol 31 (1) ◽

pp. 60-66 ◽

Cited By ~ 24

Author(s):

Tae Ik Chang ◽

Hyun Wook Kim ◽

Jung Tak Park ◽

Dong Hyung Lee ◽

Ju Hyun Lee ◽

...

Keyword(s):

Abdominal Pain ◽

Peritoneal Dialysis ◽

Intestinal Obstruction ◽

Multivariate Logistic Regression Analysis ◽

Clinical Findings ◽

Catheter Removal ◽

High Morbidity ◽

Fungal Peritonitis ◽

Presenting Symptoms ◽

Cell Counts

BackgroundFungal peritonitis (FP) is an uncommon but serious complication of peritoneal dialysis (PD) and is associated with high morbidity and mortality. Although previous studies have demonstrated that abdominal pain and catheter in situ are associated with mortality in FP patients, the effect of early catheter removal on mortality remains largely unexplored. In this study, therefore, we not only determine the risk factors for mortality but also investigate the effect of immediate catheter removal on mortality in PD patients with FP.Patients and MethodsThis retrospective study was conducted on 94 episodes of FP in 1926 patients that underwent PD at Yonsei University Health System from January 1992 to December 2008. Data including demographic characteristics, laboratory and clinical findings, management, and outcome were collected from medical records.ResultsAmong a total of 2361 episodes of peritonitis, there were 94 episodes of FP in 92 patients, which accounted for 4.0% of all peritonitis episodes and occurred in 4.8% of patients. Mean age of patients was 52.1 years and mean duration of PD before contracting FP was 46.1 months. The presenting symptoms included turbid dialysate (93.6%), abdominal pain (84.0%), and fever (66.0%). Intestinal obstruction was complicated in 39 episodes (41.5%). 75% of FP was caused by Candida species, among which Candida albicans was the most common pathogen, accounting for 41.5% of all episodes of FP. The PD catheter was removed within 24 hours in 39 patients (41.5%), whereas catheter removal was performed between 2 and 9 days after the diagnosis of FP in 42 patients (44.7%). 27 patients (28.7%) died as a result of FP, 59 patients (62.8%) required a change to hemodialysis, and PD was resumed in 8 episodes (8.5%). In addition, the mortality rate was significantly higher in patients with delayed catheter removal (13/41, 31.7%) compared to patients with catheter removal within 24 hours (5/39, 12.8%) ( p < 0.01). Multivariate logistic regression analysis revealed that delayed catheter removal, the presence of intestinal obstruction, and higher white blood cell counts in the blood and in the PD effluent were independently associated with mortality in FP patients.ConclusionThese results suggest that immediate catheter removal ( i.e., within 24 hours after the diagnosis of FP) is mandatory in PD patients with FP.

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ACUTE ABDOMINAL PAIN IN CHILDREN

The Professional Medical Journal ◽

10.29309/tpmj/2015.22.08.1161 ◽

2015 ◽

Vol 22 (08) ◽

pp. 1080-1086

Author(s):

Muhammad Ali Sheikh ◽

Tariq Latif

Keyword(s):

Abdominal Pain ◽

Acute Appendicitis ◽

Acute Abdominal Pain ◽

Paediatric Surgery ◽

Discharge Diagnosis ◽

Lower Quadrant ◽

Rebound Tenderness ◽

Presenting Symptoms ◽

Symptoms And Signs ◽

Right Lower Quadrant

Objective: To determine the clinical outcomes of acute abdominal pain andevaluation of symptoms and signs in children admitted in pediatric surgery department.Design: Cohort study. Place and Duration of study: This study was conducted in Departmentof Paediatric Surgery Shaikh Zayed Hospital, Lahore between August 2010 to August 2012.Patients and methods: Children aged 2 to 14 years who presented to emergency departmentwith complaint of acute abdominal pain of less than 5 days duration and admitted in pediatricsurgery department were included. Presenting symptoms, signs, hospital course of patientsand discharge diagnosis were recoded. Data was analyzed by SPSS. Results: Out of 73104patients who were seen in Paediatric emergency 1420 (1.94%) were referred for surgicalevaluation. Out of these 157 children were admitted. Six patients left against medical adviceso 151 patients were studied. Patients were divided into acute appendicitis, non-specificpain abdomen and miscellaneous categories on the basis of discharge diagnosis. Acuteappendicitis was diagnosed in 61(40.4%) patients. The patients who were admitted and nocause of pain abdomen could be found in them, were included in non-specific pain abdomengroup. NSPA group had 39 (25.8%) patients. Rests of the 51 (33.8%) patients were includedin miscellaneous group. Anorexia, fever, pain in right lower quadrant, tenderness in right iliacfossa, guarding, rebound tenderness and tachycardia were all significantly higher in patientswith acute appendicitis. Conclusion: Most of the children with acute abdominal pain wouldnot require surgery. Detailed history and thorough physical examination are cornerstone of thediagnosis.

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Appendicular Tuberculosis as Manifestation of Gastrointestinal Tuberculosis: A Case Report

Jurnal Respirasi ◽

10.20473/jr.v7-i.3.2021.122-126 ◽

2021 ◽

Vol 7 (3) ◽

pp. 122

Author(s):

Yuliza Yuliza ◽

Alfian Nur Rosyid ◽

Wiwin Is Effendi ◽

Prastuti Asta Wulaningrum ◽

Herley Windo Setiawan

Keyword(s):

Abdominal Pain ◽

Acute Appendicitis ◽

Histopathological Examination ◽

Signs And Symptoms ◽

Definitive Diagnosis ◽

Chronic Abdominal Pain ◽

Gastrointestinal Tuberculosis ◽

Clinical Presentations ◽

Histopathology Result ◽

The Right

Introduction: Gastrointestinal tuberculosis (GI TB) is quite rare with 3% incidence of all extrapulmonary involvement. Appendicular TB may occur in 0.1 - 3% of cases. Diagnosis is often difficult because the patient usually complains about chronic abdominal pain and fever. A definite diagnosis is based on histopathological examination of resected specimens from the appendectomy procedure.Case: We present a 37-year-old male patient admitted to the hospital with chronic abdominal pain, fever, nausea, and loss of body weight. The patient never had a persistent cough, hemoptysis, or night sweating. Physical examination showed pain and muscular rigidity in the right iliac area during palpation with Blumberg's sign and Rovsing's sign positive. Abdomen ultrasound imaging showed an appendicular abscess. The patient underwent appendectomy afterwards with histopathology result showing TB. The patient was treated with first category anti-tuberculosis drugs (ATD).Discussion: Diagnosis of appendicular TB is difficult due to unspecific clinical presentations. Appendicular TB patients often complain of signs and symptoms which are similar to acute appendicitis. These conditions can delay ATD treatment because the definitive diagnosis could be made after histopathological examination.Summary: Appendicular TB is a rare case of extrapulmonary TB. It can present as acute appendicitis. The definitive diagnosis is based on the histopathological examination. It is recommended to check the appendicectomy specimens histopathologically to exclude TB or other diseases.

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Hernia interna estrangulada por plastrón en el tercio distal del apéndice cecal

Studies in the Economic History of Southern Africa ◽

10.22201/fm.24484865e.2019.62.6.03 ◽

2019 ◽

Vol 62 (6) ◽

pp. 24-27

Author(s):

Leslie M. Leyva Sotelo ◽

José E. Telich Tarriba ◽

Daniel Ángeles Gaspar ◽

Osvaldo I. Guevara Valmaña ◽

André Víctor Baldín ◽

...

Keyword(s):

Abdominal Pain ◽

Small Bowel ◽

Early Diagnosis ◽

Intestinal Obstruction ◽

Acute Abdomen ◽

Internal Hernia ◽

Wide Spectrum ◽

Internal Hernias ◽

Mild Abdominal Pain ◽

Made In

Internal hernias are an infrequent cause of intestinal obstruction with an incidence of 0.2-0.9%, therefore their early diagnosis represents a challenge. The most frequently herniated organ is the small bowel, which results in a wide spectrum of symptoms, varying from mild abdominal pain to acute abdomen. We present the case of an eight-year old patient with nonspecific digestive symptoms, a transoperative diagnosis was made in which an internal hernia was found strangulated by plastron in the distal third of the appendix. Appendectomy was performed and four days later the patient was discharged without complications.

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