Ectopic decidua of the appendix: a case report

Abstract Background Ectopic decidua is the presence of decidual tissue outside the uterus. Ectopic decidua of the appendix is a rare entity that can present with abdominal symptoms mimicking appendicitis. We report a case of a 39-year-old female patient at 27 weeks gestational age with a 2-day history of right lower quadrant abdominal pain. Case presentation The patient was referred to our hospital with suspicion of either acute appendicitis or threatened rupture of the uterus, the latter of which was considered unlikely following close examination. Therefore, she underwent emergency appendectomy via laparotomy. Microscopic examination revealed decidual tissue with myxoid degeneration in the subserosal layer of the tip side of the appendix, without endometriosis, which was compatible with ectopic decidua (deciduosis). Conclusions Because it is extremely difficult to distinguish ectopic decidua of the appendix from acute appendicitis, even with various imaging modalities, we should be aware that ectopic decidua of the appendix is a differential diagnosis for acute appendicitis in pregnant women.

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Reduction En-Masse of Inguinal Hernia After Self-Reduction

10.21203/rs.3.rs-72119/v1 ◽

2020 ◽

Author(s):

Khosrow Najjari ◽

Hossein Zabihi Mahmoudabadi ◽

Seyed Zeynab Seyedjavadeyn ◽

Reza hajebi

Keyword(s):

Small Intestine ◽

Inguinal Hernia ◽

Closed Loop ◽

Recurrent Inguinal Hernia ◽

Lower Quadrant ◽

Case Presentation ◽

History Of ◽

The Right ◽

Right Lower Quadrant

Abstract Background: Reduction en-mass (REM) is one of the rare complications of inguinal hernia reduction. Case presentation: Our patient is a 50-year-old man with a history of inguinal hernia, who had been referred with the periumbilical pain that radiated to the right lower quadrant following hernia replacement by himself. Conclusions: Finally, REM diagnosis was made based on clinical examination and imaging, and surgical treatment was performed. in very rare cases, hernia was reduced by patients themselves. In this case study, a patient with a history of recurrent inguinal hernia was reported. The patient himself reduced his hernia the last time. In CT of the abdomen and pelvis, evidence of sac wall and small intestine fibrosis was seen as closed loop.

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Neonate born with ischemic limb to a COVID-19 positive mother: management and review of literature

Case Reports in Perinatal Medicine ◽

10.1515/crpm-2020-0086 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Shahana Perveen ◽

Karmaine A. Millington ◽

Suchitra Acharya ◽

Amit Grag ◽

Vita Boyar

Keyword(s):

Differential Diagnosis ◽

Compartment Syndrome ◽

Upper Extremity ◽

Preterm Neonate ◽

Review Of Literature ◽

Case Presentation ◽

Ischemic Limb ◽

History Of ◽

Hand Amputation ◽

Work Up

AbstractObjectivesTo describe challenges in diagnosis and treatment of congenital neonatal gangrene lesions associated with history of maternal coronavirus disease 2019 (COVID-19) infection.Case presentationA preterm neonate was born with upper extremity necrotic lesions and a history of active maternal COVID-19 infection. The etiology of his injury was challenging to deduce, despite extensive hypercoagulability work-up and biopsy of the lesion. Management, including partial forearm salvage and hand amputation is described.ConclusionsNeonatal gangrene has various etiologies, including compartment syndrome and intrauterine thromboembolic phenomena. Maternal COVID-19 can cause intrauterine thrombotic events and need to be considered in a differential diagnosis.

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Appendicitis: a rare adverse event in colonoscopy

BMJ Case Reports ◽

10.1136/bcr-2021-242523 ◽

2021 ◽

Vol 14 (7) ◽

pp. e242523

Author(s):

Samer Al-Dury ◽

Mohammad Khalil ◽

Riadh Sadik ◽

Per Hedenström

Keyword(s):

Emergency Department ◽

Adverse Event ◽

Abdominal Pain ◽

Acute Appendicitis ◽

Physical Examination ◽

De Novo ◽

Perforated Appendicitis ◽

Lower Quadrant ◽

The Right ◽

Right Lower Quadrant

We present a case of a 41-year-old woman who visited the emergency department (ED) with acute abdomen. She was diagnosed with perforated appendicitis and abscess formation on CT. She was treated conservatively with antibiotics and discharged. On control CT 3 months later, the appendix had healed, but signs of thickening of the terminal ileum were noticed and colonoscopy was performed, which was uneventful and showed no signs of inflammation. Twelve hours later, she developed pain in the right lower quadrant, followed by fever, and visited the ED. Physical examination and blood work showed signs consistent with acute appendicitis, and appendectomy was performed laparoscopically 6 hours later. The patient recovered remarkably shortly afterwards. Whether colonoscopy resulted in de novo appendicitis or exacerbated an already existing inflammation remains unknown. However, endoscopists should be aware of this rare, yet serious complication and consider it in the workup of post-colonoscopy abdominal pain.

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Amyand's hernia and acute appendicitis: Case presentation in Basic Hospital of Chone

International Journal of Health Sciences ◽

10.29332/ijhs.v4n2.440 ◽

2020 ◽

Vol 4 (2) ◽

pp. 19-23

Author(s):

Orelvis Rodríguez Palmero ◽

Liseidy Ordaz Marin ◽

María Del Rosario Herrera Velázquez ◽

Agustín Marcos García Andrade

Keyword(s):

Abdominal Pain ◽

Inguinal Hernia ◽

Acute Appendicitis ◽

Physical Examination ◽

Iliac Fossa ◽

Amyand’S Hernia ◽

Case Presentation ◽

The North ◽

History Of ◽

The Right

Present the case of a 66-year-old male patient, with a history of right inguinal hernia, who was referred to the emergency room at the IESS de Chone Basic Hospital in the north of the Manabí province, Ecuador, with symptoms of Abdominal pain of more than 24 hours of evolution located in the right iliac fossa and inguinal region on the same side, in the physical examination the hernia was impossible to reduce, so he was taken to the operating room, in the intervention the cecal appendix was found swollen within the hernial sac, a condition known as Amyand's hernia.

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Pancreatic Panniculitis Associated with Acinar Cell Pancreatic Carcinoma

Journal of Cutaneous Medicine and Surgery ◽

10.2310/7750.2007.00032 ◽

2008 ◽

Vol 12 (1) ◽

pp. 38-42 ◽

Cited By ~ 10

Author(s):

Susan M. Poelman ◽

Khue Nguyen

Keyword(s):

Differential Diagnosis ◽

Pancreatic Disease ◽

Acute Onset ◽

Clinical Approach ◽

Rare Entity ◽

Subcutaneous Nodules ◽

History Of ◽

Practical Tool ◽

Pancreatic Disorders ◽

Pancreatic Panniculitis

Background: Pancreatic panniculitis is a rare entity, occurring in less than 2% of patients with pancreatic disorders. Skin manifestations may precede the diagnosis of a pancreatic disease by many months. When treatable, correction of the underlying pancreatic disorder may lead to prompt resolution of the panniculitis. Objective: We present the case of a 74-year-old-man with a history of chronic pancreatitis who presented with an acute onset of tender, nonulcerating nodules. The clinical and histologic features of pancreatic panniculitis are discussed, with a brief review of the differential diagnosis and clinical approach to panniculitis. Conclusions: Pancreatic panniculitis is a recognizable clinical entity with characteristic histologic features that may resolve with treatment of the underlying pancreatic disorder. The algorithm-based clinical approach to panniculitis presented in this study is a practical tool designed to guide clinicians in ordering investigations and determining the appropriate management for patients presenting with subcutaneous nodules.

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Unusual case of classic testicular seminoma in a 90-year-old patient: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-020-02517-3 ◽

2020 ◽

Vol 14 (1) ◽

Author(s):

Ahmad Al-Mousa ◽

Mohammad Nour Shashaa ◽

Mohamad Shadi Alkarrash ◽

Mohamad Alkhamis ◽

Lina Ghabreau ◽

...

Keyword(s):

Differential Diagnosis ◽

Case Report ◽

Elderly Patients ◽

Unusual Case ◽

Medical Literature ◽

Testicular Tumor ◽

Testicular Seminoma ◽

Case Presentation ◽

History Of ◽

Pure Seminoma

Abstract Background Seminoma is the most common subtype of testicular cancer and occurs most commonly in patients aged 30–49 years, but decreases to a very low level in men in their 60s or older. Case presentation A 90-year-old Syrian man with a 6-year history of an increase in size of his right scrotum, presented to the urological clinic and, on clinical examination, the findings suggested testicular tumor. After orchiectomy and histology results based on microscopic and immunohistochemical examinations, a pure seminoma was diagnosed, so we describe in this case report the second-oldest patient with classical seminoma in the medical literature. Conclusion This case report has been written to focus on the probability of any type of testicular tumor occurring at any age or decade; urologists should consider seminoma as a differential diagnosis with any testicular swelling even in elderly patients.

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Predictive value of scoring systems for the diagnosis of acute appendicitis in emergency department patients: Is there an accurate one?

Hong Kong Journal of Emergency Medicine ◽

10.1177/1024907919840175 ◽

2019 ◽

Vol 27 (5) ◽

pp. 262-269

Author(s):

Rohat Ak ◽

Fatih Doğanay ◽

Ebru Unal Akoğlu ◽

Haldun Akoğlu ◽

Aslı Bahar Uçar ◽

...

Keyword(s):

Inflammatory Response ◽

Acute Appendicitis ◽

Area Under The Curve ◽

Scoring Systems ◽

Acute Inflammatory Response ◽

Quadrant Pain ◽

Lower Quadrant Pain ◽

Lower Quadrant ◽

Right Lower Quadrant Pain ◽

Right Lower Quadrant

Background: Acute appendicitis is one of the challenging surgical conditions presented in the emergency departments. Clinical scoring systems were developed to reduce the negative appendectomy rate and also to avoid unnecessary diagnostic evaluation. Objectives: The primary aim was to compare the clinical adequacy of the Alvarado, Acute Inflammatory Response, and the Raja Isteri Pengiran Anak Saleha Appendicitis scores in patients with right lower quadrant pain for the diagnosis of acute appendicitis. Methods: This was a prospective and observational study. All patients over the age of 18 years who presented with a complaint of right lower quadrant pain were enrolled. The Alvarado, Acute Inflammatory Response, and Raja Isteri Pengiran Anak Saleha Appendicitis scoring systems were compared. The patients were either admitted or followed-up as out-patient. Face-to-face or telephone follow-up visits were arranged for the patients who did not have surgery and who were not admitted. Results: 232 patients were included and 14 patients were excluded from the study. Of the 218 patients, 114 patients underwent surgery. Of the 114 patients, 107 patients were pathologically diagnosed with acute appendicitis. It was determined that Raja Isteri Pengiran Anak Saleha Appendicitis score was the most valuable score with 0.88 accuracy, followed by Acute Inflammatory Response (area under the curve = 0.79) and Alvarado (area under the curve = 0.71) scores. Conclusion: The accuracy of Raja Isteri Pengiran Anak Saleha Appendicitis scoring system was higher for the diagnosis of acute appendicitis than the other scores. The cut-off of the Raja Isteri Pengiran Anak Saleha Appendicitis score from a 7.5-point threshold provides a practical, non-invasive, rapid diagnostic method that increases acute appendicitis discriminative power in patients presenting with right lower quadrant pain.

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Pancreatic Laceration in a Pediatric Patient: An Unexpected Diagnosis

Case Reports in Pediatrics ◽

10.1155/2017/2681835 ◽

2017 ◽

Vol 2017 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Michelle J. Hong ◽

Lauren M. Porter ◽

Debra D. Esernio-Jenssen ◽

Andrew C. Miller ◽

Marna Rayl Greenberg

Keyword(s):

Partner Violence ◽

Pediatric Population ◽

Lower Quadrant ◽

System A ◽

Complete Transection ◽

Pancreatic Injuries ◽

History Of ◽

Low Threshold ◽

Preservation Of The Spleen ◽

Right Lower Quadrant

Pediatric pancreatic injuries are rare. We present an atypical case that occurred in a 4-year-old male. The child presented with a twenty-four-hour history of vomiting that had progressed to right lower quadrant abdominal pain on examination in the emergency department. The initial differential was gastroenteritis versus appendicitis. An abnormality on the ultrasonography and an elevated lipase level eventually led to an MRI showing a complete transection through the posterior margin of the pancreas. The patient was admitted to pediatric surgery and underwent a successful distal pancreatectomy with preservation of the spleen. On further inquiry specific to trauma, the child disclosed that his older brother had punched him in his abdomen the night before. The child’s parents were separated due to intimate partner violence, and this older sibling recently had been very stressed. The sibling was referred for mental health evaluation and counseling, and the case reported to the county children and youth investigative services system. A low threshold for considering trauma and child abuse in the pediatric population is recommended when significant intra-abdominal injury is diagnosed.

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Right Lower Quadrant Abdominal Pain in a Patient with Prior Ventriculoperitoneal Shunting: Consider the Tip!

Case Reports in Medicine ◽

10.1155/2012/253027 ◽

2012 ◽

Vol 2012 ◽

pp. 1-2 ◽

Cited By ~ 1

Author(s):

Petros Charalampoudis

Keyword(s):

Abdominal Pain ◽

Acute Appendicitis ◽

Lower Quadrant ◽

Vp Shunt ◽

Quadrant Abdominal Pain ◽

Ventriculoperitoneal Shunting ◽

Infection Treatment ◽

Catheter Tip ◽

Colicky Pain ◽

Right Lower Quadrant

Introduction. Ventriculoperitoneal (VP) shunting is the treatment of choice for nonobstructive hydrocephalus. In patients with such a device, right lower quadrant abdominal pain can puzzle the surgeon, posing a differential diagnostic problem among appendicitis, nonsurgical colicky pain, and primary shunt catheter tip infection. Treatment is different in either case.Presentation of Case. We hereby present a case of a young woman with prior ventriculoperitoneal shunt positioning who presented to our department with right lower quadrant abdominal pain. The patient underwent a 24-hour observation including a neurosurgery consult in order to exclude acute appendicitis and VP shunt tip infection. Twenty four hours later, the patient’s symptomatology improved, and she was discharged with the diagnosis of atypical colicky abdominal pain seeking a gastroenterologist consult.Discussion. This case supports that when a patient with prior VP shunting presents with right lower quadrant abdominal pain, differential diagnosis can be tricky for the surgeon.Conclusion. Apart from acute appendicitis, primary or secondary VP catheter tip infection must be considered because the latter can be disastrous.

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