scholarly journals Giant sigmoid diverticulitis mimicking acute appendicitis

2011 ◽  
Vol 93 (6) ◽  
pp. e89-e90 ◽  
Author(s):  
M Anderton ◽  
B Griffiths ◽  
G Ferguson
Keyword(s):  
Computed Tomography ◽  
Iliac Fossa ◽  
Treatment Options ◽  
Sigmoid Diverticulitis ◽  
Acute Presentation ◽  
Rare Manifestation ◽  
Giant Sigmoid Diverticulum ◽  
Right Iliac Fossa Pain ◽  
Colonic Diverticula

Giant colonic diverticula are a rare manifestation of diverticular disease and there are fewer than 150 cases described in the literature. They may have an acute or chronic presentation or may remain asymptomatic and be found incidentally. As the majority (over 80%) of giant diverticula are located in the sigmoid colon, they usually present with left-sided symptoms but due to the variable location of the sigmoid loop, right-sided symptoms are possible. We describe the acute presentation of an inflamed giant sigmoid diverticulum with right iliac fossa pain. We discuss both the treatment options for this interesting condition and also the important role of computed tomography in the diagnosis and management of abdominal pain in elderly patients.

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 A feasibility randomised controlled trial to evaluate the role of computed tomography in adults with atypical right iliac fossa pain

2019 ◽  
Vol 101 (8) ◽  
pp. 546-551
Author(s):  
R Jones ◽  
D Olatunbode ◽  
J Dean ◽  
B Hall ◽  
D Harji ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Randomised Controlled Trial ◽  
Diagnostic Accuracy ◽  
Standard Care ◽  
Controlled Trial ◽  
Iliac Fossa ◽  
Randomised Trial ◽  
Final Analysis ◽  
Right Iliac Fossa Pain ◽  
Randomised Controlled

Background In patients with right iliac fossa pain, the need for surgery is largely determined by the likelihood of appendicitis. Patients often undergo ultrasound scanning despite a low diagnostic accuracy for appendicitis. This study aimed to determine the feasibility of a larger trial of computed tomography in the evaluation of patients with atypical right iliac fossa pain. Materials and methods A single-centre, unblinded, parallel randomised controlled trial of computed tomography in the assessment of patients with atypical right iliac fossa pain. After a retrospective evaluation, standard care was defined as serial examination with or without ultrasound. Atypical right iliac fossa pain was defined as no firm diagnosis after initial senior review. Simple descriptions of the risks and benefits of computed tomography were devised for patients to consider. Primary objectives were to assess feasibility and acceptability of the study procedures. Results A total of 71 patients were invited to participate and 68 were randomised. Final analysis included 31 participants in the standard care arm and 33 in the computed tomography arm, with comparable demographics. Computed tomography was associated with superior diagnostic accuracy, with 100% positive and negative predictive value. The proportion of scans that positively influenced management was 73% for computed tomography and 0% for ultrasound. In the computed tomography arm, there was a trend towards a shorter length of stay (2.3 vs 3.1 days) and a lower negative laparoscopy rate (2 of 11 vs 4 of 9). Conclusion A large randomised trial to evaluate the use of unenhanced computed tomography in atypical right iliac fossa pain appears feasible and justified.

scholarly journals Diagnostic Role of Ultrasonography in Right Iliac Fossa Pathologies

2019 ◽  
Vol 7 (3) ◽  
pp. 382-386
Author(s):  
Mishal Javaid ◽  
Ayesha Tariq ◽  
Hiba Noreen Javaid
Keyword(s):  
Imaging Modality ◽  
Iliac Fossa ◽  
Sampling Technique ◽  
High Volume ◽  
Symptom Duration ◽  
Cross Sectional ◽  
Use Of Resources ◽  
Diagnostic Role ◽  
Right Iliac Fossa Pain

Ultrasound is often the imaging modality of choice in patients with acute right iliac fossa pain.  Right iliac fossa pain remains the commonest clinical dilemma encountered by general surgeons. The management of acute right iliac fossa pain is audited, examining the relationship between symptom duration, use of pre-operative radiological imaging and patient outcome. Objective: To determine the diagnostic role of ultrasonography in Right Iliac Fossa pathologies. Methods: A cross sectional descriptive study was carried out at the Department of Radiology in Sir Ganga Ram Hospital Lahore, Pakistan. Duration of study was from March 2018 to November 2018. 85 patients with Right Iliac Fossa pain selected through convenient sampling technique. Statistical software for social sciences (SPSS version 22.0) is used for the analysis of data. Conclusion: The results in the study reflect findings from high volume emergency surgical departments and patients of pain in right iliac fossa demonstrating that unfocussed abdominal and pelvic ultrasounds are not an appropriate use of resources in patients with Right iliac fossa pain. Int. J. Appl. Sci. Biotechnol. Vol 7(3): 382-386  

scholarly journals P118 The 134-year-old problem meets the 1-year-old problem: lessons learned in managing acute appendicitis during the COVID era

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Sherwin Fernando ◽  
Diwakar Ryali Sarma ◽  
Sherwin Fernando
Keyword(s):  
Pain Treatment ◽  
Iliac Fossa ◽  
Lessons Learned ◽  
Open Approach ◽  
Patient Demographics ◽  
Right Iliac Fossa Pain ◽  
American Society ◽  
The Uk ◽  
The Right

Abstract Introduction The Right Iliac Fossa Pain Treatment (RIFT) study highlighted the rate of negative appendicectomies in the UK as one third of all procedures. However, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/COVID) pandemic has changed surgical practice. New practices in the COVID era have changed the rate of negative appendicectomies. Methods A retrospective analysis was conducted of patients admitted with appendicitis from March 2020 to June 2020. Patient Demographics 58 patients were identified, 43 (74%) were adults and 15 (26%) were children. The median age of the adults was 33 (range 18-80) and the median American Society of Anaesthetists (ASA) grading was 1. The median age of children was 11 (range 4-17) and all were ASA grade 1. Results 73.8% (31) of adult patients had a Computerised Tomography (CT) scan as part of their workup. 40% of paediatric patients underwent an ultrasound scan of the abdomen whilst the remaining 60% were diagnosed clinically. The open approach was favoured in both cohorts (39.5% and 46.7% respectively). No negative appendicectomies were performed. Conclusion COVID19 has changed practice resulting in better outcomes for colorectal units. Further studies (COVID SURG and COVID HAREM) are needed to fully assess the role of imaging in reducing the number of negative appendicectomies.

scholarly journals Seeing past the appendix: the role of ultrasound in right iliac fossa pain

Ultrasound ◽  
2013 ◽  
Vol 22 (2) ◽  
pp. 104-112
Author(s):  
White EK ◽  
MacDonald L ◽  
Johnson G ◽  
Rudralingham V
Keyword(s):  
Iliac Fossa ◽  
Right Iliac Fossa Pain

scholarly journals EP.FRI.229 The Role of Ultrasound in the Diagnosis of Paediatric Appendicitis

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Lará Armstrong ◽  
Conor McGuigan ◽  
Muhammad Yousaf
Keyword(s):  
Low Cost ◽  
Iliac Fossa ◽  
District General Hospital ◽  
Highly Sensitive ◽  
Right Iliac Fossa Pain ◽  
Operative Ultrasound ◽  
Negative Appendicectomy ◽  
Surgical Unit ◽  
Do So

Abstract Background Acute appendicitis remains the most common acute surgical presentation among children and adults. Ultrasonography is a commonly used investigation for patients with right iliac fossa pain were the diagnosis is unclear, however in a district general hospital (DGH), appropriate radiologists are not often readily available. The aim of this study was to determine the value of ultrasonography in the diagnosis of appendicitis in children. Methods A retrospective review was carried out of all paediatric patients (aged 5-16), who underwent an appendicectomy in a single acute surgical unit, over a 6 month period.  An institutional database and up to date electronic care records were used to record preoperative ultrasound results, intraoperative findings and histopathology results. Results A total of 59 patients were admitted with possible appendicitis within the audit window, 31 of which underwent an appendicectomy, 58% performed laparoscopically.  38.7% underwent pre- operative ultrasound, 33.3% of which identified an acutely inflamed appendix. The remaining patients who did not proceed to theatre were successfully discharged with no re-attendance following a period of observation. Following histopathological confirmation, ultrasonography was found to have a sensitivity and specificity of 100%. Negative appendicectomy rate returned at 6.7%. Conclusion Ultrasonography is a low cost, highly sensitive diagnostic tool in appendicitis, where provisions are in place to do so. Visualising the appendix on ultrasound can reduce negative pathology rates. This is a small study within a DGH and access to ultrasound is limited. Better utilisation or the development of a protected ultrasound slot should be sought.

scholarly journals Analysis of diagnostic laparoscopy in chronic right iliac fossa pain

2017 ◽  
Vol 4 (4) ◽  
pp. 1259
Author(s):  
Umesh Vaishnav ◽  
Harshad S. Patel
Keyword(s):  
Diagnostic Laparoscopy ◽  
Iliac Fossa ◽  
Laboratory Finding ◽  
Radiological Finding ◽  
Minimal Invasive ◽  
General Surgeon ◽  
Positive Finding ◽  
Surgical Department ◽  
Right Iliac Fossa Pain

Background: Chronic right iliac fossa pain with normal radiological and laboratory finding is common indication for diagnostic laparoscopy by general surgeon. Most common cause of chronic right iliac fossa pain is appendicitis. Laparoscopic appendectomy is commonly done in diagnostic laparoscopy if other cause is not found.Methods: Patients of all the age group and either gender, undergone diagnostic laparoscopy for chronic right iliac fossa pain longer than 3 months with normal radiological finding in the surgical department. Diagnostic and therapeutic role of laparoscope was assessed.Results: 83% patients were showing visible positive finding on diagnostic laparoscopy. On follow up after 1 month, 90% patients show reliving of pain.Conclusions: Diagnostic laparoscopy is minimal invasive surgical procedure. It is useful when other pathological and radiological investigations are inclusive.

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