scholarly journals Acute Appendicitis with Perinephric Abscess - A Rare Occurrence

2021 ◽  
Vol 10 (10) ◽  
pp. 743-745
Author(s):  
Azharuddin Mohd ◽  
Harpreet Singh Jolly ◽  
Subhash Goyal
Keyword(s):  
Acute Appendicitis ◽  
Venous Blood ◽  
Ileocecal Valve ◽  
Vermiform Appendix ◽  
Low Grade ◽  
Perinephric Abscess ◽  
Direct Spread ◽  
Mesenteric Vessels ◽  
Laboratory Investigations ◽  
Loss Of Appetite

Vermiform appendix previously thought to be a vestigial organ, has a variable length of 2 - 20 cms. It arises from posteromedial wall of cecum, around 2 cms lower than the ileocecal valve. The tip of appendix can be in different directions like retrocecal, pelvic, subcecal, retroileal, preileal, subhepatic and ectopic.1 The appendix is supplied by the appendicular artery, anterior and posterior cecal arteries. Ileocolic and right colic veins drain venous blood of appendix. Ileocolic lymph nodes adjacent to the superior mesenteric artery drains the lymphatics.2 Acute appendicitis remains the commonest cause of acute abdominal pain requiring surgical intervention.3 Acute appendicitis may present as loss of appetite, periumbilical pain, nausea and few episodes of vomiting, associated with low grade fever (38˚ C), there is also signs of peritoneal inflammation in lower abdomen.4 Acute appendicitis is actually a clinical diagnosis and confirmed by laboratory investigations like neutrophilia and radiological studies like ultrasonography abdomen.5 Appendicular perforation, cecal perforation, gangrene, periappendicular abscess, peritonitis, bowel obstruction, septic seeding of mesenteric vessels, and very rarely perinephric abscess are the complications of acute appendicitis.6 Purulent collection between the kidney and Gerota’s fascia is called as perinephric abscess, mostly occurs due to rupture of intrarenal abscess into the space between kidney and Gerota’s fascia, few other causes of perinephric abscess include haematogenous spreading from other sites of infection and direct spread from adjacent viscera, perforated colon carcinoma, diverticulitis and osteomyelitis of adjacent ribs or vertebrae.7

scholarly journals De Garengeot’s hernia with appendicitis—a rare cause of an acutely painful groin swelling

2019 ◽  
Vol 2019 (5) ◽  
Author(s):  
Adam O’Connor ◽  
Peter Asaad
Keyword(s):  
Acute Appendicitis ◽  
Hernia Repair ◽  
Mesh Repair ◽  
Vermiform Appendix ◽  
Short Review ◽  
Review Of The Literature ◽  
Hernia Sac ◽  
De Garengeot’S Hernia ◽  
De Garengeot Hernia ◽  
Groin Swelling

Abstract De Garengeot hernia is a rare subtype of femoral hernia whereby the vermiform appendix is located within the hernial sac. Even rarer is the presence of appendicitis within the hernia sac. De Garengeot’s hernia is difficult to diagnose pre-operatively and can prove technically difficult at operation particularly with regards to mobilization of the caecum and appendix in order to perform appendicectomy. Laparoscopic, open, with and without mesh repair of de Garengeot hernia have all been described in the literature with varying degrees of success. We present a case of an 82 year old lady presenting with an acutely painful right sided groin lump. CT scan revealed the presence of de Garengeot hernia with acute appendicitis. We describe in text and photo format our approach to the hernia repair, appendicectomy and provide a short review of the literature with regards to the different operative approaches to such a patient.

Rheumatic Pneumonia: The Need for a New Approach

PEDIATRICS ◽  
1975 ◽  
Vol 56 (6) ◽  
pp. 1075-1078
Author(s):  
Steven P. Serlin ◽  
Mary Ellen Rimsza ◽  
John H. Gay
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Acute Appendicitis ◽  
Mexican American ◽  
Community Hospital ◽  
Good Health ◽  
Low Grade ◽  
New Approach ◽  
Rare Manifestation ◽  
Comprehensive Discussion

Rheumatic pneumonia is a well-described, poorly understood, rare manifestation of rheumatic fever that is generally fatal. Until 1958, when Brown and his colleagues presented their comprehensive discussion, pediatric journals provided only five references. Since then, only one article has appeared in the pediatric literature. As illustrated by the following case report, pediatricians need to be aware of rheumatic pnuemonia in order to determine optimal therapy and management. CASE REPORT A.M., a 13-year-old Mexican-American boy, was in apparent good health until he developed fleeting arthralgia, abdominal pain, and low-grade fever. The day following the onset of symptoms acute appendicitis was suspected, and a laparotomy was performed at a community hospital.

Role of susceptibility weighted imaging (SWI) in assessment of intra axial brain neoplasms in adults

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Pasant Mohamed Abo-Elhoda Darwish Mohamed Abo-Elhoda ◽  
Hesham Mahmoud Ahmed Mansour ◽  
Yosra Abdelzaher Abdullah ◽  
Eman Ahmed Fouad Darwish
Keyword(s):  
Brain Neoplasms ◽  
Tumor Size ◽  
Venous Blood ◽  
Brain Parenchyma ◽  
P Value ◽  
Susceptibility Weighted Imaging ◽  
Low Grade ◽  
Chi Square ◽  
Cross Sectional

Abstract Background Susceptibility weighted imaging (SWI) is a 3D gradient-echo MR technique that is based on blood oxygen level dependent (BOLD) induced phase effects between the venous blood and the surrounding brain parenchyma. SW-MR imaging allows for noninvasive visualization of small veins at submillimeter resolution and, therefore, is used to depict venous architecture in brain lesions. The extreme sensitivity of SWI for the detection of neovascularity (venous blood), haemorrhage, and calcification has been an indispensable tool for characterization of the internal architecture of brain tumours. Objectives Is to evaluate the role of Susceptibility weighted imaging in assessment of adults Intra axial brain Neoplasms, and its ability to characterize them into high and low grade lesions in comparison to histopathology which will be used as gold standard. Methods A cross sectional study including 31 patients suspecting intracranial brain neoplasm radiologically and clinically, conducted at Private center, the patients were investigated using Siemens machine Magnetom Skyra 3T, the period was between January 2018 till the end of June 2019 . Results Our study included 31 patients. Including 15 female and 16 male patients, with the patient’s age ranging from 20 to 68 years old with median 48 years old ranging from 35.75 (25% percentile) to 58.75 (75% percentile). Among total cases, there were 8 patients with grade 2 glioma, 10 patients with grade 3 glioma and 6 patients with grade 4 glioma, 2 patients with lymphoma and 5 patients with brain metastasis (1 lung cancer and 4 breast cancer). All the patients were evaluated with MRI including SWI sequence with special comment on the number of the intratumoral susceptibility signal (ITSS), the size of the ITSS, its morphology as well as the ratio of the ITSS to the tumor size, which were then correlated with the patient histopathological results obtained later. The study revealed that the best parameter to accurately grade the tumor is the number of ITSS within the lesion with P value 0.001, followed by the size of the ITSS with P value 0.002 and Pearson Chi-Square value equals 20.6, while the lowest one was the ratio of the ITSS to the tumor size with P value 0.002 Pearson Chi-Square value equals 17.3. Our study showed that the morphology alone was not able to accurately grade the tumor with P value 0.007 ( Not significant) Conclusion SWI using 3T MR system provides quite useful information for preoperative tumor grading. There seems to be a strong correlation between pathological grading and that assessed with SWI.

scholarly journals Ultrasonographicpotencial in detection of Acute Appendicitis

2009 ◽  
Vol 8 (4) ◽  
pp. 140-147
Author(s):  
V. N. Piskunov ◽  
V. D. Zavadovskaya ◽  
N. G. Zavyalova
Keyword(s):  
Acute Appendicitis ◽  
False Negative ◽  
Power Doppler ◽  
Vermiform Appendix ◽  
Vascular Pattern ◽  
True Negative ◽  
Horizontal Section ◽  
Negative Results ◽  
Interior Wall ◽  
Positive Results

On the grounds of ultrasonography of 275 patients with suspected Acute Appendicitis (AA) the diagnosis was confirmed in 63 (22,9%) cases, it was true-positive results; in 3 (1,1%) cases of non-confirmed AA ultrasound findings were regarded as false-positive results. True-negative results of examination were obtained in 194 cases (70,5%) and false-negative results — in 15 cases (5,5%). The presence of rarevascularity of interior wall and clear visualization of vessels in mesentery of vermiform appendix is typical for congestive appendicitis. When phlegmonous appendicitis there are numerous vascular branches in interior wall blood stream of appendix: they make a picture of color «crown» in horizontal section and color «stripe» in longitudinal section. Gangrenous appendicitis is attached to few color spots in those parts of appendix wall which are not destroyed yet. Vascular pattern in adjacent intestinal loops predominates over vascular pattern of vermiform appendix. In case of empyema vermiform appendix vascular pattern in the wall is detected only in mesentery area. Vascular pattern of appendix is not detected in cases of appendicular infiltrate and periappendicular abscess unlike vascular pattern of adjacent intestinal loops which is rather intensified. The sensitivity of ultrasonography in AA detection was 80,7%, specificity — 98,4%, and accuracy — 93,4%. High index of diagnostic effectiveness of the method was obtained because of adoption of combining B-mode with both Colour Doppler and Power Doppler methods.

Acute Appendicitis: The Reliability of Diagnosis by Clinical Assessment Alone

2005 ◽  
Vol 94 (3) ◽  
pp. 201-206 ◽  
Author(s):  
V. Kalliakmanis ◽  
E. Pikoulis ◽  
I. G. Karavokyros ◽  
E. Felekouras ◽  
P. Morfaki ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Clinical Assessment ◽  
Aged Patients ◽  
Duration Of Symptoms ◽  
Lower Quadrant ◽  
Rebound Tenderness ◽  
Local Rigidity ◽  
Long Duration ◽  
Appendiceal Inflammation ◽  
Loss Of Appetite

Background and Aims: This prospective study aimed to review the trustworthiness of the initial clinical assessment in acute appendicitis without employment of imaging modalities, laparoscopy or any other adjunct diagnostic test. Patients and Methods: 717 patients were operated on for appendicitis by six different surgeons. Initial clinical and laboratory examination were evaluated in relation to the intraoperative and the pathological appreciation of the appendiceal inflammation. Results: 598 patients were found to have appendicitis, 34 a different condition, 41 had both appendicitis and an additional condition and 44 no pathology. 6% of the laparotomies and 11 % of the appendectomies were unnecessary. The severity of the inflammation correlated significantly with periumbilical pain, pain migrating to right lower quadrant, loss of appetite, fever, rebound tenderness, local rigidity, polymorphonuclear predominance on deferential, polymorhonucleosis and leukocytosis. Leukocytosis was less frequent in aged patients. All the six surgeons were found to be equally reliable, although they all underestimated the setting compared to the pathologists. Patients with a long duration of symptoms had milder forms of inflammation and increased percentage of unanticipated abdominal conditions. Conclusions: Appendicitis can be reliably diagnosed clinically without employment of adjunct tests. These can be reserved for equivocal cases.

scholarly journals Morphologic criteria of vermiform appendix on computed tomography and a possible risk of developing acute appendicitis

2019 ◽  
Vol 52 (4) ◽  
pp. 217-221
Author(s):  
Amanda Chambi Tames ◽  
Fernando Ide Yamauchi ◽  
Adham do Amaral e Castro ◽  
Caroline Duarte de Mello Amoedo ◽  
Ellison Fernando Cardoso ◽  
...  
Keyword(s):  
Risk Factors ◽  
Computed Tomography ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Final Analysis ◽  
Vermiform Appendix ◽  
Transverse Diameter ◽  
Mechanical Obstruction ◽  
Abdominal Ct ◽  
Morphological Criteria

Abstract Objective: To evaluate the correlation of morphological criteria of the cecal appendix using computed tomography (CT) and the possible risk of developing acute appendicitis. Materials and Methods: Cases were defined as patients with surgically confirmed acute appendicitis who had undergone CT at least twice: at diagnosis and at least one month prior. Controls were defined as emergency patients with abdominal pain who had undergone abdominal CT that excluded acute appendicitis and had also undergone CT at least one month before. Results: 100 cases and 100 controls were selected for inclusion in the final analysis. Comparisons between the cases and controls revealed the following: mean transverse diameter of 0.6 cm (range, 0.4-1.0 cm) versus 0.6 cm (range, 0.6-0.8 cm; p = 0.37); mean length of 6.6 cm (range, 3.5-9.7 cm) versus 6.6 cm (range, 4.5-8.3 cm; p = 0.87); mean angle of 100° (range, 23-178°) versus 86° (range, 43-160°; p = 0.01); vertical descending orientation in 56% versus 45% (p = 0.2); absence of gas in 69% versus 77% (p = 0.34); and presence of an appendicolith in 17% versus 8% (p = 0.08). Conclusion: Hypothetical risk factors for obstruction of the vermiform appendix detected on CT were not associated with acute appendicitis. That suggests that factors other than those related to mechanical obstruction are implicated in the pathogenesis of acute appendicitis.

scholarly journals Acute Appendicitis Secondary to Appendiceal Endometriosis

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
João Paulo Nunes Drumond ◽  
André Luis Alves de Melo ◽  
Demétrius Eduardo Germini ◽  
Alexander Charles Morrell
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Clinical Picture ◽  
Acute Abdominal Pain ◽  
Rare Condition ◽  
Vermiform Appendix ◽  
Histopathological Analysis ◽  
Women Of Childbearing Age ◽  
Childbearing Age

Endometriosis in the vermiform appendix is a rare condition that affects women of childbearing age. The clinical picture can simulate inflammatory acute abdominal pain, especially acute appendicitis. Laboratory and imaging tests may assist in the diagnosis but are not conclusive. This article reports a case of acute appendicitis caused by appendiceal endometriosis for which laparoscopic appendectomy and diagnostic confirmation were performed after histopathological analysis.

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