COPROLITHS IN CHILDREN: RECOGNITION AND SIGNIFICANCE

PEDIATRICS ◽  
1964 ◽  
Vol 34 (3) ◽  
pp. 372-377
Author(s):  
Hugh J. Williams
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Subsequent Development ◽  
Signs And Symptoms ◽  
Proper Treatment ◽  
Asymptomatic Child ◽  
Abdominal Symptoms

1. Coproliths are sufficiently common in children and of such significance that the pediatrician should be "coprolith cognizant." 2. Eleven children with coproliths are reported including 2 under 2 years of age, the youngest recorded cases to date. 3. An abdominal roentgenogram in any child with unusual abdominal symptoms or pain is recommended since only by this step can a coprolith be detected and proper treatment implemented. 4. Immediate appendectomy is indicated in the child with abdominal pain and a demonstrable coprolith, even though the signs and symptoms are atypical for appendicitis. In 50% of such cases, rupture has already occurred. 5. Prophylactic appendectomy in the asymptomatic child in whom a coprolith is incidentally discovered is justified because of the frequent subsequent development of acute appendicitis.

scholarly journals Predictive Value of Alvarado Score and Ultrasound in the Diagnosis of Acute Appendicitis (A prospective study

2021 ◽  
Vol 62 (4) ◽  
pp. 99-103
Author(s):  
Waleed Saadi Ahmed ◽  
Salah M. Tajer ◽  
Hend M. Sayaly
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Signs And Symptoms ◽  
Cost Effective ◽  
General Surgeon ◽  
Emergency Ward ◽  
Alvarado Score ◽  
Combined Application ◽  
Abdominal Emergencies ◽  
A Prospective Study

Background:  Acute appendicitis is the commonest non traumatic cause of acute abdominal pain that needs surgical management .Alvarado score and ultrasonographies are the most cost effective, easy and available aids for diagnosis. The aim of the study was determining   the reliability of Alvarado score and ultrasound in the diagnosis of acute appendicitis. Results: The study was applied with 100 cases with different types of abdominal pain at presentation with 51 males and 49 females .The sensitivity was97.3% ,specificity 90%, and accuracy  89 of combined usage of Alvarado score and U/S findings preoperatively. Patients and method:  A prospective non-interventional study including patients admitted with suggestive history with signs and symptoms of acute appendicitis to the surgical emergency ward of Baghdad teaching hospital from July 1st 2017 to Feb 10th 2018, Alvarado score calculated and ultrasonography done for each patient enrolled in this study, then to be followed for intraoperative findings. Conclusions: Combined application of Alvarado score and U/S has sensitivity 94.1% ,specificity 90% and accuracy 89% . In our medical facility and emergency ward, acute appendicitis remains as one of the top acute abdominal emergencies needing surgery in patients presenting with atypical clinical finding. So diagnosis becomes difficult. So Alvarado score along with ultrasound findings are useful for increasing the reliability in emergency department for  accurate diagnosis of acute appendicitis therefore there should be training for the use of U/S by emergency physician and general surgeon in the diagnosis of acute appendicitis in order to decrease the rate of negative appendectomies .  

Cecal Epiploic Appendagitis: A Diagnostic and Therapeutic Dilemma

2007 ◽  
Vol 73 (8) ◽  
pp. 828-830 ◽  
Author(s):  
Vijaykumar G. Patel ◽  
Arundathi Rao ◽  
Reginald Williams ◽  
Radha Srinivasan ◽  
James K. Fortson ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Ct Scan ◽  
Abdominal Ct ◽  
Lower Quadrant ◽  
Radiographic Findings ◽  
Epiploic Appendagitis ◽  
Abdominal Symptoms ◽  
Abdominal Ct Scan ◽  
Limiting Condition

Acute epiploic appendagitis (EA) is a rare and often misdiagnosed cause of acute abdominal pain. Though a benign and often self-limiting condition, EA's ability to mimic other disease processes makes it an important consideration in patients presenting with acute abdominal symptoms. Careful evaluation of abdominal CT scan findings is crucial in the accurate diagnosis of epiploic appendagitis, thus avoiding unnecessary surgical intervention. We report a case of a 29-year-old male presenting with a two day history of generalized abdominal pain. Physical exam revealed a diffusely tender abdomen with hypoactive bowel sounds. The patient had a leukocytosis of 18,000 and abdominal CT scan revealed right lower quadrant inflammatory changes suggestive of acute appendicitis. Laparoscopic exploration revealed an inflamed gangrenous structure adjacent to the ileocecal junction. Pathologic evaluation revealed tissue consistent with epiploic appendagitis. Retrospective review of the CT scan revealed a normal appearing appendiceal structure superolateral to the area of inflammation. The patient recovered uneventfully with resolving leukocytosis. We present a case of cecal epiploic appendagitis mimicking acute appendicitis and review the current literature on radiographic findings, diagnosis, and treatment of this often misdiagnosed condition. General surgeons should be aware of this self-limiting condition and consider this in the differential diagnosis.

scholarly journals Nail Biting as a Cause of Appendicitis

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Michael Pagacz ◽  
Philip Bao ◽  
Juan Carlos Alvarez Moreno ◽  
Lydia Howard
Keyword(s):  
Abdominal Pain ◽  
Foreign Body ◽  
Acute Appendicitis ◽  
Treatment Options ◽  
Signs And Symptoms ◽  
Primary Treatment ◽  
Lower Quadrant ◽  
Nail Biting ◽  
Periappendiceal Abscess ◽  
The Right

Ingestion of a foreign body is commonly encountered in clinical practice, but most cause no complications, passing spontaneously through the gastrointestinal tract. However, they can cause obstructive signs and symptoms, and surgical intervention for extraction of the foreign body may be required after identifying its location. We present here the case of a 49-year-old woman who presented to our emergency room with abdominal pain localizing to the right lower quadrant. Evaluation was most consistent with acute appendicitis, and she underwent uncomplicated appendectomy. A keratin nail with Actinomyces was identified in her appendix. Foreign bodies in the appendix can cause simple appendicitis, perforation, periappendiceal abscess, and peritonitis. Regardless of etiology, an appendectomy often ends up the primary treatment, but unusual and rare causes are worth noting if only for the clinician to be aware of when evaluating the next patient with abdominal pain and considering treatment options or future prevention. Our case is an example of a rare scenario in which an Actinomyces-contaminated human nail lodged in the appendix of a woman eventually resulting in acute appendicitis.

Appendectomy for Vague Symptoms and Equivocal Physical Findings on Physical Exam and Computed Tomography

2021 ◽  
pp. 000313482110505
Author(s):  
Meaghan Flatley ◽  
Kyle K. Sokol ◽  
Eric M. Balent ◽  
Sara B. Placek ◽  
Joshua S. Ritenour ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Diagnostic Laparoscopy ◽  
Treatment Algorithm ◽  
Case Series ◽  
Signs And Symptoms ◽  
Imaging Characteristics ◽  
Laboratory Results

Background: Appendicitis is a common condition affecting 7-8% of the general population. With the improvement of noninvasive imaging, the diagnostic approach and treatment algorithm for patients with clear signs and symptoms suggestive of acute appendicitis are well agreed-upon. However, patients without pathognomonic signs and symptoms, but with equivocal imaging pose a diagnostic dilemma. These patients may still have acute appendicitis and could potentially benefit from laparoscopic appendectomy. This may be especially true in the subset of patients with appendicoliths. Methods: Our case series exams a group of patients with atypical symptoms who eventually underwent appendectomy and were followed after surgery for at least a month. This case series consists of eight patients with abdominal pain accompanied by a variety of other signs and symptoms in addition to laboratory results and imagining characteristics which were nondiagnostic. These patients had initial Alvarado scores ranging from 0-6. Results: All of these patients were subsequently taken to the operating room for diagnostic laparoscopy and laparoscopic appendectomy. Of these patients, six were known to have appendicoliths based on computed tomography obtained during initial diagnostic workup. Conclusions: All patients underwent a diagnostic laparoscopy and appendectomy. Four had appendicitis and four also had resolution of their symptoms. There exist atypical presentations of appendiceal disease. Patients with abdominal pain/tenderness, even without diagnostic laboratory results or imaging characteristics, may benefit from laparoscopic appendectomy.

Appendix

2020 ◽  
pp. 15-26
Author(s):  
Jad M. Abdelsattar ◽  
Moustafa M. El Khatib ◽  
T. K. Pandian ◽  
Samuel J. Allen ◽  
David R. Farley
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Clinical Diagnosis ◽  
Surgical Intervention ◽  
Open Appendectomy ◽  
Wound Dehiscence ◽  
Signs And Symptoms ◽  
Wound Infections ◽  
Deep Wound ◽  
Blind Ending

The appendix is an antimesenteric cecal outpouching that forms in the fifth month of gestation. It is a hollow, blind-ending tube approximately 11 cm in length and less than 6 mm in diameter. Obstruction of the appendiceal lumen with a fecalith, or less commonly foreign bodies, worms, and lymphadenopathy, may result in swelling of the appendix. Patients present with periumbilical abdominal pain. Acute appendicitis is a clinical diagnosis. The majority of patients with signs and symptoms of acute appendicitis should receive prompt surgical intervention. Laparoscopic or open appendectomy can be associated with ileus, superficial or deep wound infections, GI leak, bleeding or hematoma, wound dehiscence, or hernia.

scholarly journals Perforated Appendicitis with Appendicular Abscess

2017 ◽  
Vol 8 (1) ◽  
pp. 73-75
Author(s):  
Md Tahminur Rahman ◽  
Abdus Salam Arif ◽  
Md Abdul Wohab Khan ◽  
Mumtahina Setu ◽  
Md Imam Shafique ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Early Diagnosis ◽  
Acute Appendicitis ◽  
Perforated Appendicitis ◽  
Signs And Symptoms ◽  
College Hospital ◽  
Medical College ◽  
Paediatric Department ◽  
Life Threatening ◽  
History Of

Most patients with acute appendicitis can be easily diagnosed, but there are many in whom the signs and symptoms are quite variable, and a firm clinical diagnosis is often very difficult to establish. Difficulties in the early diagnosis of appendicitis, particularly in children, often lead to life threatening complications, such as gangrene or perforation of the appendix. Here we report a case where a nine-year-old boy presented to the Paediatric Department at Anwer Khan Modern Medical College Hospital in Dhaka in April 2016 with a history of abdominal pain, vomiting & fever that began nine days before admission.Anwer Khan Modern Medical College Journal Vol. 8, No. 1: Jan 2017, P 73-75

Acute abdomen: syndromes and causes of surgeries in a hospital of taubaté − sp

2008 ◽  
Vol 2 (2) ◽  
pp. 165
Author(s):  
Ana Lucia De Faria ◽  
Silvana Novaes ◽  
Monica Silva Gonçalves ◽  
Regina Celia C Peres
Keyword(s):  
Septic Shock ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Acute Abdomen ◽  
Surgical Intervention ◽  
Abdominal Cavity ◽  
Signs And Symptoms ◽  
Age Group ◽  
Inflammatory Syndrome ◽  
Hospital General

ABSTRACTAcute abdomen refers to a not traumatic disorder located in the bowels of the abdominal cavity and classifies itself in five syndromes named, inflammatory perforating, obstructive, hemorrhagic and vascular. The signs and symptoms are: abdominal pain that is installed of quick and sudden form, vomiting, fever, interruption of the elimination of gases and evacuation. The aim was identify the syndromes and the causes of surgeries resulting on acute abdomen in patients interned and submitted to a surgical intervention in a General Hospital of the Taubaté - SP. The research was the type retrospective, documentary, descriptive and quantitative, in the period 2004 to 2006. The results showed that the 91 (100%) cases studied prevailing male in the 55 (60,44%); the surgery occurred more in the age group of 40-49 years in 16 (17,58%); among the signs and symptoms abdominal pain was present in (100%) and vomiting in 41 (29,50%); due to the higher incidence of surgery was acute appendicitis with 45 (49,45%); the predominant syndrome was the inflammatory in 49 (53,85%), but perforating appeared in 23 (25,27%) to be obstructive in 18 (19,78%), vascular in 1 (1,10%) of the cases; the most frequent cause of death was septic shock in 10 (38,46%); the mortality prevailed in the age group between 80 to 89 years old with 5 (45,46%), with perforating syndrome in 6 (54,55%). It is concluded that the inflammatory syndrome and the cause appendicitis were the most frequent. Descriptors: acute abdomen; surgery; mortality.RESUMOAbdome agudo refere-se a uma afecção não traumática, localizada nas vísceras da cavidade abdominal, e classifica-se em cinco síndromes, nomeadas de: inflamatória, perfurativa, obstrutiva, hemorrágica e vascular. Os sinais e sintomas são: dor abdominal que se instala de forma súbita e rápida, vômito, febre, interrupção da eliminação de gases e fezes. O objetivo da pesquisa foi identificar as síndromes e as causas de cirurgias decorrentes do quadro de abdome agudo em pacientes internados e submetidos a uma intervenção cirúrgica em um Hospital Geral de Taubaté - SP. A pesquisa foi do tipo retrospectiva, documental, descritiva e quantitativa, no período de 2004 a 2006. Os resultados mostraram que, dos 91 (100%) casos estudados, o sexo masculino predominou em 55 (60,44%); as cirurgias ocorreram mais na faixa etária de 40-49 anos de idade, em 16 (17,58%); dentre os sinais e sintomas, a dor abdominal esteve presente em 100%, e o vômito, em 41 (29,50%); a causa cirúrgica de maior incidência foi a apendicite aguda, em 45 (49,45%); a síndrome predominante foi a inflamatória, em 49 (53,85%), a perfurativa apareceu em 23 (25.27%), a obstrutiva em 18 (19,78%),e a vascular, em 1 (1,10 %) dos casos; a causa de morte mais frequente foi o choque séptico, em 10 (38,46%); a mortalidade prevaleceu na faixa etária entre 80 e 89 anos de idade, em 5 (45,46%), com síndrome perfurativa em 6 (54,55%). Concluiu-se que a síndrome inflamatória foi predominante e que a apendicite foi a causa mais freqüente de cirurgia. Descritores: abdome agudo; cirurgia; mortalidade.RESUMENAbdomen agudo se refiere a un trastorno no traumático que se  encuentra en las vísceras de la cavidad abdominal y se clasifica en cinco síndromes nombrados de inflamatorio, perforativa, obstructiva, hemorrágica y vasculares. Las señales y síntomas son: dolor abdominal que se instalan de forma repentina y rápida, vómitos, fiebre, interrupción en la eliminación de gases y heces. El objetivo era determinar los síndromes y las causas de cirugías derivadas del cuadro de abdomen agudo en pacientes hospitalizados y sometidos a un procedimiento quirúrgico en el Hospital General del Taubate - SP. La investigación es del tipo retrospectivo, documental, descriptivo y cuantitativo, en el período de 2004 a 2006. Los resultados mostraron que de los 91 (100%) casos estudiados predominó el sexo masculino en 55 (60,44%); La cirugía ocurrieron en más frecuencia en el grupo de edad de 40 -49 años en 16 (17,58%); entre las señales y síntomas el dolor  abdominal estuvo presente en el (100%) y los vómitos en 41 (29,50%) la causa de cirugía de mayor incidencia fue apendicitis aguda con 45 (49,45%); El síndrome predominante  fue la inflamatoria en 49 (53, 85% ), Pero  perforativa apareció en 23 (25,27%), la obstructiva en 18 (19,78%), vasculares en 1 (1,10%) de los casos; la causa más frecuente de muerte fue el  choque séptico, 10 (38,46%); Prevaleció la mortalidad en el grupo de edad entre 80 a 89 años con 5 (45,46%), con síndrome  perforativa en 6 (54,55%). Se concluye que la síndrome inflamatoria y la causa apendicitis fueron las más frecuentes. Descriptores: abdomen agudo; cirurgía; mortalidad. 

scholarly journals Appendicular Tuberculosis as Manifestation of Gastrointestinal Tuberculosis: A Case Report

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. 

Adenocarcinoma of the Appendix in Elderly: Diagnostic dilemma

2020 ◽  
Vol 01 ◽  
Author(s):  
Heba Nofal ◽  
Hayder Al-Masari ◽  
Marwan Mohammed Rashed ◽  
Reham Ainawi ◽  
Desh Idnani ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Ct Scan ◽  
Laparoscopic Appendectomy ◽  
Signs And Symptoms ◽  
Morbidity And Mortality ◽  
Diagnostic Dilemma ◽  
Increased Risk

: Acute appendicitis in elderly continue to be a diagnostic dilemma as it raises both the suspicion of malignancy and increased risk of morbidity and mortality. Cancers of the appendix are rare and most of them are found accidentally on appendectomies performed for acute appendicitis. When reviewed, majority of the tumors were carcinoid, adenoma, and lymphoma. Adenocarcinomas of appendix are only 0.08% of all cancers and the treatment remains controversial. This paper presents a case of 75-year-old female presented to emergency (ER) with signs and symptoms mimicking acute appendicitis, laparoscopic appendectomy was planned after a CT scan was done as it was suggesting acute appendicitis. The specimen then was sent foe pathology lab and a diagnosis of adenocarcinoma of the appendix was made.

scholarly journals Acute appendicitis as an unusual cause of invasive ductal breast carcinoma metastasis

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Vincent De Pauw ◽  
Julie Navez ◽  
Stephane Holbrechts ◽  
Jean Lemaitre
Keyword(s):  
Abdominal Pain ◽  
Breast Carcinoma ◽  
Acute Appendicitis ◽  
Ductal Carcinoma ◽  
Hormonal Treatment ◽  
Locoregional Therapy ◽  
Invasive Ductal Breast Carcinoma ◽  
Ductal Breast Carcinoma ◽  
History Of ◽  
Anticancer Treatment

Abstract Acute appendicitis is one of the most common causes of abdominal pain at the emergency room. In rare cases, it can be caused by malignancy, even metastatic lesions from extra-abdominal neoplasia. Herein, we report a case of a 64-year-old female with a history of invasive ductal carcinoma of the breast treated by chemotherapy, surgery, radiotherapy and hormonotherapy, relapsing several years later as a bone and a pleura metastasis successfully cured by locoregional therapy and hormonal treatment. She presented with acute abdominal pain without signs of peritonitis. Abdominal computed tomodensitometry showed sign of appendicitis. Therefore, laparoscopic exploration and appendicectomy was performed. During surgery, multiple peritoneal nodules were found and harvested. Pathology showed metastatic nodules of invasive ductal breast carcinoma, including in the appendicular wall, concluding to peritoneal carcinomatosis. The postoperative course was uneventful, but the patient died 1 year later after refusing anticancer treatment.

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