scholarly journals Non specific mesenteric adenitis of forty-five cases in childhood and review

2020 ◽  
Vol 18 (4) ◽  
pp. 396-400
Author(s):  
K. Georgiev ◽  
Kr. Kalinova

Mesenteric lymphadenitis is a disease that pediatric surgeons face on a daily basis due to symptoms resembling the symptoms of acute appendicitis. 45 children with abdominal pain were examined for the last 3 years, aged 3 to 18 years, treated non-surgically, and proven laboratory, microbiological and instrumental diagnosis. Mesenteric lymphadenitis is a very common diagnosis in children with suspected acute appendicitis. In previous methods, based solely on age and location, there were many difficulties in identifying the etiology of acute abdominal pain in children. We decided to develop a new systematic classification of acute abdominal pain. Carrying out a clinical and epidemiological analysis of the diseased children with acute surgical diseases in order to establish a pre-operative imaging and laboratory diagnosis, to establish the sensitivity of microbiological markers An overview of the literature on the topic has been made

2020 ◽  
Vol 23 (6) ◽  
pp. 309-313
Author(s):  
Viktor G. Vakulchyk

Introduction. Current trends in the diagnostics of acute appendicitis have the following main objectives: to improve the diagnostic accuracy in destructive forms; to reduce the number of negative appendectomies and diagnostic laparoscopies. Purpose. To compare the effectiveness of Alvarado and PAS scales and to find out which of them is more appropriate in the differential diagnostics of acute abdominal pain in children. Material and Methods. A prospective randomized blind clinical trial was performed. 326 children aged 5-17 years with abdominal pain were examined. Results. No significant advantages of any of the analyzed scales were found in the differential diagnostics of acute abdominal pain in children aged 5-17 years. Both scales can be used in the primary stratification of patients. With the conclusion “Acute appendicitis is likely possible,” the level of non-diagnosed cases of acute appendicitis will not exceed 3%. Conclusions. Further assessment of various scales for the diagnostics of acute appendicitis in children has to be done in order to select the optimal one. The obtained results urge to make scales’ modification so as to improve the diagnostic accuracy and to reduce the number of negative appendectomies and diagnostic laparoscopies.


2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
João Paulo Nunes Drumond ◽  
André Luis Alves de Melo ◽  
Demétrius Eduardo Germini ◽  
Alexander Charles Morrell

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.


2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Martine A. Louis ◽  
Amanda R. Doubleday ◽  
Elizabeth Lin ◽  
Ji Yoon Baek ◽  
Alda Andoni ◽  
...  

General surgeons are often asked to evaluate acute abdominal pain which has an expanded differential diagnosis in women of childbearing age. Acute appendicitis accounts for many surgical emergencies as a common cause of nongynecologic pelvic pain. In some rare instances, acute appendicitis has been shown to occur simultaneously with a variety of gynecologic diseases. We report a case of concurrent acute appendicitis and ruptured ovarian endometrioma.


2011 ◽  
Vol 3 (3) ◽  
pp. 22 ◽  
Author(s):  
Katerina Kambouri ◽  
Stefanos Gardikis ◽  
Alexandra Giatromanolaki ◽  
Aggelos Tsalkidis ◽  
Efthimios Sivridis ◽  
...  

Primary omental infarction (POI) has a low incidence worldwide, with most cases occurring in adults. This condition is rarely considered in the differential diagnosis of acute abdominal pain in childhood. Herein, we present a case of omental infarction in an obese 10-year-old boy who presented with acute abdominal pain in the right lower abdomen. The ultrasound (US) examination did not reveal the appendix but showed secondary signs suggesting acute appendicitis. The child was thus operated on under the preoperative diagnosis of acute appendicitis but the intraoperative finding was omental infarct. Since the omental infarct as etiology of acute abdominal pain is uncommon, we highlight some of the possible etiologies and emphasize the importance of accurate diagnosis and appropriate treatment of omental infarction.


2018 ◽  
Vol 5 (9) ◽  
pp. 3011
Author(s):  
Prabhu R. ◽  
Vijayakumar C. ◽  
Balagurunathan K. ◽  
Senthil Velan M. ◽  
Kalaiarasi R. ◽  
...  

Background: Acute appendicitis is the most common cause of acute abdominal pain in young adults requiring emergency surgery. Appendicectomy is the most frequently performed surgery. The diagnosis is often challenging and the decision to operate in an emergency setting is always debatable. A combination of clinical signs and symptoms with laboratory findings in many scoring systems are suggesting the probability of appendicitis and the possible subsequent management pathway. The aim was to evaluate accuracy of the clinical Alvarado scoring system, radiological finding and histopathological examination for the diagnosis of acute appendicitis.Methods: A retrospective study was conducted in the department of general surgery in a tertiary care centre in South India. Total of 237 patients with acute abdominal pain were included and evaluated with the clinical Alvarado scoring system, radiological finding with (USG/CT abdomen) and histopathological examination for the diagnosis of acute appendicitis. The data was collected and analyzed retrospectively.Results: Of the 237 patients, 164 patients were male (69.1%) and rest is female. The correlation of the Alvaroda score with histopathological findings in groups with score > 7 and ≤7 the correlation of Alvarado score and the ultrasound findings were comparable between the study groups. The sensitivity of ultrasound in diagnosing acute appendicitis in patients with Alvarado score >7 was 72.99%. The sensitivity of ultrasound in diagnosing acute appendicitis in patients with Alvarado score ≤7 was decreased to 27%.Conclusions: The diagnostic accuracy of clinical features is far better than radiological investigations in the diagnosis of acute appendicitis. Therefore, it is concluded that it is better to use radiological investigations only to confirm the diagnosis of acute appendicitis rather to diagnose it.


2021 ◽  
Vol 41 (3) ◽  
pp. 1459-1469
Author(s):  
MAARET ESKELINEN ◽  
JANNICA MEKLIN ◽  
KARI SYRJÄNEN ◽  
MATTI ESKELINEN

2014 ◽  
Vol 31 (9) ◽  
pp. 787.1-787
Author(s):  
Timothy H Rainer ◽  
Ling Yan Leung ◽  
Pui Yee Cangel Chan ◽  
Yuk Ki Leung ◽  
Bo San Paul Lai ◽  
...  

Author(s):  
Müjdem Nur Azılı ◽  
Doğuş Güney ◽  
Can Ihsan Oztorun ◽  
Ahmet Ertürk ◽  
Elif Emel Erten ◽  
...  

Abstract Introduction The aim of this study was to make the differential diagnosis between acute appendicitis and multisystem inflammatory syndrome in children (MIS-C) for patients presenting with the complaint of acute abdominal pain (AAP) and to identify the determining factors for the diagnosis of MIS-C. Materials and Methods Eighty-one children presenting with AAP/suspected AAP were evaluated. Of these, 24 (29.6%) were included in the MIS-C group (MIS-C/g) and 57 were included in the suspected appendicitis group (S-A/g), which consisted of two subgroups: appendicitis group (A/g) and control observation group (CO/g). Results Comparing MIS-C/g, A/g, and CO/g, duration of abdominal pain (2.4, 1.5, 1.8 days), high-grade fever (38.8, 36.7, 37°C), severe vomiting, and severe diarrhea were higher in MIS-C/g. Lymphocytes count (LC) was lower, while values of C-reactive protein (CRP), ferritin, and coagulopathy were higher in MIS-C/g (p < 0.05). The optimal cutoffs for the duration of abdominal pain was 2.5 days; the duration of fever, 1.5 days; peak value of fever, 39°C; neutrophil count, 13,225 × 1,000 cell/µMoL; LC, 600 × 1,000 cell/µMoL; ferritin, 233 µg/L; and D-dimer, 16.4 mg/L (p < 0.05). The optimal cutoff for CRP was 130 mg/L (sensitivity 88.9, specificity 100%, positive predictive value 100%, NPV, negative predictive value 92.5%, p < 0.001). All patients in MIS-C/g tested positive by serology by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Conclusion The duration of abdominal pain, presence of high-grade and prolonged fever, and evaluation of hemogram in terms of high neutrophil count and low LC exhibit high sensitivity and negative predictive value for MIS-C presenting with AAP. In case of doubt, inflammatory markers such as CRP, ferritin, D-dimer, and serology for SARS-CoV-2 should be studied to confirm the diagnosis.


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