A féregnyúlvány diverticulosisa, diverticulitise.                         Esetismertetés és irodalmi áttekintés

Abstract: Diverticulitis of the vermiform appendix is a rare disease with clinical features often similar to conventional acute appendicitis. The importance of appendiceal diverticulosis is the fact that it can lead to an early and a higher incidence of perforation and therefore a higher mortality rate, in contrast to acute appendicitis alone. In this study we present the clinicopathology, diagnosis and therapy of the disease with a review of the literature. A 65-year-old woman presented to the emergency department with a 48-hour history of intermittent pain in the right iliac fossa. Abdominal ultrasound raised the possibility of acute appendicitis but because of the relative asymptomatic state of the patient, the lack of fever and rebound tenderness we started observation. After 2 days with episodic abdominal pain, the patient was taken to the operating theatre for laparoscopic exploration. Intraoperatively, multiple diverticula were noted on the appendix and appendectomy was performed. Histopathological examination revealed diverticulosis and inflammation of the appendiceal wall. Due to the possible complications, the difficult preoperative diagnosis and its frequent association with appendiceal neoplasm, appendiceal diverticulosis requires special attention. For asymptomatic cases, incidentally diagnosed intraoperatively or discovered by radiology prophylactic appendectomy is recommended. Orv Hetil. 2018; 159(19): 768–772.

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Caecal Epiploic Appendagitis Masquerading Clinically as an Acute Appendicitis: A Case Report and Brief Literature Review

Case Reports in Surgery ◽

10.1155/2019/6508642 ◽

2019 ◽

Vol 2019 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Tallat Ejaz ◽

Eltaib Saad ◽

Andik Nabil ◽

James Slattery

Keyword(s):

Abdominal Pain ◽

Acute Appendicitis ◽

Iliac Fossa ◽

Lower Abdominal Pain ◽

Good Health ◽

Final Diagnosis ◽

Epiploic Appendagitis ◽

Rebound Tenderness ◽

History Of ◽

The Right

A 46-year-old female presented to our emergency department (ED) with a 2-day history of right lower abdominal pain which was associated with nausea and anorexia. Abdominal examination revealed tenderness in the right iliac fossa (RIF) with rebound tenderness and a localized guarding. Urine dipstick was normal, and the pregnancy test was negative. Her laboratory investigations were significant only for a CRP of 16.6. A presumptive clinical diagnosis of acute appendicitis was suggested based on the given history and relevant physical signs. However, an abdominal computed tomography (CT) scan revealed an epiploic appendagitis of the caecum with a normal-looking appendix. She was managed conservatively and responded well and was discharged after 2 days in good health. Though being a relatively rare case of acute localized right-sided lower abdominal pain, caecal epiploic appendagitis should be considered as one of the differential diagnoses with the final diagnosis reached usually by the radiological findings due to the nonspecific nature of clinical and laboratory features.

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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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Thyroid haemangiosarcoma in a seven-year-old female Shih Tzu

Veterinary Record Case Reports ◽

10.1136/vetreccr-2019-001012 ◽

2020 ◽

Vol 8 (2) ◽

pp. e001012

Author(s):

Luis Pedro Rocha Moreira ◽

Emma Scurrell ◽

Paul Mahoney ◽

Stephen Baines

Keyword(s):

Histopathological Examination ◽

Abdominal Ultrasound ◽

Neck Mass ◽

Clinical Staging ◽

Ultrasound Guided ◽

Fine Needle ◽

Fine Needle Aspirates ◽

History Of ◽

The Right ◽

Mixed Tumours

Canine thyroid tumours are uncommon and the majority of tumours are carcinomas or adenomas, with only very few mixed tumours or metastases from distant sites described to date. A primary thyroid haemangiosarcoma has never been reported in veterinary medicine. In this case report, we describe a dog with a history of a large, non-painful, mobile ventral neck mass in the right paralaryngeal region. CT and ultrasound-guided fine needle aspirates were used for clinical staging. The mass was surgically excised and histopathological examination indicated a haemangiosarcoma. Abdominal ultrasound revealed the presence of splenic nodules and splenectomy indicated the presence of haemangiosarcoma. Chemotherapy with doxorubicin was started, but the dog was euthanased after three rounds of therapy, 97 days after the mass was discovered.

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Acute appendicitis: a 2- year review of clinical presentation and histopathology

Journal of Pathology of Nepal ◽

10.3126/jpn.v1i2.5402 ◽

1970 ◽

Vol 1 (2) ◽

pp. 104-107 ◽

Cited By ~ 3

Author(s):

N Subedi ◽

US Dangol ◽

MB Adhikary ◽

S Pudasaini ◽

R Baral

Keyword(s):

Acute Appendicitis ◽

Clinical Diagnosis ◽

Clinical Presentation ◽

Histopathological Examination ◽

Iliac Fossa ◽

Operative Procedure ◽

Lymphoid Hyperplasia ◽

Negative Appendectomy ◽

Histopathological Correlation ◽

The Right

Background: Acute appendicitis is the most common surgical emergency. Obstruction of the lumen by fecolith is the usual cause of acute appendicitis.The aim of the study was to analyze clinical presentation of acute appendicitis and its histopathological correlation. Materials and Methods: A retrospective study of acute appendicitis was done in the Department of Surgery of Helping Hands Community Hospital from January 2009 to December 2010. Three hundred forty five patients out of 415 patients with clinical diagnosis of appendicitis underwent operative treatment. The histopathological reports were reviewed and correlated with clinical diagnosis. Results: Out of 345 patients who underwent operative procedure 98% (n= 338) came with chief complaint of pain in the periumbilical region migrating to the right iliac fossa. The mean age of presentation was 42 years. Increased leucocyte count was seen in only 65% cases. Acute appendicitis was more commonly seen in male patients (214 cases, 62%). The most common per operative finding was acutely inflammed appendix (84%) followed by perforated appendix (7.5%), gangrenous appendix (3.5%) and appendicular lump (1.5%). However, histopathological diagnoses were acute appendicitis (91.9%), resolving appendicitis (3.5%), lymphoid hyperplasia (2.6%), mucocele (0.3%) and carcinoid (0.3%). Normal histology was seen in 1.4% cases. Conclusion: Though there are other causes of acute abdomen, acute appendicitis still stands first amongst all the emergencies. Histopathological examination of appendectomy specimen should not be omitted in order to see the incidence negative appendectomy rate and to avoid complications relating to malignant conditions. Keywords: Acute appendicitis; Appendectomy; Appendicular perforation; Histopathology DOI: http://dx.doi.org/10.3126/jpn.v1i2.5402 JPN 2011; 1(2): 104-107

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Torsion of caecal appendices epiploicae: mimicking acute appendicitis

International Surgery Journal ◽

10.18203/2349-2902.isj20202858 ◽

2020 ◽

Vol 7 (7) ◽

pp. 2407

Author(s):

A. P. Roshini ◽

Dattaprasad Samant ◽

F. P. Noronha

Keyword(s):

Abdominal Pain ◽

Acute Appendicitis ◽

Iliac Fossa ◽

Lower Abdominal Pain ◽

Free Fluid ◽

Normal Appendix ◽

Menstrual Cycles ◽

Rebound Tenderness ◽

Appendices Epiploicae ◽

The Right

Acute appendicitis is a common cause for pain in the right iliac fossa, which requires urgent surgical intervention. However, at the time of surgery, if the appendix is normal, the surgeon has to search for other causes of acute abdominal pain including rare etiologies, such as torsion of appendices epiploicae and subsequently its gangrene. We report the case of a 45 years old female who presented with right lower abdominal pain, rebound tenderness and guarding in right iliac fosse, with regular menstrual cycles and no urinary complaints. Investigation revealed leucocytosis and ultra-sonography abdomen was suggestive of an inflamed appendix in the right iliac fossa with free fluid. Intra-operatively, we found a normal appendix with gangrene of the appendices epiploicae which had undergone torsion. She underwent excision off appendices epiploicae with appendicectomy with uneventful post-operative period. Histopathology of the appendices was suggestive of congestion. Preoperative diagnosis of this condition is rarely made.

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Gossypiboma Posing as a Diagnostic Dilemma: A Case Report and Review of the Literature

Case Reports in Surgery ◽

10.1155/2014/713428 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3 ◽

Cited By ~ 3

Author(s):

K. N. Srivastava ◽

Amit Agarwal

Keyword(s):

Differential Diagnosis ◽

Case Report ◽

Iliac Fossa ◽

Exploratory Laparotomy ◽

Mesenteric Cyst ◽

Review Of The Literature ◽

Diagnostic Dilemma ◽

Surgical Sponge ◽

History Of ◽

The Right

The term gossypiboma is used to describe a retained surgical sponge after operation. It is a rare but serious complication which is seldom reported because of the medicolegal implications. Gossypiboma usually has varied and vague presentation and is also difficult to detect on radiological investigations. It can even remain silent and present years after the operation. We report a case of a 38-year-old lady who presented with vague pain and chronic lump in the right iliac fossa region. She had a history of cesarean section 4 years ago. Radiological investigations were inconclusive in detecting the retained sponge. A working diagnosis of mesenteric cyst was made and an exploratory laparotomy was done where she was found to have a large gossypiboma densely adhered to the small bowel and surrounding structures. Though rare, gossypiboma should be kept in mind as a differential diagnosis in postoperative cases presenting as vague pain or chronic lump even years after the operation.

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Mucosa-associated lymphoid tissue lymphoma of the appendix stump: a case report

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20204447 ◽

2020 ◽

Vol 8 (11) ◽

pp. 4108

Author(s):

Uraik F. Hernandez.Bustos ◽

Jonathan Salgado-Vives ◽

Enrique Chavez-Serna ◽

Dante A. Saldivar-Vera ◽

Elí D. Hernández-Gómez ◽

...

Keyword(s):

Acute Appendicitis ◽

Iliac Fossa ◽

Abdominal Ultrasound ◽

Lymphoid Hyperplasia ◽

Low Grade ◽

Non Hodgkin Lymphoma ◽

Surgical History ◽

Gastrointestinal Lymphomas ◽

The Right ◽

Common Manifestation

Primary lymphomas of the appendix occur in 0.015% of all gastrointestinal lymphomas. The most common manifestation is acute appendicitis secondary to luminal obstruction. The most common is immunophenotype B low-grade non-Hodgkin lymphoma. A 53-year-old male, with a previous three-week surgical history due to acute appendicitis, histopathological report of acute appendicitis and lymphoid hyperplasia. Later, he was admitted, with abdominal pain in the right iliac fossa, an abdominal ultrasound and simple abdominal tomography were performed, with suspicion of residual abscess. Surgical intervention is decided, observing paracecal tumor in the emergency site of the appendix, the tumor is removed. Pathological study that reports an appendicular base infiltrated by mucosa-associated lymphoma. The diagnosis of appendicular tumors is mostly, intraoperatively incidental. It is necessary to have the diagnostic possibility when performing an appendectomy, since it changes the prognosis and treatment of the patient.

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Idiopathic Omental Infarction, Diagnosed and Managed Laparoscopically: A Case Report

Case Reports in Surgery ◽

10.1155/2013/193546 ◽

2013 ◽

Vol 2013 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Ahmed AbdulAziz ◽

Tamer El Zalabany ◽

Abdul Rahim Al Sayed ◽

Ahmed Al Ansari

Keyword(s):

Abdominal Pain ◽

Acute Appendicitis ◽

Clinical Finding ◽

Iliac Fossa ◽

Sudden Onset ◽

Free Fluid ◽

Lower Quadrant ◽

Omental Infarction ◽

Rebound Tenderness ◽

The Right

Idiopathic omental infarction is a rare cause of acute abdomen in adults, and the clinical finding can mimic acute appendicitis. Although idiopathic omental infarction is uncommon, the incidence of its detection has become more frequent as a result of advances in radiological technologies. We reported on a 21-year-old man who presented with sudden onset of intermittent right lower quadrant abdominal pain for seven days. The pain became more localized at the right iliac fossa (RIF) at day 2 before admission. A physical examination revealed a fever (38.2∘C), severe RIF tenderness, mass-like fullness, and positive rebound tenderness. A CT of the abdomen showed inflammatory changes and increased fat density mass in the right upper quadrant measuring5×4 cm representing focal panniculitis. However, the appendix was visualized normally and the findings were not in favor of acute appendicitis. Diagnosis was carried on laparoscopically. Serosanguinous free fluid was found in all abdominal quadrants. A6×4 cm gangrenous omental mass was noted. The omental mass was excised and an appendectomy was performed. In summary, omental infarction should be considered as a deferential diagnosis for acute right-sided abdominal pain, especially if the clinical finding does not correspond to appendicitis.

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A Retrospective Analysis of Acute Appendicitis in Children Treated with Laparoscopic Appendectomies at a Single Center in Dubai, UAE

Dubai Medical Journal ◽

10.1159/000518252 ◽

2021 ◽

pp. 1-6

Author(s):

Saad Syed ◽

Hussein Naji

Keyword(s):

Abdominal Pain ◽

Acute Appendicitis ◽

Ct Scan ◽

Laparoscopic Appendectomy ◽

Pediatric Population ◽

Iliac Fossa ◽

Demographic Data ◽

Free Fluid ◽

Rebound Tenderness ◽

The Right

Background: Appendicitis is one of the most common emergency conditions that occur in the pediatric population. The condition is usually suspected clinically, and the diagnosis is confirmed by radiological investigations such as ultrasound, CT scan, or MRI. This study was conducted to contribute to global databases by presenting data from the Middle East with an objective of identifying the clinical characteristics of children who were diagnosed with acute appendicitis and underwent laparoscopic appendectomy at a single pediatric surgery center in Dubai. Methods: A 2-year hospital-based retrospective cohort study was conducted at Mediclinic Parkview Hospital, Dubai, enrolling all patients younger than 14 years who were diagnosed with acute appendicitis and who underwent laparoscopic appendectomy. Demographic data, clinical presentation, laboratory, radiological and pathology findings, postoperative complications, and readmission rates were analyzed. Results: Fifty-six patients were operated on and enrolled in this study. All patients (56/56) presented with abdominal pain, while an associated fever was present in 44.6% (25/56); 78.5% (44/56) of the patients had nausea but 64.3% (36/56) had vomiting. On examination, all patients had abdominal tenderness, while rebound tenderness in the right iliac fossa (RIF) was found in 92.8% (52/56) of the patients. Laboratory investigations showed elevated leukocyte count in 76.7% (43/56) of patients. Appendicitis was diagnosed on ultrasound in 57.4% (31/54) of the patients, and free fluid was visualized in 40.7% (22/54) of the patients. Appendicitis was diagnosed on CT scan in all 25 patients, and free fluid was visualized in 64% (16/25) of the patients. The number of admission days ranged from 1 to 5 days, with a median of 2 days. And 62.5% (35/56) of patients were discharged in the first 2 days from admission. Major and minor complications after surgery were documented in 4 and 14 patients, respectively. Pathology reports showed features of acute appendicitis in all the resected appendices. Conclusions: Acute appendicitis in children should be suspected in all children with acute abdominal pain. This study can help guide the management of pediatric appendicitis and allow proper and standardized documentation of findings and judicious use of laboratory and radiological investigations.

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A Rare Case Od Meckel’s Diverticulum Perforation Caused By a Toothpick Mimicking Acute Appendicitis

Advanced Emergency Medicine ◽

10.18686/aem.v7.119 ◽

2018 ◽

Vol 7 (1) ◽

Author(s):

Aleksandar Resanovic ◽

Milan Gojgic ◽

Vladimir Resanovic ◽

Mazen Arafeh

Keyword(s):

Acute Appendicitis ◽

Meckel’S Diverticulum ◽

Diagnostic Procedures ◽

Abdominal Ultrasound ◽

Meckel's Diverticulum ◽

Imaging Features ◽

Ileocecal Region ◽

Lower Quadrant ◽

Rebound Tenderness ◽

History Of

Meckel’s diverticulum (MD) is the most common congenital abnormality of the gastrointestinal tract and is caused by the failure of omphalomesenteric duct to obliterate during embryonal maturation. Most patients are asymptomatic with only 4-16% presenting complications which include hemorrhage, intestinal obstruction, inflamation and occasionally perforation. A preoperative diagnosis of a complicated Meckel’s diverticulum may be challenging because of the overlapping clinical and imaging features of other acute surgical and inflammatory conditions of the abdomen. A 32-year old male was admitted to the emergency department with a 48-hour history of colicky like pain in the lower part of the abdomen, which was gradually increased and was localised in the lower right quadrant, with no history of fever, nausea or vommiting, no urinary symptoms nor altered bowel habits. Laboratory revealed leukocytosis and elevated CRP, while on physical examination guarding and rebound tenderness were found in the right lower quadrant. Abdominal ultrasound established a distended small bowel with very slow peristalsis in ileocecal region. Complete workup raised suspicion for an acute appendicitis, therefore the patient was operated. Intraoperatively, the perforated Meckel’s diveriticulum was found, caused by a toothpick. Diverticulectomy and appendectomy were done. Postoperative course was uneventful. Regardless of the fact that a variety of diagnostic procedures are at the disposal of surgeons, we feel that the diagnose of a complicated MD remains a challenging task, largely in thanks to the fact that it mimics some other acute abdominal pathology and, often, is misdiagnosed.

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