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.

The Use of Abdominal Computed Tomography Imaging Technology in the Treatment of Surgical Acute Abdominal Perforation

2020 ◽  
Vol 10 (9) ◽  
pp. 2130-2135
Author(s):  
Yong Liu ◽  
Tuo Su ◽  
Ping Wei ◽  
Wei Han ◽  
Zhili Ji
Keyword(s):  
Computed Tomography ◽  
Acute Appendicitis ◽  
Diagnostic Value ◽  
Imaging Features ◽  
Abdominal Ct ◽  
Imaging Technology ◽  
Abdominal Computed Tomography ◽  
Specific Sign ◽  
Suspected Acute Appendicitis ◽  
Image Performance

Objective: The objective of this study is to explore the imaging features of abdominal Computed Tomography (CT) in patients with surgical acute abdominal perforation and to improve the diagnostic ability of perforated acute appendicitis (PAA). Method: Patients with suspected acute appendicitis and abdominal pain are selected as the study objects. According to the surgical records and pathological results, the patients are divided into PAA group and nonperforated acute appendicitis (NPAA) group. All patients are examined by abdominal CT. Postprocessing reconstruction technology such as multiple planar reconstruction (MPR) algorithm and curved planar reformat (CPR) algorithm are used as assistance to display the appendix, analyze and compare the images, observe the image performance of abdominal CT, and measure the diameter of the appendix. Results: The incidence of PAA specific signs (i.e. cellulitis around the appendix, abscess around the appendix, enhancement defect of the appendix wall, air accumulation outside the appendix cavity, fecal stone outside the appendix cavity) in PAA group is significantly higher than that in NPAA group (P < 0.05). Appearance of at least one specific sign for the diagnosis of PAA is 95.65%, the specificity is 92.59%, and the accuracy is 94.00%. The diameter of appendix in PAA group is significantly larger than that in NPAA group (P < 0.05). Compared with the diagnosis of simple specific signs, the specificity and accuracy of the combination of appendiceal diameter and specific signs in the diagnosis of PAA have been improved. Conclusion: With the help of MPR algorithm and CPR algorithm, abdominal CT imaging technology can accurately identify PAA and NPAA, which has important diagnostic value.

scholarly journals Watch What You Swallow!—A Rare Cause of Not So Rare Entity Presenting to the Emergency Room

2019 ◽  
Vol 02 (01) ◽  
pp. 049-052
Author(s):  
Pratik Mukherjee ◽  
Daniel Wu Peng ◽  
Ashish Chawla
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Foreign Body ◽  
Acute Appendicitis ◽  
Emergency Room ◽  
Complete Recovery ◽  
Foreign Body Ingestion ◽  
Rare Entity ◽  
Inflammatory Changes

AbstractForeign-body ingestion is a rare cause for acute appendicitis. The authors report a case of a 48-year-old man who presented with abdominal pain for 3 days. Computed tomography (CT) revealed a foreign body in the appendix with peri-appendicular inflammatory changes. The patient underwent a successful appendectomy with complete recovery.

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 Torsion of vermiform appendix: case report and review of the literature

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Kosuke Endo ◽  
Masahito Sato ◽  
Kenichi Saga ◽  
Atsushi Higashio ◽  
Yoshiaki Yuba ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Rare Disease ◽  
Treatment Plan ◽  
Laboratory Data ◽  
Lower Abdominal Pain ◽  
Emergency Operation ◽  
Abdominal Ultrasound ◽  
Vermiform Appendix ◽  
Ileocecal Region

Abstract Background Torsion of the vermiform appendix is a rare disease with symptoms very similar to those of acute appendicitis. We herein report a case of torsion of the vermiform appendix diagnosed by intraoperative findings. Case presentation A 4-year-old boy presented to our hospital because of abdominal pain and vomiting. Laboratory data revealed a C-reactive protein level of 0.08 mg/dL and white blood cell count of 19,300/μL (neutrophils, 88.9%). Abdominal ultrasound showed a target sign-like finding in the ileocecal region. A computed tomography scan showed swelling of the appendix. We performed an emergency operation under suspicion of acute appendicitis. Laparoscopic examination showed that the appendix had twisted 720° in the clockwise direction. Appendectomy was performed, and the postoperative course was uneventful. Conclusions Although torsion of the vermiform appendix is a very rare disease and difficult to differentiate from appendicitis, an inappropriate treatment plan could lead to necrosis and perforation of the appendix. It is important to consider this disease as a differential diagnosis in patients with right lower abdominal pain.

scholarly journals Risk Factors for Early Return Visits to the Emergency Department in Patients Presenting with Nonspecific Abdominal Pain and the Use of Computed Tomography Scan

Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1470
Author(s):  
Fei-Fei Flora Yau ◽  
Ying Yang ◽  
Chi-Yung Cheng ◽  
Chao-Jui Li ◽  
Su-Hung Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Computed Tomography ◽  
Abdominal Pain ◽  
Underlying Disease ◽  
Control Group ◽  
Early Return ◽  
Ed Visits ◽  
Male Sex ◽  
Return Visits ◽  
Tomography Scan

Over a quarter of patients presenting with abdominal pain at emergency departments (EDs) are diagnosed with nonspecific abdominal pain (NSAP) at discharge. This study investigated the risk factors associated with return ED visits in Taiwanese patients with NSAP after discharge. We divided patients into two groups: the study group comprising patients with ED revisits after the index ED visit, and the control group comprising patients without revisits. During the study period, 10,341 patients discharged with the impression of NSAP after ED management. A regression analysis found that older age (OR [95%CI]: 1.007 [1.003–1.011], p = 0.004), male sex (OR [95%CI]: 1.307 [1.036–1.650], p = 0.024), and use of NSAIDs (OR [95%CI]: 1.563 [1.219–2.003], p < 0.001) and opioids (OR [95%CI]: 2.213 [1.643–2.930], p < 0.001) during the index visit were associated with increased return ED visits. Computed tomography (CT) scans (OR [95%CI]: 0.605 [0.390–0.937], p = 0.021) were associated with decreased ED returns, especially for those who were older than 60, who had an underlying disease, or who required pain control during the index ED visit.

scholarly journals Mimickers of Acute Appendicitis

2021 ◽  
Author(s):  
Esam Amer
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Emergency Department ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Imaging Modality ◽  
Correct Diagnosis ◽  
Emergency Setting ◽  
Magnetic Resonance Imaging Mri ◽  
Clinical Conditions

Acute appendicitis (AA) is a common surgical diagnosis in patients presenting to the Emergency Department with acute abdominal pain. A wide variety of other clinical conditions can present with a very similar presentation to acute appendicitis and therefore it can be occasionally challenging to make the correct diagnosis. In this review paper, the focus is to shed some light on the differential diagnosis of acute appendicitis which includes a variety of gastrointestinal, vascular, urological, and gynaecological conditions. In the emergency setting there are three main imaging modalities to evaluate patients presenting with abdominal pain, this includes computed tomography (CT), ultrasound (US) and magnetic resonance imaging (MRI). The choice of imaging modality for each clinical condition is variable and as such being familiar with those differential diagnoses is vital in deciding what is the best imaging modality for every patient presenting with abdominal pain.

scholarly journals Correction: Yau et al. Risk Factors for Early Return Visits to the Emergency Department in Patients Presenting with Nonspecific Abdominal Pain and the Use of Computed Tomography Scan. Healthcare 2021, 9, 1470

Healthcare ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 136
Author(s):  
Fei-Fei Flora Yau ◽  
Ying Yang ◽  
Chi-Yung Cheng ◽  
Chao-Jui Li ◽  
Su-Hung Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Computed Tomography ◽  
Emergency Department ◽  
Abdominal Pain ◽  
Computed Tomography Scan ◽  
Early Return ◽  
Return Visits ◽  
Published Paper ◽  
Tomography Scan

The authors would like to make corrections to their published paper [...]

scholarly journals Torsion of cecal appendix. Report of the first Italian case and review of the literature

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
Salvatore Fabio Chiarenza ◽  
Lorenzo Costa ◽  
Cosimo Bleve
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Pediatric Patients ◽  
Clinical Presentation ◽  
Clinical Signs ◽  
Rare Condition ◽  
Vermiform Appendix ◽  
Lower Quadrant ◽  
Italian Case ◽  
Right Lower Quadrant

In pediatric patients appendicitis is the most common cause of abdominal pain and surgery. Torsion of vermiform appendix is a rare cause, clinically indistinguishable from appendicitis with usually an intraoperative diagnosis. The first description of vermiform appendix torsion was made by Payne in 1918. Clinical presentation is similar to acute appendicitis. Preoperative investigations play a minimal role. Etiology of this condition is unclear, but is possible to distinguish a primary and a secondary torsion. We report a case of 5-years-old boy who presented with right lower quadrant abdominal pain. His clinical signs, symptoms and investigations mimicked an acute appendicitis. Intraoperatively we found a 720° appendix torsion on its base with its mesentery rotated in counter-clockwise direction. The appendix was gangrenous in appearance. A video-assisted trans-umbilical appendectomy was performed. We describe clinical presentation and management of this rare condition reviewing the literature.

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.

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