scholarly journals THE CASE OF DIFFICULTY DIAGNOSIS OF ACUTE APENDICITIS IN ATYPICAL POSITION ON THE APPENDIX ON THE BACKGROUND OF THE MALFORMATION OF ABDOMINALCAVITY

2015 ◽  
Vol 7 (1) ◽  
pp. 144-146
Author(s):  
M S Sultanov ◽  
A N Litvinov ◽  
M M Nakhumov
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Laparoscopy ◽  
Clinical Case ◽  
Abdominal Cavity

The article presents a clinical case of acute destructive appendicitis on the background of the anomalies of the abdominal cavity. This observation demonstrates the significant difficulties in the diagnosis of acute appendicitis occurring against the background of an atypical location of the appendix if you can not perform a diagnostic laparoscopy.

scholarly journals IMPROVEMENT OF METHODS OF DIAGNOSTICS AND TREATMENT OF ACUTE DISEASES OF ORGANS OF ABDOMINAL CAVITY IN CHILDREN

2019 ◽  
Vol 23 (1) ◽  
pp. 40-43
Author(s):  
Sherali R. Sultonov ◽  
M. F. Abdulloev ◽  
S. S. Rasulov ◽  
R. Sh. Akhmedov ◽  
D. M. Kurbanov ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Intestinal Obstruction ◽  
Acute Cholecystitis ◽  
Diagnostic Laparoscopy ◽  
Abdominal Cavity ◽  
Meckel Diverticulum ◽  
Pelvic Organs ◽  
Adhesive Intestinal Obstruction ◽  
Positive Results

There are presented results of therapeutic-diagnostic laparoscopy in 317 children with various pathologies of the abdominal cavity organs, aged from 2 to 15 years. Among patients there were 163 children with acute appendicitis and its complications, 68 girls with acute pathologies of pelvic organs, 39 cases with the acute adhesive intestinal obstruction, 14 - with intussusception, 11 patients with pathology of Meckel diverticulum, 5 - with acute cholecystitis, 5 - with cystic doubling intestine - and 6 - with intestinal mesentery tumor. Diagnostic laparoscopy also revealed acute mesadenitis in 4 cases, and urolithiasis was diagnosed in 2 cases. In the treatment and diagnostic laparoscopy, the switch to the conversion was noted in 19 (5.9%) cases. In 298 (94.1%) cases, the treatment and diagnostic laparoscopy was effective and in these patients positive results were noted

scholarly journals ARROSIVE BLEEDING FROM THE APPENDICULAR ARTERY IN ACUTE DESTRUCTIVE APPENDICITIS

2021 ◽  
pp. 133-136
Author(s):  
A. V. Kapshitar ◽  
A. A. Kapshitar
Keyword(s):  
Acute Appendicitis ◽  
Research Methods ◽  
Antibacterial Therapy ◽  
Emergency Surgery ◽  
Clinical Case ◽  
Rare Complication ◽  
Abdominal Cavity ◽  
Favorable Outcome ◽  
Surgical Department ◽  
Prolonged Delay

Summary. Objective of the study: to present to the surgical community a rather rare complication of severe destructive appendicitis – arrosive bleeding and the cause of its development. Material and methods. Published a rare clinical case from prac-tice — the development of perforation of the appendix and arrosive bleeding from the appendicular artery in a patient with acute gangrenous appendicitis. Results and its discussion. The atypical course of acute appendicitis of undulating nature under the mask of acute adnexitis and antibacterial therapy has led to a prolonged delay with surgery in the surgical department. Only the appendicular abscess, which spontaneously opened into the abdominal cavity, made it possible to diagnose acute appendicitis and determine indications for emergency surgery, during which arrosive bleeding was diagnosed. The favorable outcome of the disease is due to the local purulent-necrotic process and small hemoperitoneum. Findings. Timely diagnosis of acute appendicitis, with the involvement of additional research methods in unclear cases, and subsequent appendectomy, are the prevention of a rather rare complication — arrosive bleeding from the appendicular artery in the development of severe complicated forms of acute destructive appendicitis.

scholarly journals Endometriosis as a Reason of Intraabdominal Bleeding in Pregnancy. Clinical Case

2019 ◽  
Vol 23 (3) ◽  
pp. 283-289
Author(s):  
Y. A. Revzoeva ◽  
E. Y. Shakurova
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Laboratory Tests ◽  
Clinical Case ◽  
Abdominal Cavity ◽  
Diagnostic Procedures ◽  
Reproductive Period ◽  
Diagnostic Methods ◽  
Dark Blood ◽  
Abdominal Bleeding

The article defines the significance and relevance of the problem of endometriosis during pregnancy. 10% of women in the reproductive period have different localization of endometriosis. 25% of pregnancies with endometriosis are complicated by preterm labor. The article presents a clinical case of intra-abdominal bleeding in a 28-year-old pregnant woman with retrocervical endometriosis at gestation age of 32 weeks and 6 days. The article covers the results of examination and special diagnostic procedures of intra-abdominal bleeding in pregnant women with retrocervical endometriosis. The main diagnostic methods were the study of past medical history, ultrasound examination, and laboratory tests. Due to their infrequency during pregnancy internal bleedings present difficulties in their diagnosis. Ultrasound reliably revealed a large amount of fluid in the abdominal cavity and small pelvis and excluded the presence of intrauterine bleeding. Clinical and laboratory tests indicated the severity of the patient's condition. Symptoms of moderate fetal distress were also identified. Therefore, a decision was made about an emergency delivery by the cesarean section followed by an abdominal revision. During the cesarean section, 500 ml of blood in the form of dark blood clots was found in the abdominal cavity. The condition of the premature newborn was in conformity with his gestational age. The source of bleeding were the of endometriosis on the back wall of the uterus. These focuses most likely caused hemoperitoneum. The revision of the abdominal cavity did not find any other foci of bleeding. The postoperative period was uneventful. The article provides general guidelines for the management of pregnant women with severe forms of endometriosis.

scholarly journals Importance of Laparoscopy to Solve the Diagnostic Dilemma of Abdominal Tuberculosis

KYAMC Journal ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 14-17
Author(s):  
Md Saiful Islam ◽  
Md Masudar Rahman ◽  
M Fardil Hossain Faisal ◽  
Md Alamgir Jalil Pramanik ◽  
Muhammad Abdur Rouf
Keyword(s):  
Minimally Invasive ◽  
Diagnostic Laparoscopy ◽  
Abdominal Cavity ◽  
Correct Diagnosis ◽  
Abdominal Tuberculosis ◽  
Diagnostic Dilemma ◽  
Peritoneal Tissue ◽  
Appropriate Treatment ◽  
Liver Surface ◽  
Minimally Invasive Access

Background: Diagnosis of abdominal tuberculosis as well as histopathological confirmation is difficult because of suboptimal access to the intraperitoneal pathology. Laparoscopy provides minimally invasive access to the peritoneal cavity and materials can be collected for confirmation of diagnosis. Objectives: To study the importance of laparoscopy as a tool for the diagnosis of abdominal tuberculosis and initiation of appropriate treatment without delay. Materials & Methods: In this study 25 patients with suspected abdominal tuberculosis were selected within the period of May, 2014 to October, 2014. Diagnostic laparoscopy performed on all patients with biopsy of tissue from accessible sites. Results: Diagnostic laparoscopy with biopsy confirmed the diagnosis in 24 (96%) patients, 23 of these patients (96%) had nodules at different site of abdominal cavity and 19 of these patients (76%) had ascites. In two cases there were nodules over liver surface; biopsy was taken also from both liver nodules. One nodule revealed fibrosis and another nodule revealed tuberculosis. Conclusion: Imaging and culture of ascitic fluid may fail to confirm or exclude abdominal tuberculosis in clinically suspected cases. Laparoscopy with peritoneal tissue biopsy provided rapid and correct diagnosis of abdominal tuberculosis and should be performed early in suspected cases. KYAMC Journal.2021;12(01): 14-17

scholarly journals Mathematical modeling for prediction of complicated acute appendicitis in children

2018 ◽  
Vol 1 (1) ◽  
pp. 70-80
Author(s):  
V. S. Konoplitsky ◽  
V. V. Motygin ◽  
A. G. Yakimenko ◽  
D. V. Dmytriiev ◽  
T. I. Mikhalchuk
Keyword(s):  
Mathematical Model ◽  
Acute Appendicitis ◽  
Postoperative Period ◽  
Abdominal Cavity ◽  
Control Group ◽  
Toxic Substances ◽  
Healthy Children ◽  
Endogenous Intoxication ◽  
Complicated Course ◽  
Complicated Acute Appendicitis

Endogenous intoxication, which accompanies the complicated course of acute appendicitis in children, is one of the serious conditions, which are the main cause of complications in the postoperative period. Diverse clinical observations done by clinicians suggest that despite the use of modern technologies in operating equipment, anesthetic support, the number of complications in the postoperative period has no tendency to decrease, and the main cause of lethal outcomes with appendicular peritonitis is lightning development of severe degree of endotoxicosis, which develops as a result of resorbing toxic substances formed of many components, including pathogenic microflora and destruction metabolism. Purpose. Creation of a mathematical model for prediction of complicated acute appendicitis in children using the functions of regression analysis of EXCEL spreadsheet by approximating experimental data. Materials and methods. In the work, there is information about 59 patients with acute appendicitis treated at the clinic of pediatric surgery at the National Pirogov Memorial Medical University. The data on patients were divided into two groups: patients with not complicated course of pathology – 24 patients, and patients with complicated course of acute appendicitis – 35 children. The control group served the data of 37 healthy children. In each of the three groups, the following parameters were studied: gender, age, bed day, duration of the disease, presence of symptoms of peritoneal irritation, the nature of exudate in the abdominal cavity, the number of red blood cells, hemoglobin, leukocytosis, quantitative characteristics of white blood formula, ESR, cellogenic endogenous intoxication: leukocyte index of intoxication and hematological index of intoxication. All the data were determined directly at the time of hospitalization of a patient to the hospital. Results. Discussion. Based on multiple correlation x = f (x1 , x2 ) a two-factor mathematical model of probability of the complicated course of acute appendicitis in children was created. According to the obtained results of the study of the system of three equations with three unknowns, it was established that if the indicator of the form of the disease is y = 2.67 and above, when, in numerical terms, the result falls into the zone of complicated flow of acute appendicitis and completely coincides with data analysis of the three groups of patients. Conclusions. The components that determine the uncomplicated course of acute appendicitis in children, according to the developed two-factor model, include LII and GPI, which exceed the values intoxication of certain intervals studied at the time of hospitalization. The analyzed indices were determined by the degree of severity of the pathological process, duration of disease, virulence of microflora and age of patients against the background of the formed endogenous intoxication syndrome.

scholarly journals Вміст фактора некрозу пухлин α і трансформуючого фактора росту β1 у сироватці крові хворих на гострий апендицит та абдомінальний туберкульоз

2018 ◽  
Author(s):  
V. M. Akimova
Keyword(s):  
Differential Diagnosis ◽  
Immune System ◽  
Serum Level ◽  
Acute Appendicitis ◽  
Inflammatory Process ◽  
Abdominal Cavity ◽  
Abdominal Tuberculosis ◽  
Urgent Problem ◽  
Elisa Method ◽  
Chronic Inflammatory Process

Introduction. Differential diagnosis of acute appendicitis with abdominal tuberculosis is аn urgent problem of medicine. Тhe immune system is involved іn the pathogenesis of diseases, and cytokines are the regulators of inflammation.The aim of the study – to determine the level of cytokines with the pro- and anti-inflammatory potential of TNFα and TGFβ1 and their correlation in the blood of patients with acute appendicitis and abdominal tuberculosis in order to improve diagnosis and treatment tactics. Research Methods. 51 patients with urgent abdominal pathology were examined, 21 of them with phlegmonous form of acute appendicitis, 30 patients with histologically confirmed diagnosis of abdominal tuberculosis. The content of TNFα и ТGFβ1 in serum was examined by the ELISA method by the reagents “Diaclone” and “DRG Diagnostic”.Results and Discussion. The results of studies have shown that the development of acute and chronic inflammatory process in the abdominal cavity is determined by activation of the macrophage-monocytic system, manifested by a significant increase in the serum level of TNFα. It was established that in patients with abdominal tuberculosis on the background of increased serum level of TNFα ((17.57±1.05) vs. (4.97±0.18) pg/ml) the TGFβ1 level does not differ from the control ((16.52±1.15) vs. (17.94±0.71) ng/ml) at that time, as with acute appendicitis, its level decreased ((11.32±0.65) vs. (17.94±0.71) ng/ml). ТGFβ1/TNFα ratio during the abdominal inflammation was much lower than control, but in abdominal tuberculosis in 1.5 times higher than in acute appendicitis.Conclusions. The serum level and ratio of monocyte-macrofage derived TNFα and ТGFβ1 determines the type of inflammation and may be useful in differential diagnostic of acute appendicitis and abdominal tuberculosis.

scholarly journals Perforated Peptic Ulcer Combined with Posttraumatic Diaphragmatic Hernia in Third Gestation Trimester: a Clinical Case

2021 ◽  
Vol 11 (3) ◽  
pp. 251-255
Author(s):  
V. S. Panteleev ◽  
I. B. Fatkullina ◽  
A. Kh. Mustafin ◽  
R. S. Khalitova ◽  
A. S. Petrov
Keyword(s):  
Peptic Ulcer ◽  
Pregnant Women ◽  
Diaphragmatic Hernia ◽  
Clinical Case ◽  
Abdominal Cavity ◽  
Perforated Peptic Ulcer ◽  
Favourable Outcome ◽  
Duodenal Perforation ◽  
Duodenal Ulcers ◽  
In Pregnancy

Background. Gastric and duodenal ulcers are extremely rare in pregnancy, according to published literature. Peptic ulcer is found in 1 per 4,000 pregnant women, a figure probably underestimated due to its hampered diagnosis in pregnancy. Pregnancy peptic ulcer is considered less expected. Perforated gastric and duodenal ulcers comprise about 1.5 % of total acute abdominal diseases, and the perforation rate in ulcer patients ranges within 5–15 %. This complication afflicts the ages of 20–40 years in men much more frequently than in women. Three perforation types occur: free into abdominal cavity (87 %), contained (9 %), into lesser omentum and retroperitoneal tissue (4 %).Materials and methods. The clinical case describes surgical management of posttraumatic diaphragmatic hernia-comorbid perforated gastric ulcer in a pregnant woman in third trimester. Surgery with postoperative patient management enabled for a favourable outcome.Results and discussion. Perforation-entailing gastric and duodenal ulcers in pregnant women have received negligible attention due to rarity in clinical practice. Paul et al. described 14 cases of duodenal perforation in pregnancy, all fatal.Conclusion. Early diagnosis of surgical pathology during gestation is still difficult contributing to the development of severe complications associated with high mortality. The patient’s admission to a level III interspecialty hospital was key to enable a timely consilium-driven decision of caesarean intervention for saving the child, diagnosing intraoperatively life-threatening complicated surgical diseases and opting for radical surgery that ended in a favourable outcome.

scholarly journals Torsion of undescended abdominal testicle in a 16-year-old and its management

2020 ◽  
Vol 13 (1) ◽  
pp. e232179
Author(s):  
Muhamamd Isfandyar Khan Malik ◽  
Joshua Abbas ◽  
Shariq Sabri ◽  
George Michael ◽  
Simon Ellenbogen
Keyword(s):  
Emergency Department ◽  
Testicular Torsion ◽  
Diagnostic Laparoscopy ◽  
Iliac Fossa ◽  
Abdominal Cavity ◽  
External Genitalia ◽  
Malignant Potential ◽  
Testicular Pain ◽  
Left Testicle ◽  
Right Iliac Fossa Pain

A 16-year-old boy attended the Emergency Department with sudden severe right iliac fossa pain and associated vomiting. He denied any urinary symptoms, diarrhoea or testicular pain. On examination, he had a locally tender right iliac fossa with guarding. External genitalia and testicular examination revealed an absent right testicle, the left testicle was not tender. The patient was haemodynamically stable. A clinical diagnosis of acute appendicitis and possible testicular torsion was made and the patient sent for an urgent diagnostic laparoscopy. At laparoscopy, the patient was found to have a torted, non-viable right-sided testicle in the abdominal cavity. On discussion with urology, a decision was made to excise the torted testicle as it was atrophic and had significant malignant potential. The appendix was normal. The patient made an unremarkable recovery and was discharged.

scholarly journals Methods of Diagnostic Laparoscopy

2016 ◽  
Vol 23 (3) ◽  
Author(s):  
M G Gonchar ◽  
A Ye Bogush ◽  
L D Pryymak
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Laparoscopic Surgery ◽  
Epidural Anesthesia ◽  
Local Anaesthesia ◽  
Diagnostic Laparoscopy ◽  
Hemorrhagic Stroke ◽  
Abdominal Cavity ◽  
Abdominal Organs

During the period of three years, 1,414 patients underwent laparoscopic surgery. 18 patients underwent diagnostic laparoscopy under local anaesthesia. All these patients in addition to the suspected pathology of the abdominal cavity were diagnosed with severe concomitant cardiopulmonary pathology including acute myocardial infarction, ischemic and hemorrhagic stroke, coma of various genesis, pneumonia. The proposed technique included a local anaesthesia around the navel, laparolifting, the insertion of a laparoscope and a short inspection (3-5 min) of the abdominal organs. Sometimes, especially in patients with hypertension, spinal or epidural anesthesia was used. While diagnosticating the pathology, if necessary, the anaesthesia was given, carboperitonium was applied and the necessary surgery was performed. 

scholarly journals A NEW METHOD OF TREATMENT FOR APPENDICEAL STUMP

2018 ◽  
Vol 7 (2) ◽  
pp. 129-133
Author(s):  
A. L. Charyshkin ◽  
M. M. Yartsev
Keyword(s):  
Acute Appendicitis ◽  
Standard Method ◽  
Comparison Group ◽  
Abdominal Cavity ◽  
Operation Time ◽  
Wound Complications ◽  
Group Comparison ◽  
Postoperative Wound ◽  
Duration Of Surgery ◽  
Appendiceal Stump

Background.In 30% of acute destructive appendicitis, the disease is accompanied by typhlitis, which makes it difficult to perform classical methods of appendiceal stump treatment.Aim of study.To improve the way of appendiceal stump treatment in the destructive form of acute appendicitis complicated by significant typhlitis.Material and methods.We studied 57 cases of acute destructive appendicitis complicated by typhlitis, which were divided into two groups depending on the method of treatment. The first group (comparison group) consisted of 30 patients who underwent a standard method for treating the appendiceal stump after appendectomy, such as ligation at the base and putting the stump into the cupula of the cecum and fixing it with interrupted serous-muscular sutures or with a purse and Z-shaped sutures. The second (main) group included 27 patients, who were treated by the method we proposed. The essence of the method is successive U-shaped stitching of the stump. After that, the stump curls in the form of a cochlea, peritonizes, reaching the necessary tightness without going into the cupula of the cecum. In this case, the abdominal cavity of patients in both groups was adequately sanitized and drained.Results.In the first group of patients there were technical difficulties associated with immersion of the appendiceal stump, which caused the serous damage, hematoma of the cupula of the cecum in 7 (23.3%) patients. In the second group of patients, due to the developed method of forming the appendiceal stump, technical difficulties did not arise, there were no complications. The duration of appendectomy in the first group of patients with standart treatment (interrupted serous-muscular sutures or purse and Z-shaped stiches) was 28.7±5.4 minutes, and in the second group of patients appendectomy with stump management with the suggested method lasted 20.3±6.1 minutes, p <0.05, which reduced the operation time by 8 minutes on the average. Purulent-inflammatory wound complications in the first group were detected in 7 patients (23.3%), and in 1 (3.7%) patient of the second group, which is significantly less by 19.6%.Conclusion.The proposed method is technically simple, as peritonization of the stump is performed without putting it into the cupula of the cecum. The use of this method is indicated in destructive forms of acute appendicitis complicated by severe typhlitis, which significantly reduces the operation trauma and contributes to reduction in the number of postoperative wound purulent-inflammatory complications by 19.6%. Findings The proposed method for treating the appendiceal stump during appendectomy for acute destructive appendicitis complicated by typhlitis is simple enough, reliable, characterized by low traumatism and shortens the duration of surgery by 8 minutes on the average (p <0.05). 

Sign in / Sign up

Export Citation Format

Share Document