scholarly journals Emergency surgical management of sub-hepatic appendicular perforation with abscess; rare presentation of a common disease: a case report

2021 ◽  
Vol 9 (11) ◽  
pp. 3478
Author(s):  
S. K. Sekendar Ali ◽  
Narendra Nath Mukhopadhyay
Keyword(s):  
Case Report ◽  
Surgical Management ◽  
Perforated Appendicitis ◽  
Exploratory Laparotomy ◽  
Clinical Suspicion ◽  
Common Disease ◽  
Emergency Setting ◽  
Atypical Presentation ◽  
Rare Presentation ◽  
High Level

Subhepatic appendicitis is a very rare presentation that has been rarely reported, accounting for 0.01% of acute appendicitis case. It is difficult to diagnose and prime to be aware of variants, manage such challenging case in emergency setting. We present a case of 29 years male patient with subhepatic perforated appendicitis and its sequelae-abscess and peritonitis who underwent an exploratory laparotomy and appendectomy. The initial diagnosis and surgical management of such patients is challenging due to very rare and atypical presentation in emergency setting. A high level of clinical suspicion, promote decision to operate and skillful surgical approach is discussed with briefly.

A Case Report on the Surgical Management of Subhepatic Perforated Appendicitis: A Rare Presentation

2020 ◽  
Author(s):  
Mumin Hakim ◽  
Rania Mostafa ◽  
Mohammed Al Shehri ◽  
Sherif Sharawy
Keyword(s):  
Case Report ◽  
Acute Appendicitis ◽  
Female Patient ◽  
Surgical Management ◽  
Perforated Appendicitis ◽  
Exploratory Laparotomy ◽  
Atypical Presentation ◽  
Review Of Literature ◽  
Rare Presentation ◽  
Case Presentation

Abstract Background: Subhepatic appendicitis is an exceedingly rare presentation accounting for 0.01% of Acute appendicitis. It is of prime importance to be aware of various variants and thereby managing such challenging cases accordingly.Case presentation: We present a middle-aged female patient with subhepatic perforated appendicitis and peritonitis who underwent an exploratory laparotomy and appendectomy.Conclusions: Surgical management of such patients is challenging due to an atypical presentation. The surgical management of such patients is discussed with a brief review of literature.

scholarly journals Surgical management of subhepatic perforated appendicitis: a case report

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Mumin Hakim ◽  
Rania Mostafa ◽  
Mohammed Al Shehri ◽  
Sherif Sharawy
Keyword(s):  
Case Report ◽  
Acute Appendicitis ◽  
Surgical Management ◽  
Perforated Appendicitis ◽  
Exploratory Laparotomy ◽  
Atypical Presentation ◽  
Review Of The Literature ◽  
Middle Aged ◽  
Rare Presentation ◽  
Case Presentation

Abstract Background Subhepatic appendicitis is an exceedingly rare presentation, accounting for 0.01% of acute appendicitis cases. It is of prime importance to be aware of variants and manage such challenging cases accordingly. Case presentation We present a case of a middle-aged Saudi woman with subhepatic perforated appendicitis and peritonitis who underwent an exploratory laparotomy and appendectomy. Conclusions The initial diagnosis and surgical management of such patients is challenging due to an atypical presentation. The surgical management of such patients is discussed with a brief review of the literature.

ROTATORY SUBLUXATION OF THE METACARPOPHALANGEAL INDEX FINGER JOINT: A CASE REPORT

Hand Surgery ◽  
2013 ◽  
Vol 18 (01) ◽  
pp. 103-105 ◽  
Author(s):  
Ken Teo ◽  
Anthony Berger
Keyword(s):  
Case Report ◽  
Index Finger ◽  
Extensor Tendon ◽  
Metacarpophalangeal Joint ◽  
Clinical Suspicion ◽  
Collateral Ligament ◽  
Open Injury ◽  
Complete Tear ◽  
Rotatory Subluxation ◽  
High Level

We report a case of rotatory subluxation of the metacarpophalangeal joint (MCPJ) of the finger. A 40-year-old man sustained an open injury to his index finger following an explosive injury. Radiographs showed rotatory subluxation of the index finger MCPJ. The index finger extensor digitorium was found interposed in the MCPJ, with a complete tear of the radial collateral ligament. Treatment was by open reduction and repair of the collateral ligament and the extensor tendon. A high level of clinical suspicion is needed to diagnose this entity.

scholarly journals Pemphigus Vegetans of Neumann Type on Lip: A Case Report

2021 ◽  
Vol 7 (4) ◽  
Author(s):  
Anil P Gosavi ◽  
Ravindranath Brahmadeo Chavan ◽  
Jheel Shriniwas Ambike ◽  
Nitika S Deshmukh
Keyword(s):  
Case Report ◽  
Rare Variant ◽  
Pemphigus Vulgaris ◽  
Common Disease ◽  
Middle Aged ◽  
Rare Presentation ◽  
Neumann Type ◽  
Pemphigus Vegetans ◽  
Intralesional Steroids

: Pemphigus is a chronic autoimmune vesiculobullous disease caused by autoantibodies directed against desmogleins (Dsgs). Pemphigus vegetans is a rare variant of pemphigus vulgaris, characterized by vegetative plaques, primarily occurring in flexures. It is a less common disease and involves the skin and mucosa due to disintegration of cellular adherence (acantholysis), resulting in intradermal split. We report this case of pemphigus vegetans of Neumann type for its rare presentation. We report a case of pemphigus vegetans, involving lips in a middle-aged female and sparing flexural areas. This patient was diagnosed on the basis of histopathology and treated successfully with intralesional steroids, resulting in the resolution of her plaques.

Appendicitis Perforata in CAPD Patients -Report of Two Cases

1985 ◽  
Vol 5 (4) ◽  
pp. 237-240 ◽  
Author(s):  
Konstantin Vogt ◽  
Bernhard Hess ◽  
Dieter Baumgartner ◽  
Dirk Maass ◽  
Gerald Keusch ◽  
...  
Keyword(s):  
Rare Complication ◽  
White Cell Count ◽  
Perforated Appendicitis ◽  
Exploratory Laparotomy ◽  
Fecal Peritonitis ◽  
Therapeutic Implications ◽  
Replacement Treatment ◽  
Perforated Appendix ◽  
Appendicitis Perforata ◽  
High Level

Two patients on CAPD had peritonitis due to perforated appendicitis. Both presented with diffuse painful peritonitis with nausea, fever and prostration. There was blood leukocytosis with a shift to the left. The peritonitis did not respond to antibiotic therapy. The diagnosis was made after 8 and 18 days respectively by exploratory laparotomy. Both patients had a gangrenous perforated appendix surrounded by abscess. Both patients had uncomplicated recovery after appendectomy, drainage, removal of the Tenckhoff catheter with discontinuation of CAPD and change to hemodialysis. Our experience suggests that a perforated appendix might be recognized early in a patient with apparent fecal peritonitis in whom other more common causes (e.g. diverticulosis/ diverticulitis) have been ruled out, or when he presents with severe symptoms and a low peritoneal white cell count. Perforated appendicitis leading to fecal peritonitis is a rare complication of continuous ambulatory peritoneal dialysis (CAPD). Among 85 patients treated with CAPD since 1978 for a total of 1062 patient months, we observed two such cases. Although CAPD now is established as a kidney replacement treatment and appendicitis is a common condition, we know of no other report of perforated appendicitis during CAPD. Therefore we describe our experience with two such patients, treated with CAPD for 14 and 5 months, respectively. The diagnostic and therapeutic implications are discussed in the context of other forms of fecal peritonitis, mainly due to colonic perforation, secondary to diverticular disease. This report emphasizes the need for a high level of suspicion that the peritonitis may be related to bowel disease, especially when it does not respond quickly to standard treatment.

scholarly journals Mesenteroaxial Gastric Volvulus: A Case Report

2021 ◽  
Vol 59 (237) ◽  
Author(s):  
Sampanna Pandey ◽  
Madhav Paudel ◽  
Anuj Parajuli ◽  
Roshan Ghimire ◽  
Asmita Neupane
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Primary Repair ◽  
Wedge Resection ◽  
Gastric Volvulus ◽  
Exploratory Laparotomy ◽  
Uneventful Recovery ◽  
Atypical Presentation ◽  
Surgical Exploration ◽  
Low Threshold

Gastric volvulus is defined as an abnormal rotation of the stomach. Classical textbook presentation may not always be present. Meticulous assessment and broadened differential diagnosis are thus crucial. Various types have been described in literature. Low threshold for detection with aggressive resuscitation and immediate surgical exploration on suspected incarceration or perforation are mandatory. We report a case of 16-years-female who had atypical presentation of mesenteroaxial gastric volvulus. Emergency exploratory laparotomy with wedge resection and primary repair of stomach with anterolateral gastropexy was performed. She had uneventful recovery with discharge on fifth postoperative day.

scholarly journals Neonatal COVID-19 with Rare Presentation in COVID Dedicated Hospital of Bangladesh: A Case Report

2021 ◽  
Vol 7 (1) ◽  
pp. 87-89
Author(s):  
Rifat Taher Anne ◽  
Md Zakirul Islam ◽  
Farhana Noman ◽  
Ferdousi Hasnat ◽  
Shamima Sharmin Shova ◽  
...  
Keyword(s):  
Case Report ◽  
Early Detection ◽  
Respiratory Distress ◽  
Death Rate ◽  
Neonatal Death ◽  
Clinical Presentation ◽  
Age Groups ◽  
Atypical Presentation ◽  
Rare Presentation ◽  
Recurrent Seizure

Although Coronavirus disease (COVID-19) can affect all age groups, severity of clinical presentation among children and newborns are milder than in adults. Along with classical symptoms, atypical presentation could be noted in the neonate. We report here a case of neonatal COVID-19 where a newborn infant presented with fever, lethargy, respiratory distress and recurrent seizure. Early detection and prompt management is the prerequisite for limiting transmission and reducing neonatal death rate. Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 87-89

scholarly journals Damage Control Laparotomy with Appendectomy and Cesarean Section in the Setting of Perforated Appendicitis

2020 ◽  
pp. 1-3
Author(s):  
Hossam Abdou ◽  
Hossam Abdou ◽  
Jose J Diaz ◽  
Lindsay B O’Meara
Keyword(s):  
Cesarean Section ◽  
General Surgery ◽  
Damage Control ◽  
Delayed Diagnosis ◽  
Perforated Appendicitis ◽  
Clinical Suspicion ◽  
Operative Intervention ◽  
Maternal Distress ◽  
Damage Control Laparotomy ◽  
High Level

Appendicitis is the most common general surgery problem in pregnant patients, but patients can present with vague symptoms making diagnosis difficult. Misdiagnosis and delayed diagnosis can lead to complications such as perforation, which can result in dire outcomes, including fetal and maternal demise. A high level of clinical suspicion should be maintained to identify the diagnosis and progress to operative intervention quickly. Here we present a case highlighting prompt recognition of perforated appendicitis leading to fetal and maternal distress with emergent operative intervention leading to good outcomes for both mother and baby.

scholarly journals Cerebellar Tuberculoma in a Patient with Lung Tuberculosis New Case: A Case Report

2020 ◽  
Vol 6 (3) ◽  
pp. 75
Author(s):  
Gemilang Khusnurrokhman ◽  
Tutik Kusmiati
Keyword(s):  
Infectious Disease ◽  
Computed Tomography ◽  
Case Report ◽  
Left Lung ◽  
Atypical Presentation ◽  
Radiological Imaging ◽  
Rare Presentation ◽  
Lung Tuberculosis ◽  
Ct Head ◽  
Chest Radiology

Background: Tuberculosis (TB) is an infectious disease which can occur in the lungs and extra lung. One kind of extra lung TB is Cerebellum tuberculoma, which is one of rare manifestations form of TB, difficult to diagnosed, because sign and symptom is not specific.Case: A 17-year-old female presented a TB symptoms. She also had contact with her neighbor that was diagnosed with TB. In physical examination there was reduced motor function on her right extremities. Chest radiology revealed opacities in 2/3 superior in the left lung before treatment. Computed Tomography (CT) head scan with contrast showed ring contrast enhancement in left subcortical hemisphere cerebellum with size as 1.8 x 1.8 x 1.7 cm. Multiple lymphadenopathy in right-left upper-aid jugular and lymph node subcentimeter in right of submandibular, right-left lower jugular with varieties of size, the biggest is 1.6 x 1.5 cm. After 6 months treatment the tuberculoma of cerebellum was gone.  Conclusion:Cerebellum tuberculoma is a rare presentation of active TB. Radiological imaging plays an important role in the diagnosis and monitoring of the disease. The appereance of tuberculoma on our patient CT showed nodular-enhancing lesion. Intracranial tuberculoma should be treated conservatively, since the majority of these lesions resolve completely with Anti-Tuberculosis Drugs (ATD). Our patient started ATD and the lesions completely disappeared within 6 months. We wanted to present our case due to well-responded to ATD and being an example of atypical presentation of tuberculosis both clinically and radiologically. 

scholarly journals Pneumoperitoneum due to perforated appendicitis: a rare anatomo-radiologic correlation

2008 ◽  
Vol 21 (3) ◽  
pp. 142-143
Author(s):  
André Luiz Santos Rodrigues ◽  
Marcelino Ferreira Lobato ◽  
Augusto César Santana ◽  
Lucas Crociati Meguins ◽  
Daniel Felgueiras Rolo
Keyword(s):  
Peptic Ulcer ◽  
Severe Sepsis ◽  
Abdominal Pain ◽  
Case Report ◽  
Medical Literature ◽  
Perforated Appendicitis ◽  
Perforated Peptic Ulcer ◽  
Exploratory Laparotomy ◽  
Diffuse Peritonitis ◽  
Diffuse Abdominal Pain

BACKGROUND: Pneumoperitoneum is usually associated with a perforated peptic ulcer. However, perforated appendicits may be evolved on it. In the medical literature, the anatomo-radiologic correlation between them is an uncommon event. CASE REPORT: Man with 56-year-old look for assistance with diffuse abdominal pain and distension associated with fever, vomit and absence of flatus and evacuation for about 14 days. The chest radiography revealed a pneumoperitoneum. Diffuse peritonitis was found during the exploratory laparotomy. Appendectomy, peritoneal cavity cleaning and drainage with tubular drains were carried out. However, severe sepsis occurred and the patient died on the 16th post-operative day with multiple systemic organ failure. CONCLUSION: Although rare as pneumoperitoneum ethiology, acute appendicitis may be thought as it's cause.

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