scholarly journals Evaluation of RIPASA score in the diagnosis of acute appendicitis

2017 ◽  
Vol 5 (1) ◽  
pp. 193
Author(s):  
Shubhi P. Bhatnagar ◽  
Shahaji Chavan
Keyword(s):  
Acute Appendicitis ◽  
Iliac Fossa ◽  
The Elderly ◽  
Reproductive Age ◽  
Cross Sectional ◽  
Efficient Score ◽  
Surgical Emergencies ◽  
Negative Findings ◽  
The Right ◽  
Ripasa Score

Background: Acute appendicitis is one of the most common surgical emergencies. Despite being a common problem, it remains a difficult diagnosis to establish, particularly among the young, the elderly and females of reproductive age. The study aimed to compare the efficacy of RIPASA score in the diagnosis of acute appendicitis.Methods: In this cross sectional comparative study, 100 cases of pain in the right iliac fossa were admitted and evaluated clinically. RIPASA score was calculated for all. Ultrasound (USG) of abdomen and pelvis was done. A positive RIPASA score or USG finding was the criteria for open appendicectomy. The postoperative histopathological reports were compared with the RIPASA scores.Results: RIPASA score was positive in 90% cases. Histopathologically, appendicitis was present in 99% cases. One case of normal appendix histopathologically had a lower RIPASA score. This indicated that RIPASA score could correctly diagnose acute appendicitis in 90% cases.Conclusions: RIPASA score is an efficient score in the diagnosis of acute appendicitis. As compared with ultrasonography of abdomen and pelvis, the RIPASA score is more diagnostic in cases of acute appendicitis. Negative findings of acute appendicitis on ultrasonography of abdomen and pelvis are not the diagnostic test to rule out appendicitis.

scholarly journals A study to compare RIPASA (Raja Isteri Pengiran Anak Saleha Appendicitis) and Alvarado scores in diagnosing acute appendicitis in Indian population

2018 ◽  
Vol 5 (5) ◽  
pp. 1826
Author(s):  
Dijo S. Joseph ◽  
Alfie J. Kavalakat ◽  
John M. Mandumpala ◽  
Suresh V. Mayyattil
Keyword(s):  
Acute Appendicitis ◽  
Predictive Value ◽  
Scoring System ◽  
Iliac Fossa ◽  
Asian Population ◽  
Scoring Systems ◽  
Alvarado Score ◽  
Cross Sectional ◽  
Study Results ◽  
Ripasa Score

Background: Acute appendicitis is one of the most common surgical emergencies. Various clinical scoring systems have been used for early diagnosis of acute appendicitis, of which Alvarado score is the most popular but it is found to be less accurate when applied to Asian population compared to RIPASA score. Radiological modalities such as computed tomography (CT) imaging may aid in making a definite diagnosis but will inflate the cost of treatment. This study aims to compare RIPASA and Alvarado scoring system in the diagnosis of acute appendicitis in our population.Methods: It was a comparative cross-sectional study done in 100 patients. RIPASA and Alvarado scores were applied to each patient. Our inclusion criteria were patients presenting with Right iliac fossa pain who subsequently underwent Appendicectomy in the same admission. Exclusion criteria included patients admitted under other specialties, those who underwent previous appendicectomy, elective appendicectomy and those not willing for the study.  Results: The sensitivity and specificity of RIPASA score was 95.12% and 66.67% and that of ALVARADO score was 64.63% and 77.78%. The positive predictive value (PPV) and negative predictive value (NPV) of RIPASA score was 92.86% and 75% and that of Alvarado score was 92.98% and 32.5%. The diagnostic accuracy of Alvarado and RIPASA scores were 67.0% and 90.0% respectively.Conclusions: RIPASA scoring system is more accurate and specific scoring system for our population than Alvarado in diagnosing acute appendicitis.

scholarly journals Amyand's hernia and acute appendicitis: Case presentation in Basic Hospital of Chone

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.

Appendicoliths: the neglected stones

2017 ◽  
Vol 4 (1) ◽  
pp. 3-6
Author(s):  
Saroj Dhital ◽  
Udaya Koirala ◽  
Birendra Dhoj Joshi ◽  
Amit Mani Upadhyaya ◽  
Arbin Joshi
Keyword(s):  
Acute Appendicitis ◽  
Iliac Fossa ◽  
Vermiform Appendix ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Recurrent Appendicitis ◽  
Right Iliac Fossa Pain

Introductions: Cases of colic of the vermiform appendix have been rarely described or diagnosed. Appendicoliths cause acute appendicitis and appendicular perforation. It is still not clear whether appendicoliths cause appendicular colic in the absence of acute appendicitis. Methods: A cross sectional study that included appendectomy done for recurrent appendicitis or chronic right iliac fossa pain. Histology reports were reviewed. The presence of an appendicolith in the report was noted. Results: Thirty-two cases of recurrent appendicitis and chronic right iliac fossa pain were included. Twenty-four patients (75%) had fecoliths in the histology specimens. Eight patients (25%) who presented with appendicular colic without signs of appendicitis were further evaluated. Conclusions: Majority of patients with chronic or colicky right iliac fossa pain had appendicoliths.

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

1970 ◽  
Vol 1 (2) ◽  
pp. 104-107 ◽  
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

scholarly journals EP.FRI.90 Should laparoscopy be performed before or after appendicectomy in females of reproductive age with a clinical diagnosis of appendicitis?

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Charles Scott ◽  
Anthony Lambert
Keyword(s):  
Clinical Diagnosis ◽  
Patient Group ◽  
Single Port ◽  
Iliac Fossa ◽  
Reproductive Age ◽  
General Surgeon ◽  
Ovarian Cysts ◽  
Open Appendicectomy ◽  
Pelvic Organs ◽  
The Right

Abstract Introduction Females of reproductive age with a clinical diagnosis of appendicitis may undergo laparoscopy prior to appendicectomy. This paper advocates laparoscopy after appendicectomy only if the appendix is macroscopically normal in this patient group.  Method A cohort of patients under the care of a single general surgeon is reported. If the appendix was macroscopically normal a laparoscopic port was inserted through the right iliac fossa incision. This single port was used for laparoscopic assessment of the pelvic organs. Results Fourteen females of reproductive age underwent laparoscopy following a macroscopically normal open appendicectomy. No additional laparoscopic ports were required. A benign dermoid ovarian cyst was identified in a 14 year-old which was electively excised following further investigation by a gynaecologist. Two ruptured simple ovarian cysts were also identified. There were no complications reported in this patient group. Conclusions Laparoscopy following a macroscopically normal open appendicectomy allows assessment of the pelvic organs in females of reproductive age and reduces the number of ports required during surgery.  

scholarly journals Idiopathic Omental Infarction Mimic Acute Appendicitis: A Case Report

2020 ◽  
pp. 1-3
Author(s):  
Hamad Almakinzy ◽  
Bandar Idress ◽  
Hamad Almakinzy
Keyword(s):  
Case Report ◽  
Acute Appendicitis ◽  
Acute Abdomen ◽  
Inflammatory Markers ◽  
Iliac Fossa ◽  
Young Patients ◽  
Acute Onset ◽  
First Case ◽  
Laparoscopy Surgery ◽  
The Right

Idiopathic Omental Infarct (IOI) is a rare cause of an acute abdomen that arises from an interruption of blood supply to the omentum. Since first case was described by Elitelin 1899, more than 300 cases have been published [1]. It can mimic serious surgical pathology. It occurs in <1% of appendicitis cases [2]. It’s challenge to diagnose, as features may mimic acute appendicitis and therefore in young patients, may only be discovered intra-operative. Here, we present a case of omental infarct in 26-year-old gentleman with no significant medical or surgical background who present with acute onset of right iliac fossa (RIF) pain. Examination revealed tenderness over the right iliac fossa and was having localized rebound. His inflammatory markers were high. He was successfully treated with laparoscopy surgery and he was subsequently discharged the following day.

EVALUATION OF THE PERTINENCE OF MODIFIED ALVARADO SCORE IN THE DIAGNOSIS OF SUSPECTED ACUTE APPENDICITIS

2021 ◽  
pp. 68-70
Author(s):  
Debasish Ray ◽  
Nipun Roy ◽  
Subikash Biswas ◽  
Ashim Mandal ◽  
Debarshi Jana
Keyword(s):  
Acute Appendicitis ◽  
Iliac Fossa ◽  
Surgical Removal ◽  
Lower Abdomen ◽  
Alvarado Score ◽  
Suspected Appendicitis ◽  
Surgical Emergencies ◽  
Grade 3 ◽  
Modified Alvarado Score ◽  
Suspected Acute Appendicitis

INTRODUCTION:Appendicitis remains one of the most common surgical emergencies faced by surgeons during his surgical practice. The rst formal description of Acute Appendicitis as a disease entity and its natural process, along with common clinical features and recommendation for its prompt surgical removal was done by Reginald Heber Fitz in 1886 in Harvard University1.AIMS AND OBJECTIVES: This study is aimed to evaluate the pertinence of modied Alvarado score in the diagnosis of suspected acute appendicitis. To look for the effectiveness of Modied Alvarado Score in clinical practice for diagnosis of acute appendicitis by correlating the score with operative and histopathological ndings. MATERIALS AND METHODS:Patients admitted in the inpatient department with pain right lower abdomen especially right iliac fossa tenderness, suspected appendicitis in the department of General Surgery, College of Medicine& JNM Hospital, Kalyani. 6 MONTHS from the period of institutional ethical committee clearance. RESULTS: A MODIFIED ALVARADO SCORE of 6 has been obtained in most of the participants (26.87%), followed by higher Modied Alvarado Score scores of 7, 8 and 9 in 25%, 18.75% and 17.5% respectively. Only about 11.88% participants have a score less than 6.Most of the participants, a little less than two-third of them had a MODIFIED ALVARADO SCORE grade 3, almost one-third had a grade 2 and only 5.6% belonged to grade 1 group.

scholarly journals Abdominal aortic aneurysm and acute appendicitis: a case report and review of the literature

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Rubén Peña ◽  
Sergio Valverde ◽  
José A. Alcázar ◽  
Paloma Cebrián ◽  
José Ramón González-Porras ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Acute Appendicitis ◽  
Iliac Fossa ◽  
Perforated Appendicitis ◽  
Case Presentation ◽  
Abdominal Symptoms ◽  
Abdominal Aortic ◽  
The Right ◽  
The Relationship

Abstract Background Abdominal aortic aneurysm and acute appendicitis occur relatively frequently in elderly patients. However, the co-occurrence of the two pathologies is very rare and serious. Case presentation We present the case of an elderly Caucasian patient who was aware of having an abdominal aortic aneurysm but refused treatment and was subsequently admitted to the hospital’s emergency department with acute abdominal symptoms. A computed tomography scan raised the possibility of complication due to the characteristics of the aneurysm. The patient then agreed to emergency surgery. Laparotomy revealed the existence of an acute perforated appendicitis with a significant abscess in the right iliac fossa and an uncomplicated aneurysm. Appendectomy was performed and the abscess drained. The postoperative period passed without complications, and the patient again refused surgery for the aneurysm, which due to its anatomical characteristics was not a candidate for standard endovascular treatment. Conclusions In light of this experience, we review the literature about the relationship between abdominal aortic aneurysm and acute appendicitis.

scholarly journals A féregnyúlvány diverticulosisa, diverticulitise. Esetismertetés és irodalmi áttekintés

2018 ◽  
Vol 159 (19) ◽  
pp. 768-772
Author(s):  
Tamás Vass ◽  
Attila Zaránd ◽  
Dániel Horányi ◽  
László Harsányi
Keyword(s):  
Acute Appendicitis ◽  
Preoperative Diagnosis ◽  
Histopathological Examination ◽  
Iliac Fossa ◽  
Abdominal Ultrasound ◽  
Vermiform Appendix ◽  
Review Of The Literature ◽  
Rebound Tenderness ◽  
History Of ◽  
The Right

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.

scholarly journals Acute eosinophilic appendicitis simulating uncomplicated appendicitis

2018 ◽  
Vol 11 (1) ◽  
pp. e227178
Author(s):  
Kazuya Takabatake ◽  
Tsutomu Imanishi ◽  
Tetsuji Yoshikawa
Keyword(s):  
Acute Appendicitis ◽  
Antibiotic Therapy ◽  
Iliac Fossa ◽  
Japanese Woman ◽  
Chief Complaint ◽  
Histopathological Diagnosis ◽  
Uncomplicated Appendicitis ◽  
Old Japanese ◽  
Abdominal Emergencies ◽  
The Right

Acute appendicitis is one of the most common abdominal emergencies worldwide. Uncomplicated appendicitis (UA), which does not involve perforation or peritonitis, has recently been treated with antibiotic therapy. Here, we report a case of acute eosinophilic appendicitis (AEA) that simulated UA and did not respond to antibiotic therapy. A 20-year-old Japanese woman emergently presented with the chief complaint of pain at the right iliac fossa. CT showed only swelling of the appendix. She was diagnosed with UA, and she received antibiotic therapy initially. However, the treatment was not effective and appendectomy was performed. The final histopathological diagnosis was AEA. The findings of this case suggest that AEA is likely to be diagnosed as UA. As AEA can simulate UA, the possibility of AEA should be considered when antibiotic therapy is not effective.

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