scholarly journals Stump appendicitis

2020 ◽  
Vol 7 (7) ◽  
pp. 2461
Author(s):  
Ketan Vagholkar
Keyword(s):  
Computed Tomography ◽  
Acute Appendicitis ◽  
Clinical Presentation ◽  
Abdominal Operation ◽  
Diagnosis And Management ◽  
Stump Appendicitis ◽  
Contrast Enhanced ◽  
The World ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Appendectomy is one of the commonest abdominal operation performed all over the world. Stump appendicitis is one of the uncommon complications of appendectomy. The diagnosis of stump appendicitis is delayed due to low index of suspicion by virtue of the fact that an appendectomy has already been done. The clinical presentation exactly simulates acute appendicitis. Contrast enhanced computed tomography is diagnostic. Completion appendectomy either open or laparoscopic is the mainstay of treatment. Awareness regarding the possible aetiology, diagnosis and management is essential for avoiding delay in the diagnosis.

scholarly journals Acute Focal Bacterial Nephritis: Two Cases and Review of the Literature

2019 ◽  
Vol 6 ◽  
pp. 205435811988431
Author(s):  
Adnane Guella ◽  
Arshee Khan ◽  
Dima Jarrah
Keyword(s):  
Computed Tomography ◽  
Clinical Presentation ◽  
Renal Scarring ◽  
Lessons Learned ◽  
Antibiotic Administration ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Acute Focal Bacterial Nephritis ◽  
Contrast Enhanced Computed Tomography ◽  
Worse Prognosis

Rationale: Acute focal bacterial nephritis (AFBN) has mainly been reported in pediatrics. It may be an underdiagnosed condition in adults because it resembles acute pyelonephritis (APN) in its clinical presentation. Presenting concerns of the patients: Two young women (25 and 27 years old, respectively) presented with complaints compatible with a diagnosis of APN. However in both, fever was of high grade, persistent for several days in spite of antibiotic administration, and there was demonstrated worsening of the inflammatory biomarkers. A contrast-enhanced computed tomography (CECT) led to the diagnosis in both cases. Diagnoses: Contrast-enhanced computed tomography reveals the most sensitive and specific images of AFBN. This includes wedge-shaped lesions with decreased enhancement, which may be focal or multifocal. Interventions (including prevention and lifestyle): Antibiotic therapy for at least 3 weeks. Outcomes: Resolution of AFBN was obtained after 3 weeks of antibiotics. Lessons learned: Our 2 cases illustrate the importance of CECT imaging to confirm the diagnosis of AFBN. Interstitial bacterial inflammation may have a worse prognosis if not diagnosed early and efficiently treated. Unlike APN, the management of AFBN requires at least 3 weeks of antibiotics to prevent the development of renal scarring and renal abscess.

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