scholarly journals Sub hepatic acute appendicitis: a challenging case to diagnose and successfully managed by laparoscopic procedure

2021 ◽  
Vol 8 (11) ◽  
pp. 3479
Author(s):  
Pranay Palle ◽  
Krishna Ramavath ◽  
Nyna Sindhu ◽  
Tushar Parmeshwar ◽  
Sunil B. Boya Tailor ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Acute Cholecystitis ◽  
Liver Abscess ◽  
Laparoscopic Appendectomy ◽  
Rare Condition ◽  
Developmental Period ◽  
Laparoscopic Procedure ◽  
Quadrant Pain ◽  
Early Management

Sub hepatic acute appendicitis is a rare condition to occur. It can present as right upper quadrant pain and makes challenging in diagnosis and early management. Sub hepatic appendix normally due to malrotation of intestine during developmental period. This condition can mimic as acute cholecystitis, liver abscess. We are presenting a case of sub hepatic acute appendicitis and successfully managed by laparoscopic appendectomy. Sub hepatic acute appendicitis is challenging case to diagnosis and early management. Because late in diagnosis can cause to perforation of appendix and its complications.

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.

scholarly journals Haemorrhagic cholecystitis: a rare entity not to be forgotten

2018 ◽  
pp. bcr-2018-226469 ◽  
Author(s):  
Zi Qin Ng ◽  
Sharin Pradhan ◽  
Kim Cheah ◽  
Ruwan Wijesuriya
Keyword(s):  
Acute Cholecystitis ◽  
Case Reports ◽  
Rare Condition ◽  
Morbidly Obese ◽  
High Morbidity ◽  
Rare Entity ◽  
Management Options ◽  
Quadrant Pain ◽  
Morbidly Obese Patient ◽  
Clinical Presentations

Haemorrhagic cholecystitis is a rare entity of acute cholecystitis that carries a high morbidity and mortality rate if management is delayed. Its clinical course can mirror that of acute cholecystitis. Characteristic findings on ultrasound or CT scan are useful clues to early diagnosis. Urgent cholecystectomy is required prior to progressing to perforation of gallbladder. Most of the literature are case reports with causes associated with anticoagulation. Herein, we described a morbidly obese patient with poorly controlled diabetes presenting with non-specific right upper quadrant pain and was subsequently diagnosed with haemorrhagic cholecystitis. A review of the literature was also performed to summarise the potential clinical presentations, distinctive imaging findings and management options available for this rare condition.

scholarly journals Laparoscopic Incidental Finding of Pneumatosis Intestinalis in Acute Appendicitis

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
N. Mayooran ◽  
A. Olu Shola ◽  
N. Iqbal
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Bowel Wall ◽  
Clinical Presentation ◽  
Incidental Finding ◽  
Rare Condition ◽  
Pneumatosis Intestinalis ◽  
Home Management ◽  
Underlying Causes ◽  
Laparoscopic Finding

Pneumatosis intestinalis (PI) is a rare condition where the gas trapped inside the bowel wall. It is commonly found as an incidental finding on routine abdominal imaging or scans. We present a case of incidental laparoscopic finding of pneumatosis intestinalis on a 32-year-old male, who underwent a laparoscopic appendectomy for an acute appendicitis. Laparoscopic appendectomy was performed and pneumatosis intestinalis managed conservatively. Patient did well and was discharged home. Management of PI depends on clinical presentation; asymptomatic PI can be managed adequately by treating underlying causes. We report a case of incidental laparoscopic finding of Pneumatosis intestinalis, which was adequately managed by treating underlying appendicitis.

scholarly journals Appendiceal Diverticulitis in a Young Female Diagnosed on Pathology after Laparoscopic Appendectomy for Acute Appendicitis

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Oluwatobi O. Onafowokan ◽  
Aboubakr Khairat ◽  
Hugo J. R. Bonatti
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Malignant Tumors ◽  
Rare Condition ◽  
Young Female ◽  
Sudden Onset ◽  
Lower Quadrant ◽  
Increased Risk ◽  
Acute Appendicits ◽  
Appendiceal Diverticulitis

Background. Appendiceal diverticulitis is a rare cause of inflammation of the appendix, which may mimic acute appendicitis. Its diagnosis is often delayed, and its occurrence carries an increased risk of significant complications, such as perforation. Case Presentation. A 23-year-old woman presented with sudden onset, severe, right lower quadrant abdominal pain and nausea. Her WBC was elevated, and abdominal CT showed findings indicative of acute appendicitis with a 13 mm fluid-filled appendix and local stranding. During laparoscopic appendectomy, significant inflammation was found around the appendix with some mucous material around the tip. The appendix base was not involved, and an endoloop was used to secure the stump. No other intra-abdominal abnormalities were observed. The patient recovered uneventfully. Pathology showed no classic appendicitis but appendiceal diverticulitis with signs of perforation. Discussion. Appendiceal diverticulitis is a rare condition which cannot be distinguished from acute appendicits clinically and on imaging. Diagnosis may be established based on pathology such as in our case. Appendectomy is indicated in appendiceal diverticulitis, and an appendix diverticulum is incidentally found during surgery or other investigations. This is due to the increased risk of perforation and the reported development of malignant tumors, including the appendix carcinoid.

scholarly journals Acute appendicitis located within Amyand’s hernia—a complex case with concurrent acute cholecystitis

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Adam O’Connor ◽  
Fallon John ◽  
Shariq Sabri
Keyword(s):  
Acute Appendicitis ◽  
Acute Cholecystitis ◽  
Vermiform Appendix ◽  
Complex Case ◽  
Successful Outcome ◽  
Amyand’S Hernia ◽  
Quadrant Pain ◽  
Hernia Sac ◽  
Tomography Scan ◽  
Prolonged Antibiotic Therapy

Abstract Amyand’s hernia is the presence of the vermiform appendix within an inguinal hernia sac. It is rare, and even rarer is the presence of acute appendicitis within the sac. It presents in a variety of different ways and often is only diagnosed intra-operatively. We present the case of a 90 year old male with extensive co-morbidities presenting with right upper quadrant pain, who on computed tomography scan of the abdomen, had acute cholecystitis alongside acute appendicitis within Amyand’s hernia. Ultimately given his co-morbidities, a conservative approach with prolonged antibiotic therapy was adopted, with a successful outcome. This case highlights that although classifications for treatment of Amyand’s hernia exist, careful clinical assessment is warranted in each case to ensure optimal outcome based upon individual circumstances.

Study of Ultrasound in Acute Abdomen at Ccmmc and Hospital, Durg

2018 ◽  
Vol 3 (06) ◽  
Author(s):  
Dr. Urvil A. Shah ◽  
Dr. Anil K. Shah
Keyword(s):  
Acute Appendicitis ◽  
Acute Cholecystitis ◽  
Ectopic Pregnancy ◽  
Acute Abdomen ◽  
Liver Abscess ◽  
Imaging Technique ◽  
Psoas Abscess ◽  
Initial Evaluation ◽  
Amoebic Liver Abscess ◽  
Ulcer Perforation

Acute abdomen is a term frequently used to describe the patients who are having abdominal tenderness and rigidity. Before the use of imaging technique, these patients were candidates for surgery. Ultrasound plays an important role in the initial evaluation of the acute abdomen. Ultrasound may be used as a first line of investigation in order to make a definitive diagnosis or can be used as a triage tool to direct subsequent patient management appropriately. Ultrasonography remains the primary imaging technique in the majority of cases, especially in young and female patients, when there is a limitation of the radiation exposure. Material and methods: 50 cases of acute abdomen were selected for the study. Patients with trauma and with compromised vital signs were excluded from the study. History taking and thorough clinical examination was carried out. All necessary biochemical and haematological investigations were carried out. Provisional diagnosis was made on the basis of sonographic findings. Results: 27 patients were male and 23 were females. Mean age of the patients was 36.34± 21.03 years. Final diagnosis was made on the basis of operative procedure, histopathology and therapeutics. Finally, 15 (30%) cases were diagnosed as acute appendicitis. 9 (18%) were diagnosed as acute cholecystitis, 4 (8%) each as pancreatitis, ulcer perforation and instentinal obstruction, 2(4%) each were diagnosed as ectopic pregnancy, Amoebic liver abscess, psoas abscess and Renal cause, 4 (8%) were diagnosed as pelvic inflammatory disease and 2 (4%) were chronic liver disease. Among the surgically treated patients, 38 patients (72%) were correctly diagnosed by preoperative ultrasonography. These included acute appendicitis (n = 14), acute cholecystitis (n = 10), ulcer perforation (n = 4), and liver abscess (n = 2), ectopic pregnancy (n=2), intestinal obstruction (n=4) and psoas abscess (n= 2). Conclusion: Ultrasonography plays an important role in the evaluation of the acute abdomen and initial evaluation by supporting the differential diagnosis.

Laparoscopic Cholecystectomy in Acute Gall Bladder Disease

1970 ◽  
Vol 24 (1) ◽  
pp. 10-13
Author(s):  
TK Maitra ◽  
NA Alam ◽  
E Haque ◽  
MH Khan ◽  
HK Chowdhury
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Acute Cholecystitis ◽  
Early Phase ◽  
Gall Bladder Disease ◽  
Laparoscopic Procedure ◽  
Bladder Disease ◽  
Complication Of Surgery

Laparoscopic cholecystectomy is one of the procedures through which gall bladder can be removed. Acute cholecystitis was considered a contraindication for laparoscopic procedure but with time and experience this shortcoming is now overcome. Here is a study of 32 patients who were selected for laparoscopic cholecystectomy. Among them, 29 patients were operated by laparoscopic method and rest three patients were converted. This study showed the appropriate time for surgery, technical difficulties and the complication of surgery. It may be concluded that laparoscopic cholecystectomy is feasible and beneficial to the patient with acute cholecystitis in its early phase, if necessary support and expertise is available. (J Bangladesh Coll Phys Surg 2006; 24: 10-13)

Adenocarcinoma of the Appendix in Elderly: Diagnostic dilemma

2020 ◽  
Vol 01 ◽  
Author(s):  
Heba Nofal ◽  
Hayder Al-Masari ◽  
Marwan Mohammed Rashed ◽  
Reham Ainawi ◽  
Desh Idnani ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Ct Scan ◽  
Laparoscopic Appendectomy ◽  
Signs And Symptoms ◽  
Morbidity And Mortality ◽  
Diagnostic Dilemma ◽  
Increased Risk

: Acute appendicitis in elderly continue to be a diagnostic dilemma as it raises both the suspicion of malignancy and increased risk of morbidity and mortality. Cancers of the appendix are rare and most of them are found accidentally on appendectomies performed for acute appendicitis. When reviewed, majority of the tumors were carcinoid, adenoma, and lymphoma. Adenocarcinomas of appendix are only 0.08% of all cancers and the treatment remains controversial. This paper presents a case of 75-year-old female presented to emergency (ER) with signs and symptoms mimicking acute appendicitis, laparoscopic appendectomy was planned after a CT scan was done as it was suggesting acute appendicitis. The specimen then was sent foe pathology lab and a diagnosis of adenocarcinoma of the appendix was made.

Torsion of the gallbladder: a rare but important differential to consider when treating acute cholecystitis non-operatively

2021 ◽  
Vol 14 (1) ◽  
pp. e237842
Author(s):  
Arun Ahluwalia ◽  
Matthew George Roy Allaway ◽  
Serena Giga ◽  
Richard James Curran
Keyword(s):  
Acute Cholecystitis ◽  
Inflammatory Markers ◽  
Epigastric Pain ◽  
Vital Signs ◽  
Rare Condition ◽  
Liver Function Tests ◽  
Uneventful Recovery ◽  
Imaging Characteristics ◽  
Gallbladder Torsion ◽  
Torsion Of The Gallbladder

A 79-year-old woman presented with postprandial epigastric pain. She had normal vital signs, inflammatory markers and liver function tests. Ultrasound and CT of the abdomen demonstrated features consistent with acute cholecystitis. Her medical comorbidities and extensive abdominal surgical history prompted the decision to treat non-operatively. Despite optimal medical management, worsening abdominal pain and uptrending inflammatory markers developed. She underwent an emergency laparoscopy which revealed a necrotic gallbladder secondary to an anticlockwise complete gallbladder torsion; a rare condition associated with significant morbidity and mortality if managed non-operatively. Laparoscopic cholecystectomy was achieved without complication and the patient had an uneventful recovery. Preoperative diagnosis of torsion of the gallbladder is difficult. However, there are certain patient demographics and imaging characteristics that can help surgeons differentiate it from acute cholecystitis; a condition which can be safely managed non-operatively in selected patients. The differentiating features are elaborated on in this case report.

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