scholarly journals Alvarado score in the diagnostic of pain in the right lower quadrant

2017 ◽  
Vol 74 (3) ◽  
pp. 214 ◽  
Author(s):  
Paul Eduardo Lada
Keyword(s):  
Font Size ◽  
Alvarado Score ◽  
Lower Quadrant ◽  
The Right ◽  
Right Lower Quadrant

<p><strong><span style="font-size: medium;">RESUMEN</span></strong></p><p><span style="font-family: Arial;"><span style="font-size: medium;"><strong><span style="text-decoration: underline;">Antecedentes:</span></strong> La apendicitis aguda no sospechada y diagnosticada puede evolucionar hacia la perforación, ó por el contrario conduce a la remoción de un apéndice normal. </span></span></p><p><span style="font-family: Arial;"><span style="font-size: medium;"><strong><span style="text-decoration: underline;">Objetivo:</span></strong> La utilización de un  sistema  de Score, desde un  punto de vista clínico, para el diagnóstico de esta patología y lograr disminuir las apendicetomías negativas.</span></span></p><p><span style="font-family: Arial;"><span style="font-size: medium;"><strong><span style="text-decoration: underline;">Lugar de Aplicación:</span></strong> Hospital Nacional de Clínicas. Córdoba. (Argentina)</span></span></p><p><span style="font-family: Arial;"><span style="font-size: medium;"><strong><span style="text-decoration: underline;">Diseño:</span></strong> Estudio prospectivo y protocolizado.</span></span></p><p><span style="font-family: Arial;"><span style="font-size: medium;"><strong><span style="text-decoration: underline;">Material y Métodos:</span></strong> Comprende a 594 pacientes estudiados entre octubre de 2002 y diciembre del 2013. De ellos, 312 eran del sexo masculino y 282 del femenino, con una edad promedio de 26,2 años de edad. A todos los pacientes se les realizo al ingreso el Score de Alvarado. En base a la clínica y a una segunda valoración con el Score se decidió la exploración quirúrgica en 574 pacientes. De los 20 restantes, fueron excluidos por otra patología. El diagnóstico de apendicitis aguda fue confirmado por los hallazgos quirúrgicos y la  anatomía patológica.</span></span></p><p><span style="font-family: Arial;"><span style="font-size: medium;"><strong><span style="text-decoration: underline;">Resultados:</span></strong> En los hallazgos operatorios se encontró en 524 pacientes (91,28%) que tenían una apendicitis aguda. No hubo mortalidad postoperatoria. En relación a la morbilidad hubo un 1,74 % de complicaciones médicas y un 13,93 % de las quirúrgicas. El informe anatomopatológico mostró en 50 pacientes un apéndice cecal normal. Por lo tanto la incidencia de las apendicetomías negativas fue del 8,71%. </span></span></p><p><span style="font-family: Arial;"><span style="font-size: medium;"><strong><span style="text-decoration: underline;">Conclusiones:</span></strong> La utilización del Score en relación a los hallazgos quirúrgicos y anatomopatológicos confirma que fue sensible a partir de 6 puntos para el diagnóstico de apendicitis aguda.</span></span></p><p> </p>

scholarly journals The use of ultrasonographic and Alvarado scores in evaluating abdominal pain suggestive of acute appendicitis

2017 ◽  
Vol 4 (2) ◽  
pp. 757 ◽  
Author(s):  
Jorge Fernández Álvarez ◽  
José Manuel Gómez López ◽  
Alberto M González Chávez ◽  
Benjamín Valente Acosta ◽  
Diego Abelardo Álvarez Hénandez ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Sensitivity And Specificity ◽  
Area Under The Curve ◽  
Alvarado Score ◽  
Lower Quadrant ◽  
Efficient Alternative ◽  
Two Parameters ◽  
The Right ◽  
Right Lower Quadrant

Background: Ultrasonographic scores for appendicitis to determine if, combined with Alvarado scores, they can increase the sensitivity and specificity of the diagnosis of appendicitis.Methods: All cases of abdominal pain suggestive of appendicitis presented between 2013 and 2015 were analysed. An Alvarado score was obtained. All patients underwent ultrasound, and an ultrasonographic score was determined, including the appendicitis classical findings.Results: Two hundred and fifty-one patients with abdominal pain in the right lower quadrant were analysed. Appendicitis was confirmed in 211 (84%) patients. For these patients, the average Alvarado score was 7.95/10 (±1.25) vs. 5.7/10 (± 1.11) for patients who did not have appendicitis (p < 0.001). In patients with confirmed appendicitis, the average ultrasonographic score was 2.48/6 (± 1.06) vs. 0.6/6 (± 0.92) for patients who did not have acute appendicitis (p < 0.001). The ultrasonographic score has a sensitivity of 90% and a specificity of 87% with only two parameters. The combination of the Alvarado and ultrasonographic scores decreased the percentage of negative appendectomies to 2.36% and increased the area under the curve by 0.970.Conclusions: The sum of the Alvarado and ultrasonographic scores provides an efficient alternative for diagnosing abdominal pain suggestive of appendicitis and predicts which patients should undergo surgery with good certainty.

scholarly journals APPLICATION OF APPENDICITIS INFLAMMATORY RESPONSE (AIR) SCORING SYSTEM FOR DIAGNOSIS OF ACUTE APPENDICITIS AND ITS COMPARISON WITH ALVARADO SCORE

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Ghaus Mohd Chouhan ◽  
Mahesh Kumar Sharma
Keyword(s):  
Inflammatory Response ◽  
Acute Appendicitis ◽  
High Specificity ◽  
High Risk Group ◽  
Alvarado Score ◽  
Lower Quadrant ◽  
Positive Predict Value ◽  
High Negative Predictive Value ◽  
The Right ◽  
Right Lower Quadrant

Background: The appendicitis inflammatory response (AIR) score is recently developed diagnostic tool that uses seven scored variables to stratify patients into low-, intermediate and high risk group. Methods: The present study was conducted in the department of surgery. 100 patients presenting with pain in the right lower quadrant of abdomen, who after clinical examination were provisionally diagnosed to have acute appendicitis and warranted surgery for the same. Results: AIR (98.00%) were more sensitive than Modified alverdo score (90.00%). Specificity (100%) and positive predict value (100%) were same in MAS & AIR. Conclusion: To conclude, AIR scoring performed well almost equally with Alvarado system with high specificity and high negative predictive value preventing unnecessary negative appendectomies. Keywords: AIR, MAS, Acute appendicitis

scholarly journals APPLICATION OF APPENDICITIS INFLAMMATORY RESPONSE (AIR) SCORING SYSTEM FOR DIAGNOSIS OF ACUTE APPENDICITIS AND ITS COMPARISON WITH ALVARADO SCORE

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Pramod Kumar ◽  
Sandeep Sarawagi ◽  
Devi Singh Kachhawa
Keyword(s):  
Inflammatory Response ◽  
Acute Appendicitis ◽  
High Specificity ◽  
High Risk Group ◽  
Alvarado Score ◽  
Lower Quadrant ◽  
Positive Predict Value ◽  
High Negative Predictive Value ◽  
The Right ◽  
Right Lower Quadrant

Background: The appendicitis inflammatory response (AIR) score is recently developed diagnostic tool that uses seven scored variables to stratify patients into low-, intermediate and high risk group. Methods: The present study was conducted in the department of surgery. The popultion consists of 100 patients presenting with pain in the right lower quadrant of abdomen, who after clinical examination were provisionally diagnosed to have acute appendicitis and warranted surgery for the same. Results: AIR (98.91%) were more sensitive than Modified alverdo score (89.3%). Specificity (100%) and positive predict value (100%) were same in MAS & AIR Conclusion- To conclude, AIR scoring performed well almost equally with Alvarado system with high specificity and high negative predictive value preventing unnecessary negative appendectomies. Keywords: AIR, MAS, Acute appendicitis

scholarly journals Intestinal obstruction caused by pericecal internal herniation

2020 ◽  
Vol 2020 (2) ◽  
Author(s):  
Floris B Poelmann ◽  
Ewoud H Jutte ◽  
Jean Pierre E N Pierie
Keyword(s):  
Abdominal Pain ◽  
Intestinal Obstruction ◽  
Acute Abdominal Pain ◽  
Treatment Preference ◽  
Treatment Modalities ◽  
Internal Herniation ◽  
Lower Quadrant ◽  
Surgical History ◽  
The Right ◽  
Right Lower Quadrant

Abstract Intestinal obstruction caused by pericecal internal herniation are rare and only described in a few cases. This case describes an 80-year-old man presented with acute abdominal pain, nausea and vomiting, with no prior surgical history. Computed tomography was performed and showed a closed loop short bowel obstruction in the right lower quadrant and ascites. Laparoscopy revealed pericecal internal hernia. This is a viscous protrusion through a defect in the peritoneal cavity. Current operative treatment modalities include minimally invasive surgery. Laparoscopic repair of internal herniation is possible and feasible in experienced hands. It must be included in the differential diagnoses of every patient who presents with abdominal pain. When diagnosed act quick and thorough and expeditiously. Treatment preference should be a laparoscopic procedure.

Appendicitis: a rare adverse event in colonoscopy

2021 ◽  
Vol 14 (7) ◽  
pp. e242523
Author(s):  
Samer Al-Dury ◽  
Mohammad Khalil ◽  
Riadh Sadik ◽  
Per Hedenström
Keyword(s):  
Emergency Department ◽  
Adverse Event ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Physical Examination ◽  
De Novo ◽  
Perforated Appendicitis ◽  
Lower Quadrant ◽  
The Right ◽  
Right Lower Quadrant

We present a case of a 41-year-old woman who visited the emergency department (ED) with acute abdomen. She was diagnosed with perforated appendicitis and abscess formation on CT. She was treated conservatively with antibiotics and discharged. On control CT 3 months later, the appendix had healed, but signs of thickening of the terminal ileum were noticed and colonoscopy was performed, which was uneventful and showed no signs of inflammation. Twelve hours later, she developed pain in the right lower quadrant, followed by fever, and visited the ED. Physical examination and blood work showed signs consistent with acute appendicitis, and appendectomy was performed laparoscopically 6 hours later. The patient recovered remarkably shortly afterwards. Whether colonoscopy resulted in de novo appendicitis or exacerbated an already existing inflammation remains unknown. However, endoscopists should be aware of this rare, yet serious complication and consider it in the workup of post-colonoscopy abdominal pain.

Appendicitis

2016 ◽  
Author(s):  
David Scordino
Keyword(s):  
Antibiotic Therapy ◽  
Acute Inflammation ◽  
Surgical Intervention ◽  
Significant Risk ◽  
Disease Course ◽  
Lower Quadrant ◽  
Nonoperative Therapy ◽  
Atypical Presentations ◽  
The Right ◽  
Right Lower Quadrant

Appendicitis is caused by acute inflammation of the appendix (usually secondary to obstruction) and can result in perforation, leading to peritonitis, sepsis, and/or abscess formation. Symptomatology includes anorexia, nausea, vomiting, and periumbilical pain (later localizing to the right lower quadrant). Patients at the extremes of age and pregnant women may have atypical presentations and higher rates of perforation and complications. Most patients suspected of having appendicitis receive prompt surgical intervention (usually laparoscopic). Antibiotic therapy, initiated preoperatively, varies for perforated vs nonperforated appendicitis. In patients with evidence of a contained abscess, nonoperative therapy is considered, as abscess is evidence of a prolonged disease course (more than 5 days) prior to presentation. On imaging, patients may have a well-circumscribed abscess or phlegmon; if immediate surgical intervention is attempted, there is significant risk of morbidity due to adhesions to adjacent tissues.

The Management of Terminal Ileum Diverticulitis

2009 ◽  
Vol 75 (12) ◽  
pp. 1199-1202 ◽  
Author(s):  
Hyoung-Chul Park ◽  
Bong Hwa Lee
Keyword(s):  
Clinical Features ◽  
Terminal Ileum ◽  
Nonoperative Management ◽  
Perforated Diverticulitis ◽  
Radiographic Evaluation ◽  
Lower Quadrant ◽  
Average Hospital ◽  
The Right ◽  
Right Lower Quadrant

Terminal ileum diverticulitis is a very rare disease that may lead to an acute abdomen mimicking appendicitis. Because of its rarity, an optimal treatment for this disease has not been established yet. In this study, we evaluated the clinical features and outcomes of nonoperative management of terminal ileum diverticulitis, including suspected perforation. From 2000 to 2007, 346 patients were treated for acute symptomatic right-sided diverticulitis. Radiographic evaluation revealed that nine patients (2.6%) had terminal ileum diverticulitis. All patients presented with pain in the right lower quadrant. The clinical features and outcomes, including recurrence, were evaluated from a collected database and by phone interview. The average age of the patients was 43.7 years. Radiographic imaging was used to diagnose diverticulitis in all patients. Two of nine patients had suspected perforated diverticulitis, and three patients had multiple diverticula. Nonoperative management was successfully carried out on these patients. The average hospital stay was 8 days and the duration of antibiotic treatment was 6.4 days. The median follow-up was 36 months, and patients showed no recurrence within this interval. Nonoperative management may be feasible to treat terminal ileum diverticulitis.

scholarly journals Isolated intestinal Ganglioneuromatosis: case report and literature review

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Angela Mauro ◽  
Letizia Zenzeri ◽  
Francesco Esposito ◽  
Giovanni Gaglione ◽  
Caterina Strisciuglio ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Polypoid Lesion ◽  
Occult Blood ◽  
Fecal Occult Blood ◽  
Ileal Loop ◽  
Lower Quadrant ◽  
Blood Tests ◽  
Fecal Occult ◽  
The Right ◽  
Right Lower Quadrant

Abstract Background Intestinal Ganglioneuromatosis (IG) is a rare disorder of the enteric nervous system. In pediatric age it is often associated with genetic syndromes such as Neurofibromatosis 1 (NF1), multiple endocrine neoplasia type 2B (MEN2B) and Cowden syndrome (PTEN mutation), and ganglioneuromas (GNs) may be sometimes the first sign of the disease. Isolated GNs are rare and sporadic. Clinical symptom vary and depend on the size and on the location of the GNs. This disorder affects intestinal motility and it, consequently, causes changes in bowel habits, abdominal pain, occlusive symptoms and rarely lower gastrointestinal bleeding secondary to ulceration of the intestinal mucosa. On the other hand, patients can remain asymptomatic for many years. Case presentation We describe a 9-year-old boy referred to our emergency department for right lower quadrant abdominal pain. No familial history for gastrointestinal disorders. No history of fever or weight loss. At physical examination, he had diffused abdominal pain. Abdominal ultrasonography showed a hypoechoic formation measuring 41.8 mm by 35 mm in the right lower quadrant of the abdomen. Routine blood tests were normal, but fecal occult blood test was positive. Abdominal TC confirmed the hypodense formation, of about 5 cm in transverse diameter, in the right hypochondrium that apparently invaginated in the caecum-last ileal loop. Colonoscopy showed in the cecum an invaginated polypoid lesion of the terminal ileal loop. Laparoscopic resection of the polypoid lesion was performed. Histological diagnosis of the large neoplasm observed in the terminal ileum was diffuse ganglioneuromatosis. NF1, RET and PTEN gene tests resulted negative for specific mutations. At the 1 year follow-up, the patient presented good general condition and blood tests, fecal occult blood test, esophagogastroduodenoscopy, colonoscopy and MR-enterography were negative. Conclusions Only few cases are reported in literature of IG in pediatric age. Although rare, the present case suggests that this disorder must be taken in consideration in every patient with GI symptoms such as abdominal pain, constipation, lower intestinal bleeding, in order to avoid a delayed diagnosis.

scholarly journals Duplicate Appendix With Acute Ruptured Appendicitis: A Case Report

2015 ◽  
Vol 100 (4) ◽  
pp. 662-665 ◽  
Author(s):  
Sharique Nazir ◽  
Alex Bulanov ◽  
Mohammed Iyoob Mohammed Ilyas ◽  
Ibrahim I. Jabbour ◽  
Larry Griffith
Keyword(s):  
Diagnostic Laparoscopy ◽  
Medical Literature ◽  
The Other ◽  
Associated Anomalies ◽  
Blood Cell Count ◽  
Lower Quadrant ◽  
Rare Congenital Anomaly ◽  
Life Threatening ◽  
The Right ◽  
Right Lower Quadrant

Duplication of the appendix is a rare congenital anomaly that, in adults, is most often found incidentally during surgery for other reasons. Appendicitis in the duplicated appendix is very rare and has been reported less than 10 times in the medical literature. We describe a 33-year-old woman with worsening periumbilical pain, nausea, vomiting, and fever. Physical examination showed localized peritonitis in the right lower quadrant. She had an elevated white blood cell count with neutrophilia. Computed tomography showed acute ruptured appendicitis. Diagnostic laparoscopy showed 2 appendices attached via separate bases to a single cecum with no other concurrent anomalies. Both appendices were removed laparoscopically. Histopathology confirmed normal appendiceal tissue in one and severe acute transmural appendicitis in the other. Awareness of appendiceal duplication and a thorough intraoperative inspection are critical to assess the presence of significant associated anomalies and avoid life-threatening complications.

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