Coexistence of Stump Appendicitis and Ovarian Fibro-Thecoma in a Young Women with Recurrent Right Iliac Fossa Pain During Pregnancy; A Rare Case Report

Med Phoenix ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 59-62
Author(s):  
Sana Ansari
Keyword(s):  
Rare Case ◽  
Iliac Fossa ◽  
Previous History ◽  
Ovarian Mass ◽  
Lower Quadrant ◽  
Stump Appendicitis ◽  
Mixed Features ◽  
History Of ◽  
Right Iliac Fossa Pain ◽  
Appendicular Stump

Ovarian Fibro-thecoma is a rare, benign, sex cord-stromal neoplasm, with a typically unilateral location in the ovary, characterized by mixed features of both fibroma and thecoma. Ovarian Fibro-thecoma is Uncommon tumor of gonadal stromal cell origin accounting for 3-4% of all ovarian tumors. We describe a rare case of Fibro-thecoma in a 27- year women with a history of recurrent right iliac fossa pain during pregnancy associated with fever and vomiting with previous history of laparotomy for appendicular abscess 10 years back. She presented to us during pregnancy with this complain for which she was managed conservatively. She did not maintain her follow up regularly at our hospital and visited again after delivery of her baby with a still birth outcome with a newly diagnosed complex bilateral ovarian cyst demonstrated on ultrasound and computed tomography showed inflammatory Right sided tubo-ovarian mass along with inflammatory thickening of ileum in right lower quadrant adjacent to right ovarian mass lesion. The patient underwent laparotomy for this with the removal of mass along with the removal of appendicular stump for appendicular stump appendicitis which was diagnosed intraoperatively. The finding from histopathological examination of the mass was consistent with the diagnosis of Fibro-thecoma.

scholarly journals PROMPT RECOGNITION OF STUMPAPPENDICITIS IS IMPORTANT TO AVOID SERIOUS COMPLICATIONS: A CASE REPORT

2020 ◽  
pp. 1-2
Author(s):  
Anil Kumar M S ◽  
D. Shiva Manohar
Keyword(s):  
Psoas Abscess ◽  
Rare Condition ◽  
Late Complications ◽  
Retroperitoneal Abscess ◽  
Lower Quadrant ◽  
Stump Appendicitis ◽  
Histologic Evaluation ◽  
History Of ◽  
Appendicular Stump ◽  
The Right

Retroperitoneal abscess is a rare condition which is difficult to diagnose and treat because of its insidious onset. Herein, we present a case of retroperitoneal abscess secondary to stump appendicitis. A 50-year-old female was admitted with history of abdominal pain more in the right lower quadrant for 1 week. History of fever present since week associated with chills, History of poor stream of urine for 1 week, not associated with burning micturition. Her past medical history showed a laparoscopic appendectomy operation performed 5 months ago. Computed tomography of abdomen and pelvis showed features suggestive of right psoas abscess with possible communication with the tubular structure arising from IC junction (? appendicular stump), Ill-defined peripherally enhancing collection in presacral region and bilateral ischiorectal region -? Abscess. CECT Abdomen and pelvis showed right mild Hydroureteronephrosis. Cystoscopy + DJ stenting was done post which Exploration with drainage of retroperitoneal abscess with stump appendectomy done on 15/2/19. Intraoperatively 50cc pus with caseous material was drained, psoas was bulky. 3cm appendicular stump was noted, dissected, ligated and buried. A drain was placed in the site of the operation. Post-operative course was uneventful and he was discharged 9 days after surgery. The histologic evaluation reported suppurative stump appendicitis. Residual long stump of the appendix after appendectomy might lead to persistence of infection and possibly late complications such as intraperitoneal, retroperitoneal or iliopsoas abscess. Surgical exploration may be necessary in persistent cases of Retroperitoneal abscess, to allow for recognition and treatment of the underlying pathology.

scholarly journals Snapshot quiz – recurrent right iliac fossa pain in the patient with a previous history of appendicitis

2015 ◽  
Vol 3 (6) ◽  
pp. 512-512 ◽  
Author(s):  
Johan Aris Chandran ◽  
Will A. Cobb ◽  
Barrie D. Keeler ◽  
Bob Soin
Keyword(s):  
Iliac Fossa ◽  
Previous History ◽  
History Of ◽  
Right Iliac Fossa Pain

scholarly journals ACCURACY OF CLINICAL AND LABORATORY PARAMETERS IN THE DIAGNOSIS OF ACUTE APPENDICITIS

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Praveen Agrawal
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Complete Blood Count ◽  
Iliac Fossa ◽  
Previous History ◽  
Control Group ◽  
Case Group ◽  
Lower Quadrant ◽  
Laboratory Parameters ◽  
History Of

Introduction: The diagnosis of acute appendicitis is generally clinical and once it is diagnosed, operative management ensues. Abdominal pain is the main presenting complaint of patients with acute appendicitis. The diagnostic sequence of colicky central abdominal pain which is followed by vomiting with migration of the pain to the right iliac fossa. The site of maximal tenderness is often said to be over McBurney's point. Specialist investigations are rarely needed to confirm a diagnosis of acute appendicitis, and the diagnosis is predominantly a clinical one. Judicious use of urine and blood tests, for inflammatory response variables, allow exclusion of other pathologies and provide additional evidence to support a clinical diagnosis of appendicitis. Material and Methods: Every patient with acute onset of right lower quadrant abdominal pain and without previous history of appendectomy was considered as suspected of having acute appendicitis. Every patient with right iliac fossa pain and without history of appendectomy is suspected of having appendicitis until proven otherwise were included in the study. All Clinical and laboratory tests relevant to acute appendicitis were done among study participants. In Clinical parameters appetite, diarrhea, dysuria, vomiting, signs of localized peritonitis i.e. rebound tenderness and or guarding and pain migration was observed.in laboratory parameters, CRP, complete blood count (CBC) were measured and analysed. Patient’s demographic characteristics were noted. Results: A total of 100 patients were included in the study of which 50 were included in the control and 50 in case group. Mean age in control group was 29±7.23 years while in acute appendicetomy group was 29 ±8.77 years. In control group 44% were male and 56 % were female while in acute appendicitis 42% were male and 58 % were female. All clinical presentations were statistically significant in case and control group. CRP was positive in 8 (16%) in control group while in Acute appendicitis group it was 21 (42%)  (P=0.0071). Conclusion: CRP did not contribute to the overall diagnostic accuracy. The successful diagnosis of acute appendicitis can be done through proper clinical examination and adequate evaluation of laboratory parameters Keywords: Acute Appendicitis, CRP, appendicetomy

scholarly journals Unexpected findings at diagnostic laparoscopy: caecal incarceration with concurrent appendicitis in a patient with bilateral broad ligament defects

2010 ◽  
Vol 92 (6) ◽  
pp. e19-e20 ◽  
Author(s):  
S Onida ◽  
K Lynes ◽  
BA Ozdemir ◽  
PA Whitehouse
Keyword(s):  
Diagnostic Laparoscopy ◽  
Iliac Fossa ◽  
Broad Ligament ◽  
Previous History ◽  
Abdominal Ultrasound ◽  
Free Fluid ◽  
History Of ◽  
Right Iliac Fossa Pain ◽  
Unexpected Findings ◽  
The Right

Internal herniations through broad ligament defects are very rare. We present the first report of the triad of broad ligament defect, internal herniation of the caecum and appendicitis. A 36-year-old woman with phocomelia presented with right iliac fossa pain and vomiting. The patient had no previous history of trauma or surgery. Abdominal ultrasound showed a small amount of free fluid. At laparoscopy, bilateral broad ligament defects were found, with herniation of the caecum and an inflamed appendix through the right-sided defect. A laparoscopic salpingo-oophorectomy was required for reduction of the herniated bowel, and an appendicectomy was performed. Broad ligament defects may be congenital or acquired. In this case, in light of the limb abnormality and absence of previous surgery, a congenital aetiology is more likely. Ultrasound scan is not reliable and, although computed tomography may be of help, a diagnostic laparoscopy is the best investigation.

Lockdown dilemma: ingestion of magnetic beads presenting as right iliac fossa pain and subacute small bowel obstruction

2020 ◽  
Vol 13 (11) ◽  
pp. e236429
Author(s):  
Bankole Oyewole ◽  
Anu Sandhya ◽  
Ian Maheswaran ◽  
Timothy Campbell-Smith
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Magnetic Beads ◽  
Iliac Fossa ◽  
Serous Fluid ◽  
Magnetic Resonance Scan ◽  
History Of ◽  
Right Iliac Fossa Pain ◽  
Multiple Episodes ◽  
Safety Netting

A 13-year-old girl presented with a 3-day history of migratory right iliac fossa pain. Observations and inflammatory markers were normal, and an ultrasound scan was inconclusive. A provisional diagnosis of non-specific abdominal pain or early appendicitis was made, and she was discharged with safety netting advice. She presented again 6 days later with ongoing abdominal pain now associated with multiple episodes of vomiting; hence, the decision was made to proceed to diagnostic laparoscopy rather than a magnetic resonance scan for further assessment. Intraoperative findings revealed 200 mL of serous fluid in the pelvis, normal-looking appendix, dilated stomach and a tangle of small bowel loops. Blunt and careful dissection revealed fistulous tracts that magnetised the laparoscopic instruments. A minilaparotomy was performed with the extraction of 14 magnetic beads and the repair of nine enterotomies. This case highlights the importance of careful history taking in children presenting with acute abdominal pain of doubtful aetiology.

A rare case of high-grade chondroblastic osteosarcoma post-radiotherapy for a right frontal oligodendroglioma

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Sinead Horan ◽  
◽  
Oscar Breathnach ◽  
Liam Grogan ◽  
David Fitzpatrick ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Brain Tumour ◽  
Radiation Field ◽  
Rare Case ◽  
Previous History ◽  
High Grade ◽  
History Of ◽  
Rare Malignancy ◽  
Chondroblastic Osteosarcoma

This is the fourteenth case of an intracranial and dural-based osteosarcoma in the literature to date. The case involves a forty-year old woman with a previous history of a brain tumour, which was treated with surgery, chemotherapy and radiotherapy six years previously. The hypothesis is that this rare malignancy is secondary to the radiation exposure given the growth of the lesion in the previous radiation field

Torsion of a parasitic leiomyoma: a rare but important differential in women presenting with lower abdominal pain

2021 ◽  
Vol 14 (1) ◽  
pp. e232797
Author(s):  
Clemmie Stebbings ◽  
Ahmed Latif ◽  
Janakan Gnananandan
Keyword(s):  
Abdominal Pain ◽  
Iliac Fossa ◽  
Lower Abdominal Pain ◽  
Sudden Onset ◽  
Greater Omentum ◽  
Caribbean Woman ◽  
History Of ◽  
Right Iliac Fossa Pain ◽  
The Right ◽  
Fat Stranding

A 39-year-old multiparous Afro-Caribbean woman attended the emergency department with sudden-onset severe right iliac fossa pain. Her inflammatory markers were mildly elevated. Computerised tomography of the abdomen demonstrated features of fat stranding in the right iliac fossa suspicious of acute appendicitis. The scan also noted uterine leiomyomas. The patient was taken to theatre for an emergency diagnostic laparoscopy where her appendix was found to be macroscopically normal. A necrotic heavily calcified parasitic leiomyoma was seen in the right adnexa, free of the uterus and adherent to the greater omentum on a long torted pedicle. The parasitic leiomyoma was successfully removed piecemeal laparoscopically. Complications of leiomyomas, namely, torsion and necrosis, are important differentials in women presenting with sudden-onset lower abdominal pain. A history of sudden-onset severe lower abdominal pain with a background of known leiomyoma should prompt the clerking surgeon to consider a complication of leiomyoma as part of the differential diagnoses.

scholarly journals Ūminis skausmas dešinėje klubinėje srityje: ar visada tai apendicitas?

2010 ◽  
Vol 8 (2) ◽  
pp. 0-0
Author(s):  
Agnius Juška ◽  
Ieva Žostautienė ◽  
Jonas Pivoriūnas ◽  
Jonas Jurgaitis ◽  
Marius Paškonis ◽  
...  
Keyword(s):  
Pathological Condition ◽  
Iliac Fossa ◽  
University Hospital ◽  
Lower Quadrant Pain ◽  
Lower Quadrant ◽  
Right Lower Quadrant Pain ◽  
Surgical Trainees ◽  
G 21 ◽  
Right Iliac Fossa Pain ◽  
Vilnius University

Agnius Juška1, Ieva Žostautienė1, Jonas Pivoriūnas1, Jonas Jurgaitis2, Marius Paškonis2, 3, Vytautas Lipnickas2, Kęstutis Strupas21Vilniaus universiteto Medicinos fakultetas,M. K. Čiurlionio g. 21, LT-03101 Vilnius2Gastroenterologijos, urologijos ir abdominalinės chirurgijos klinika, Vilniaus universiteto ligoninė Santariškių klinikos,Santariškių g. 2, LT-08661 VilniusEl paštas: [email protected] Aklosios žarnos pavienis divertikulas – reta patologija ir pagal požymius beveik neatskiriama nuo ūminio apendicito. Aklosios žarnos divertikulitas gali nesukelti simptomų tol, kol nepasireiškia uždegimas, divertikulas neprakiūra ar iš jo neprasideda kraujavimas. Nors atliekami echoskopiniai ir kompiuterinės tomografijos tyrimai, tikslią diagnozę prieš operaciją vis vien sunku nustatyti ir dažniausiai ji paaiškėja operuojant. Nors ši liga reta Vakarų šalyse, ją reikia turėti omenyje diferencijuojant tuomet, kai pacientas skundžiasi skausmu dešinėje klubinėje srityje. Dėl to į šią retą būklę norime atkreipti ne tik chirurgų bet ir kitų gydytojų dėmesį. Reikšminiai žodžiai: pavienis aklosios žarnos divertikulas, divertikulitas dešinėje, skausmas apatiniame dešiniajame kvadrante, įgimtas aklosios žarnos divertikulas. Acute pain in right iliac fossa region – is it always an appendicitis? Agnius Juška1, Ieva Žostautienė1, Jonas Pivoriūnas1, Jonas Jurgaitis2, Marius Paškonis2, 3, Vytautas Lipnickas2, Kęstutis Strupas21Vilnius University Faculty of Medicine,M. K. Čiurlionio str. 21, LT-03101 Vilnius, Lithuania2Clinic of Gastroenterology, Urology and Abdominal Surgery, Vilnius University Hospital Santariškių Clinics,Santariškių Str. 2, LT-08661 Vilnius, LithuaniaE-mail: [email protected] Solitary diverticulum of caecum is an uncommon pathological condition almost indistinguishable from acute appendicitis. Caecal diverticulitis can be asymptomatic until it becomes inflamed, perforated or begins to bleed. In spite of routine ultrasonography and computer tomography findings, correct preoperative diagnosis is still difficult and is usually made in the operating theater. Although this condition is very rare in Western countries, it should be considered in the differential diagnosis for patients complaining of right iliac fossa pain. Therefore, the aim of this case report is to improve the awareness of this condition not only among surgical trainees but also among the rest of medical staff. Key words: solitary diverticulum of the caecum, right diverticulitis, right lower quadrant pain, congenital diverticulum of the caecum.

Foreign body perforation of the distal ileum: an unusual cause of right iliac fossa pain managed via single incision laparoscopic surgery (SILS) approach

2021 ◽  
Vol 14 (2) ◽  
pp. e238563
Author(s):  
Matthew R Bonomaully ◽  
Zia Haque ◽  
Milind Rao
Keyword(s):  
Foreign Body ◽  
Single Incision ◽  
Iliac Fossa ◽  
Exploratory Laparotomy ◽  
Distal Ileum ◽  
Emergency Setting ◽  
Single Incision Laparoscopic Surgery ◽  
Single Incision Laparoscopy ◽  
History Of ◽  
Right Iliac Fossa Pain

A 61-year-old woman was seen by the emergency general surgical team with a 2-week history of right iliac fossa pain. Imaging revealed the possibility of a distal ileum perforating foreign body. Using a single incision laparoscopy surgery (SILS) approach, this diagnosis was confirmed at operation. This emerging technique meant a much smaller incision could be used than traditional exploratory laparotomy, with the benefit of less postoperative pain and a faster recovery. This case highlights an uncommon cause for abdominal pain and the importance of close liaison with radiologists and the low threshold for use of laparoscopy as a diagnostic tool. We advocate the use of SILS in the emergency setting for appropriate cases.

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