scholarly journals Appendicitis Mimicking Orchitis-A Case Report

2019 ◽  
pp. 1-2
Author(s):  
NG Bertrand RJ ◽  
Subramanian Pradeep

Acute appendicitis is one of the most common emergency surgical procedure, yet atypical presentation sometimes can be challenging for clinician. I present a case of 19-year-old gentleman that initially presented with 1day history of bilateral testicular pain and lower abdominal pain. His past history includes a positive sexual history. Initial ultrasound of the testis showed bilateral orchitis and an equivocal appendix. With a significantly raised inflammatory marker and highly suspicious for appendicitis, a CT scan was obtained which showed perforated appendicitis and the patient underwent laparoscopic appendicectomy with resolution of symptoms after that. We encourage clinician to be aware of this clinical pitfall as patient can sometimes be managed in other department to minimise any delayed diagnosis or any unnecessary procedure.

2019 ◽  
pp. 1-7
Author(s):  
Laleh Melstrom ◽  
Indra M. Newman ◽  
Jae Kim ◽  
Laleh Melstrom ◽  
Massimo D’Apuzzo ◽  
...  

Acute appendicitis is one of the most common emergency surgical procedure, yet atypical presentation sometimes can be challenging for clinician. I present a case of 19-year-old gentleman that initially presented with 1day history of bilateral testicular pain and lower abdominal pain. His past history includes a positive sexual history. Initial ultrasound of the testis showed bilateral orchitis and an equivocal appendix. With a significantly raised inflammatory marker and highly suspicious for appendicitis, a CT scan was obtained which showed perforated appendicitis and the patient underwent laparoscopic appendicectomy with resolution of symptoms after that. We encourage clinician to be aware of this clinical pitfall as patient can sometimes be managed in other department to minimise any delayed diagnosis or any unnecessary procedure


2021 ◽  
Vol 55 (3) ◽  
pp. 183-189
Author(s):  
Augustine D. Onyeabochukwu ◽  
Emmanuel O. Izuka ◽  
Onyema A. Onyegbule ◽  
Chiemeka C. Onumajuru ◽  
Uchenna T. Ejelonu ◽  
...  

Objectives: This study evaluates the association between genital Chlamydial infection and tubal factor infertility in a tertiary health facility in South-East Nigeria.Design: This was a case-control analytical study.Setting: Gynaecology Clinic and Maternity Unit of the Department of Obstetrics and Gynaecology of the Federal Medical Centre (FMC), Owerri, Imo State, Nigeria.Participants: Ninety-six (96) women with confirmed tubal factor infertility served as the cases, and 96 women with normal intra-uterine pregnancy matched in age served as the control.Data Collection/Intervention: A structured questionnaire was used to extract information on the sociodemographic data and the sexual history of the participants. About 2mls of blood was collected, the blood was allowed to clot, and the sera were used for the test.Statistical analysis/Main outcome measure: Pearson Chi-square, Fisher’s exact test, likelihood ratio and multivariate logistic regression were used to determine risk associations and identify factors independently related to tubal factor infertility. P-value < 0.05 was considered significant.Results: The sociodemographic characteristics of both cases and control did not differ (P = 0.975). The Chlamydial antibody seropositivity was significantly higher in the cases than the control 78(81.2%) versus 13(13.5%) respectively {(P < 0.001; OR (95% CI) = 27.7(12.7-60.2)}. Only lower abdominal pain {(P = 0.011); OR (95% CI) = 4.3(1.4-13.3)}; was independently associated with tubal factor infertility.Conclusion: Tubal factor infertility is strongly associated with chlamydial IgG antibodies, and a history of lower abdominal pain significantly predicted tubal factor infertility.


2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Ban Ibrahim ◽  
Sabyasachi Chowdhury ◽  
Matei Dordea

Abstract Introduction There are various case reports of intraluminal foreign body following a clear history of ingestion commonly presenting in paediatrics or in patients with a psychiatric background. Case presentation We present a rare cause of unusual foreign bodies evident within the abdomen, radiologically. There was no history of ingestion nor insertion. 70-year-old male has been suffering from chronic abdominal pain, presented to the emergency department with acute lower abdominal pain. He had previous splenectomy with distal pancreatectomy 23 years ago and laparotomy (adhesiolysis) 5 years back. He sought medical opinion on several occasions whereby, based on his intricate surgical history, adhesions were a possible culprit. This admission with acute pain warranted a thorough review of past history and a closer radiological investigation. These showed historical presence of sewing needles for 3 years. Conclusion Foreign body can manifest as acute reactions with inflammatory response, however if not removed can cause scarring and chronic pain as seen in this case. Although evident in radiological images over period of pain recurrence, this was not identified as a cause. We emphasize the need for direct communication between surgical and radiological teams in an unusual case scenario like these, to prevent incidence of symptoms from foreign bodies.


2021 ◽  
Vol 14 (1) ◽  
pp. e232797
Author(s):  
Clemmie Stebbings ◽  
Ahmed Latif ◽  
Janakan Gnananandan

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.


2019 ◽  
Vol 33 (3) ◽  
pp. 364-367 ◽  
Author(s):  
Yoonsun Mo ◽  
Shiv Gandhi ◽  
Jose Orsini

Purpose: To report a case of sudden cardiac arrest possibly associated with the administration of GoLytely® (polyethylene glycol 3350 and electrolytes). Summary: A 60-year-old male with a history of hypertension, hyperlipidemia, type 2 diabetes, and coronary artery disease presented to the emergency department with complaints of constipation and lower abdominal pain over the past week, and the inability to urinate over the past day. The patient had received GoLytely as treatment to alleviate symptoms of constipation and abdominal pain. However, several hours after administration of the bowel prep solution, the patient suffered an episode of cardiac arrest. After ruling out other possible etiologies, GoLytely was suspected as a possible cause of cardiac arrest. The patient had suffered an anoxic brain injury and remained intubated and unconscious until he eventually expired, 20 days after the event. Conclusion: Although GoLytely appears to be a safe agent with fewer side effects, clinicians need to be mindful of potential life-threatening adverse events following GoLytely administration and monitor patients closely during and after administration.


2019 ◽  
Vol 13 (3) ◽  
pp. 364-368
Author(s):  
Vishnu Charan Suresh Kumar ◽  
Kishore Kumar Mani ◽  
Hisham Alwakkaa ◽  
James Shina

Epiploic appendages are peritoneal structures that arise from the outer serosal surface of the bowel wall towards the peritoneal pouch. They are filled with adipose tissue and contain a vascular stalk. Epiploic appendagitis is a rare cause of acute lower abdominal pain. It most commonly results from torsion and inflammation of the epiploic appendages, and its clinical features mimic acute diverticulitis or acute appendicitis resulting in being often misdiagnosed as diverticulitis or appendicitis. This frequently leads to unnecessary hospitalization, antibiotic administration, and unwarranted surgeries. Epiploic appendagitis is usually diagnosed with CT imaging, and the classic CT findings include: (i) fat-density ovoid lesion (hyperattenuating ring sign), (ii) mild bowel wall thickening, and (iii) a central high-attenuation focus within the fatty lesion (central dot sign). It is treated conservatively, and symptoms typically resolve in a few days. Therefore, epiploic appendagitis should be considered as one of the differential diagnosis for acute lower abdominal pain and prompt diagnosis of epiploic appendagitis can avoid unnecessary hospitalization and surgical intervention. In this case report, we discuss a 72-year-old woman who presented with a 2-day history of acute left lower abdominal pain.


KYAMC Journal ◽  
2013 ◽  
Vol 3 (1) ◽  
pp. 262-264
Author(s):  
Mst Atia Sultana ◽  
Monira Akter ◽  
Shafiul Anam

Mrs. Lalbanu 65 years old lady presented to us with the complaints of something coming down per vagina for 10 years, foul smelling discharge for 2 months, fever & maggot formation for 5 days, she  also gave history of applying some chemical substances on her prolapsed mass of genitalia, and she also complains of lower abdominal pain for last 5 days. On examination, prolapsed mass was distorted, edematous, infected, irreducible & there were maggots, her temperature was raised & having lower abdominal tenderness. She was treated at first conservatively & then surgically. Now  she is well & with our follow up.DOI: http://dx.doi.org/10.3329/kyamcj.v3i1.13662 KYAMC Journal Vol. 3, No.-1, June 2012 pp.262-264


2021 ◽  
Vol 39 (4) ◽  
pp. 261-265
Author(s):  
ABM Moniruddin ◽  
Salma Chowdhury ◽  
Tanvirul Hasan ◽  
Kazi Muhammad Mahmudul Hasan ◽  
- RounakJahan ◽  
...  

Acute appendicitis is a very common surgical emergency. It has got diverse presentations and various complications. Here, we report case history of a young male patient with a 2- year history of recurrent abdominal pain, who presented to our center with a 4-day history of increasing abdominal pain, constipation and vomiting. Clinical and radiological evaluation revealed it as a case of acute intestinal obstruction preoperatively. Per-operative findings suggested acute appendicitis without perforation, small gut obstruction by adhesions, appendicular lump or internal herniation. Appendicectomy was done along with other necessary procedures. His post-operative period was uneventful. This case is reported here to highlight that acute appendicitis may present with atypical features like acute small gut obstruction. J Bangladesh Coll Phys Surg 2021; 39: 261-265


Medicina ◽  
2019 ◽  
Vol 55 (1) ◽  
pp. 9 ◽  
Author(s):  
Atsushi Kohga ◽  
Kiyoshige Yajima ◽  
Takuya Okumura ◽  
Kimihiro Yamashita ◽  
Jun Isogaki ◽  
...  

Isolated cecal necrosis (ICN) is a rare condition which is developed under decreased mesenteric perfusion. Only a few dozen cases of ICN have been reported previously. The patient was a 59-year-old male with a previous history of atrial fibrillation. He presented to our emergency room with the chief complaint of lower abdominal pain. Computed tomography imaging revealed a dilated cecum and presence of free air. With a preoperative diagnosis of perforation of the cecum; an urgent surgery was conducted. Intraoperative findings revealed an ischemic change of the cecum and a laparoscopic-assisted ileocecal resection was performed. The pathological findings showed transmural ischemic change on the anti-mesenteric side of the cecum, and the diagnosis of ICN was achieved. Preoperative diagnosis of ICN is difficult because of its non-specific radiological features. In patients with right lower abdominal pain, ICN should be considered as a differential diagnosis especially if the patient has a comorbidity causing hypotension attack.


Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 4038-4038
Author(s):  
Debra Ferman ◽  
Thomas P. Bradley ◽  
Robin Warshawsky ◽  
Steven L. Allen

Abstract Background: Nonpuerperal ovarian vein thrombosis (OVT) is a rare clinical entity. Therapy is not well defined. OVT is usually asymptomatic. Improved CT and MR imaging technology enables OVT to be diagnosed with greater frequency. Nonpuerperal OVT may be a distinct clinical entity. Methods: The medical records of women with nonpuerperal OVT were reviewed and their clinical course and treatment recorded. Cases were identified by scanning a CT computerized database over the past 3 years with the key words ovarian vein thrombosis. Results: 7 patients (pts) were identified. Age range was 38–61, median 51 years. 3 pts had OVT on the left and 4 on the right. OVT followed a procedure in 2 pts. 2 pts with breast cancer developed OVT, 1 during adjuvant tamoxifen and 1 receiving chemotherapy for metastatic disease. 1 pt had AML in CR. 3 pts presented with lower abdominal pain on the involved side and 1 pt had lower abdominal pain on the opposite side. The 3 pts with cancer were asymptomatic. 4 pts had uterine fibroids. 1 developed OVT in the setting of an acute diarrheal illness. 1 pt had prior DVT and 1 a family history of DVT. Only 1 pt had a hypercoagulable evaluation; negative. 2 pts had clot extending to the junction with the inferior vena cava (IVC) and both were anticoagulated with enoxaparin followed by warfarin. 1 pt was anticoagulated with enoxaparin alone. No embolic complications occurred. Conclusion: 4 pts with OVT were symptomatic and 3 were detected incidentally. 2 developed OVT following procedures, 3 had predisposing underlying conditions, and 2 had a personal or family history of thrombosis. Optimum therapy is not defined. Symptomatic disease alone is not an indication for anticoagulation. Anticoagulation may be indicated if clot extends to the IVC.


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