scholarly journals Appendiceal Endometriosis: A Rare Cause of Acute Appendicitis

2020 ◽  
Vol 3 (5) ◽  
pp. 01-03
Author(s):  
Georgios Koimtzis
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Laparoscopy ◽  
Reproductive Organs ◽  
Lymphoid Hyperplasia ◽  
Reproductive Age ◽  
Histologic Examination ◽  
Diagnostic Process ◽  
Lower Quadrant ◽  
The Right ◽  
Right Lower Quadrant

Background: Acute appendicitis is the most common cause of acute abdomen. The etiology has not been defined clearly but potential causes are fecoliths, lymphoid hyperplasia and malignancies. However, an extremely uncommon cause of acute appendicitis is endometriosis which leads to dilemmas in the diagnostic process. Case report: A 21-year-old Caucasian female patient presented in the Emergency department complaining of acute progressive abdominal pain in the right lower quadrant. The physical examination revealed signs consistent with acute appendicitis. The patient underwent diagnostic laparoscopy, which revealed early inflammation of the appendix and thus was subjected to appendicectomy. Histologic examination revealed endometriosis of the appendix. Conclusion: The presented case emphasizes on how endometriosis can affect only the appendix without any involvement of the reproductive organs. A high index of clinical suspicion is required especially in women of reproductive age who present with periodic chronic pain associated with their menstrual cycle. Nonetheless, this can only be confirmed through diagnostic laparoscopy and histologic examination, which also provides the definite cure of the disease.

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.

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.

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.

Manifestations of Pediatric Appendicopathia Oxyurica

2013 ◽  
Vol 79 (9) ◽  
pp. 873-874 ◽  
Author(s):  
Mary M. Jordan ◽  
Jennifer E. Sanders ◽  
Christina R. Stallworth ◽  
Scott Russell ◽  
Olivia Titus ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Ex Vivo ◽  
Low Grade ◽  
Enterobius Vermicularis ◽  
Lower Quadrant ◽  
First Case ◽  
Human Digestive Tract ◽  
The Right ◽  
Right Lower Quadrant

Enterobius vermicularis is a parasite that inhabits the human digestive tract. We present two pediatric patients with symptoms mimicking acute appendicitis who were found to have E. vermicularis infection. The first case is a 5-year-old female who presented with flank and abdominal pain associated with low-grade fever and anorexia. She had localized tenderness in the right lower quadrant and a leukocytosis with left shift. Intraoperative findings included a normal-appearing appendix, but ex vivo examination revealed Enterobius vermicularis. The second case is a 7-year-old female who presented with periumbilical abdominal pain, anorexia, and emesis. She had tenderness at McBurney's point, and ultrasound revealed a small echogenic focus within the appendix. Intraoperatively, the distal tip of the appendix appeared inflamed. Again, ex vivo examination revealed E. vermicularis. Enterobius vermicularis infection of the appendix can present with a clinical picture similar to acute appendicitis. In at-risk populations, it should be included in the differential diagnosis for children with right lower quadrant abdominal pain. Complete therapy requires treatment with mebendazole.

A new technique for the diagnosis of acute appendicitis: abdominal CT with compression to the right lower quadrant

2017 ◽  
Vol 27 (8) ◽  
pp. 3317-3325 ◽  
Author(s):  
Abidin Kılınçer ◽  
Erhan Akpınar ◽  
Bülent Erbil ◽  
Emre Ünal ◽  
Ali Devrim Karaosmanoğlu ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
New Technique ◽  
Abdominal Ct ◽  
Lower Quadrant ◽  
A New Technique ◽  
The Right ◽  
Right Lower Quadrant

Acute Appendicitis Masquerading as Acute Scrotum

2011 ◽  
Vol 5 (6) ◽  
pp. 524-527 ◽  
Author(s):  
Paul O. Dienye ◽  
Nze J. Jebbin
Keyword(s):  
Acute Appendicitis ◽  
Acute Scrotum ◽  
Scrotal Pain ◽  
Lower Quadrant ◽  
Diffuse Abdominal Pain ◽  
Close Observation ◽  
Negative Appendicectomy ◽  
Atypical Presentations ◽  
The Right ◽  
Right Lower Quadrant

Acute appendicitis presents typically with periumbilical pain that in a few hours settles at the right lower quadrant of the abdomen. Atypical presentations are common but association with acute scrotum is an extreme rarity. A 30-year-old fisherman presented at a rural medical facility with a 2-day complaint of severe pain at the right hemiscrotum followed about 24 hours later with mild diffuse abdominal pain. There was associated mild fever and nausea but no vomiting. There were no urinary symptoms and no recent sexual exposure. Initial physical examination revealed mild generalized tenderness worse at the right lower quadrant but the scrotum was not remarkable, and cremasteric sign was negative. He was admitted as a case of acute abdomen for close observation. Abdominal and scrotal ultrasound scan were normal. By the second day of admission, pain became marked at the right lower abdomen with associated vomiting. There was also marked tenderness at the right lower quadrant with rebound. A diagnosis of acute appendicitis was thus made and appendicectomy done after proper workup. The abdominal and scrotal pain stopped after surgery and the patient was discharged on the seventh postoperative day. Patients with unusual abdominal and scrotal pain should be admitted and closely observed and evaluated to prevent unnecessary scrotal exploration or negative appendicectomy.

scholarly journals A Case of Postpartum Thrombophlebitis of a Retroperitoneal Varix Mimicking Acute Appendicitis

2019 ◽  
Vol 35 (5) ◽  
pp. 432-437
Author(s):  
Paula Glackin ◽  
Lars G. Crabo
Keyword(s):  
Acute Appendicitis ◽  
Correct Diagnosis ◽  
Ovarian Vein ◽  
Quadrant Pain ◽  
Sonographic Examination ◽  
Lower Quadrant Pain ◽  
Lower Quadrant ◽  
Right Lower Quadrant Pain ◽  
The Right ◽  
Right Lower Quadrant

A case of thrombophlebitis of a retroperitoneal varix in a postpartum patient with right lower quadrant pain is presented. The sonographic examination was falsely positive for appendicitis, but the correct diagnosis was made with a subsequent computed tomogram. The thrombosed varix was likely a collateral of the right ovarian vein, analogous to postpartum ovarian vein thrombophlebitis (POVT), an uncommon potentially fatal disorder. POVT is reviewed, emphasizing features useful for distinguishing it from appendicitis at sonography. Sonographers should be aware of the possibility of thrombophlebitis when examining postpartum patients with right lower quadrant pain.

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 Laparoscopic Right Hemicolectomy for Appendiceal Mucocele

2021 ◽  
Vol 64 (3) ◽  
pp. 165-169
Author(s):  
Eva Kudelová ◽  
Martin Grajciar ◽  
Marek Smolar ◽  
Michal Kalman ◽  
Ludovit Laca
Keyword(s):  
Surgical Treatment ◽  
Acute Appendicitis ◽  
Right Hemicolectomy ◽  
Cystic Mass ◽  
Lower Quadrant ◽  
Appendiceal Mucocele ◽  
Laparoscopic Right Hemicolectomy ◽  
The Right ◽  
Right Lower Quadrant ◽  
Ct And Mri

Appendiceal mucocele is a rare disease with an incidence of 0.07–0.63% of all appendectomies and was first described in 1842 by Carl von Rokitansky. It is defined as an abnormal intraluminal accumulation of mucin. The clinical picture of AM can vary from asymptomatic mass in the right lower quadrant to symptoms of acute appendicitis. In some cases, AM can be found accidentally on CT performed due to other reasons or during surgery. Diagnosis consists mainly of imaging methods such as ultrasound, CT, and MRI with the finding of encapsulated cystic mass with calcifications. The main goal of surgical treatment is to remove an intact mucocele and prevent spillage of mucin into the peritoneal cavity. We present a case of large mucocele treated with laparoscopic right hemicolectomy.

Abdominal CT Scanning in Reproductive-Age Women with Right Lower Quadrant Abdominal Pain: Does Its Use Reduce Negative Appendectomy Rates and Healthcare Costs?

2007 ◽  
Vol 73 (6) ◽  
pp. 580-584 ◽  
Author(s):  
Bryan C. Morse ◽  
Richard H. Roettger ◽  
Corey A. Kalbaugh ◽  
Dawn W. Blackhurst ◽  
William B. Hines
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Ct Scanning ◽  
Reproductive Age ◽  
Negative Appendectomy ◽  
Abdominal Ct ◽  
Lower Quadrant ◽  
Quadrant Abdominal Pain ◽  
Reproductive Age Women ◽  
Right Lower Quadrant

Although acute appendicitis is the most frequent cause of the acute abdomen in the United States, its accurate diagnosis in reproductive-age women remains difficult. Problems in making the diagnosis are evidenced by negative appendectomy rates in this group of 20 per cent to 45 per cent. Abdominal CT scanning has been used in diagnosing acute appendicitis, but its reliability and usefulness remains controversial. There is concern that the use of CT scanning to make this diagnosis leads to increased and unwarranted healthcare charges and costs. The purpose of our study is to determine if abdominal CT scanning is an effective test in making the diagnosis of acute appendicitis in reproductive-age women (age, 16–49 years) with right lower quadrant abdominal pain and to determine if its use is cost-effective. From January 2003 to December 2006, 439 patients were identified from our academic surgical database and confirmed by chart review as undergoing an appendectomy with a pre- or postoperative diagnosis of acute appendicitis. Data, including age, presence and results of preoperative abdominal CT scans, operative findings, and pathology reports were reviewed. Comparison of patients receiving a preoperative CT scan with those who did not was performed using chi-squared analysis. In the subgroup of reproductive-age women, there was a significant difference in negative appendectomy rates of 17 per cent in the group that received abdominal CT scans versus 42 per cent in the group that did not ( P < 0.038). After accounting for the patient and insurance company costs, abdominal CT scan savings averaged $1412 per patient. Abdominal CT scanning is a reliable, useful, and cost-effective test for evaluating right lower quadrant abdominal pain and making the diagnosis of acute appendicitis in reproductive-age women.

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