Neonatal appendicitis: An experience with 2 cases at Hue Central Hospital

2021 ◽  
Author(s):  
Huu Thien Ho
Keyword(s):  
Neonatal Intensive Care ◽  
Pulmonary Atresia ◽  
Perforated Appendicitis ◽  
Abdominal Distension ◽  
Hemodynamic Instability ◽  
Term Infant ◽  
Older Children ◽  
Reactive Protein ◽  
First Case ◽  
High Index Of Suspicion

Bаckground: Аcute аppendicitis is extremely rаre in the neonаtаl periods. The number of cаses published in the lаst century is just over 100. Mortаlity аnd morbidity аre still high due to diаgnostic problems becаuse there аre no specific clinicаl feаtures аnd reliаble investigаtion for the diаgnosis. Herein, we present two pаtients to remind physiciаns thаt the diаgnosis of neonаtаl аppendicitis should аlwаys be kept in mind. Cаse presentаtions: The first case presented at Neonatal Intensive Care Unit with an 18-hour-history of irritability, vomiting, and abdominal distension. With high white blood cell count and C-reactive protein level, the baby was initially diagnosed with neonatal sepsis. The ultrasound performed on day 3 after hospitalization found peritonitis but not seen appendicitis. Post-operative diagnosis confirmed acute perforated appendicitis withperitonitis. The baby was well covered without complication. The second case was a 6-year-old full-term infant with Down syndrome and Pulmonary atresia with ventricular septal defect. The patient underwent surgery and postoperative critical care. However, he died at post-operative day 5 due to worsening sepsis and decompensated hemodynamic instability. Conclusion: It is а fаct thаt аcute аppendicitis in neonаtes аnd infаnts mаy not be diаgnosed eаsily аnd quickly аs in older children becаuse there аre no specific clinicаl feаtures аnd reliаble investigаtion for the diаgnosis. Delаy in diаgnosis аnd treаtment often results in аppendiculаr perforаtion аnd peritonitis. The mаin sаfeguаrd аgаinst mortаlity аnd morbidity remаins а high index of suspicion.

scholarly journals An Experience with 31 Cases of Neonatal Appendicitis: A Retrospective Study

2019 ◽  
Vol 8 (3) ◽  
pp. 21
Author(s):  
Xuxu Huang ◽  
Xuefei Huang ◽  
Juma Mfaume Mbugi ◽  
Liu Wei ◽  
Hua Ziyu ◽  
...  
Keyword(s):  
Clinical Features ◽  
Abdominal Distension ◽  
Abdominal Sepsis ◽  
Reactive Protein ◽  
Neonatal Appendicitis ◽  
Normal White Blood Cell ◽  
High Index Of Suspicion ◽  
Medical University ◽  
Specific Symptoms ◽  
Symptoms And Signs

Background: Neonatal appendicitis (NA) is rarely diagnosed due to lack of specific symptoms and signs. The aim of this study is to share our experience with NA.Methods: We performed a retrospective data review from electronic medical records of patients admitted at Children’s Hospital of Chongqing Medical University (CHCMU) with the clinical diagnosis of NA from October 2001 to July 2018.Results: Of 31 neonates, male neonates (n=20) accounted for 64.5%. Abdominal distension and anorexia were the most common clinical features (61.3%, n=19). Neonates with elevated C- reactive protein (CRP) accounted for 92.6% (n=25) where as 51.6% (n=16) had normal white blood cell count (WBC). Of 29 neonates who underwent surgery, 69% (n=20) had perforated appendicitis.Conclusion: Neonatal appendicitis lacks specific clinical features, and early diagnosis is difficult. Clinicians need to have high index of suspicion when attending neonates with features of abdominal sepsis.

scholarly journals Perforated Acute Appendicitis in a Six-Day-Old Neonate: A Rare Differential Diagnosis of Neonatal Peritonitis

2021 ◽  
pp. 188-194
Author(s):  
Thanh Xuan Nguyen ◽  
Nhu Thanh Dang ◽  
Hai Thanh Phan ◽  
Nhu Hien Pham ◽  
Hoai Anh Vu
Keyword(s):  
Differential Diagnosis ◽  
Critical Care ◽  
Acute Appendicitis ◽  
Septal Defect ◽  
Pulmonary Atresia ◽  
Hemodynamic Instability ◽  
Term Infant ◽  
Rare Differential Diagnosis ◽  
Rare Diagnosis ◽  
Neonatal Peritonitis

Acute appendicitis is a rare diagnosis of acute abdomen in neonates which is associated with high mortality due to late diagnosis. Here, we presented a case of acute neonatal appendicitis in a 6-year-old full-term infant with Down syndrome and pulmonary atresia with ventricular septal defect. The patient underwent surgery and postoperative critical care. However, he died on postoperative day 5 due to worsening sepsis and decompensated hemodynamic instability.

scholarly journals Intussusception in preterm neonates: A systematic review of a rare condition

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mostafa Kotb ◽  
Mostafa Abdelatty ◽  
Hayssam Rashwan ◽  
Yasmine AbdelMeguid ◽  
Ahmed Elrouby
Keyword(s):  
Systematic Review ◽  
Neonatal Intensive Care ◽  
Case Reports ◽  
Case Series ◽  
Rare Condition ◽  
Abdominal Distension ◽  
Contrast Enema ◽  
Preterm Neonates ◽  
Lead Point ◽  
High Index Of Suspicion

Abstract Background While necrotizing enterocolitis (NEC) is a prevalent condition in preterm neonates admitted to neonatal intensive care unit (NICU), intussusception is exceedingly uncommon and often overlooked. This is due to the fact that they share many clinical characteristics. The initial misdiagnosis of intussusception in preterm neonates (IPN) especially has led to a delay in their management, which increases the risk of developing compromised bowel. Additionally, it is difficult to reach a diagnosis as neonatal intussusception does not have any classical radiological signs even when contrast enema is used. This systematic review is based on the published literature including case reports and case series to review the clinical features of IPN and how to differentiate it from NEC in order to shed the light on this rare disease and how having a high index of suspicion would help practitioners to make an early and accurate diagnosis Methods A systematic literature search to report all cases of relevant articles that reported IPN till date. All cases that were born before 37 weeks gestational age, presented within the neonatal period and having well established documentation were included in the study. Any case that did not have these criteria was excluded from our study. Results Only 52 cases met these criteria during the period from 1963 till date. An average of 10 days had elapsed before the cases were confirmed to have IPN either clinically or intraoperatively. The most frequent manifestations were abdominal distension and bilious gastric residuals, occurring in 85% and 77% of the cases respectively, followed by bloody stools in 43% of cases. However, this triad was present only in approximately one-third of the cases. Only 13 cases were diagnosed as having intussusception preoperatively. About two thirds of the intussusception were located in the ileum. Pathological lead point was present in 7 cases only; 4 of them were due to Meckel’s diverticulum. Nine cases only out of the 52 cases with IPN died. Conclusion It is crucial to detect the clues for diagnosis of intussusception because in contrast to NEC, it is unresponsive to conservative management, affects the viability of the bowel and surgery is essential.

scholarly journals Report of a Confirmed SARS-CoV-2 Positive Newborn after Delivery Despite Negative SARS-CoV-2 Testing on Both Parents

2021 ◽  
Vol 11 (02) ◽  
pp. e80-e83
Author(s):  
Benjamin R. Harding ◽  
Farha Vora
Keyword(s):  
Neonatal Intensive Care ◽  
Community Hospital ◽  
Material Testing ◽  
Term Infant ◽  
Accurate Diagnosis ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Potential Case ◽  
Polymerase Chain ◽  
Negative Material

AbstractWe present a case of a term infant born to an asymptomatic mother at a community hospital who required transfer to a local neonatal intensive care unit (NICU) immediately after birth for respiratory distress. The infant was tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at 24 hours of life by reverse transcription polymerase chain reaction (RT-PCR) testing due to the absence of prenatal maternal COVID-19 testing and was found to be positive for SARS-CoV-2 at that time. A second RT-PCR test was obtained on the infant on day of life (DOL) 4 and was also positive, confirming an accurate diagnosis of COVID-19 disease in the infant. Both the mother and father remained asymptomatic and concomitantly tested negative for SARS-CoV-2 on two separate occasions. The infant subsequently clinically improved and was discharged without any complications. This case raises the potential concern for two unreported newborn issues related to COVID-19. First, the potential unreliability of negative maternal COVID-19 testing surrounding the time of delivery as it relates to routine newborn testing and isolation needs, and second, if the negative material testing was accurate, this raises the concern for a potential case of nosocomial COVID-19 infection within the first 24 hours of life.

scholarly journals Predictive factors of perforated appendicitis: Impact of the C-reactive protein level

2021 ◽  
Author(s):  
Shiori Yamazaki ◽  
Yusuke Shimodaira ◽  
Akira Kobayashi ◽  
Manabu Takata ◽  
Kaori Hayashibara ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Protein Level ◽  
Perforated Appendicitis ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals Inflammatory Biomarkers in the Short-Term Prognosis of Venous Thromboembolism: A Narrative Review

2021 ◽  
Vol 22 (5) ◽  
pp. 2627
Author(s):  
Francisco Galeano-Valle ◽  
Lucía Ordieres-Ortega ◽  
Crhistian Mario Oblitas ◽  
Jorge del-Toro-Cervera ◽  
Luis Alvarez-Sala-Walther ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Risk Stratification ◽  
Hemodynamic Instability ◽  
Inflammatory Biomarkers ◽  
Right Ventricle Dysfunction ◽  
Reactive Protein ◽  
Cancer Associated Thrombosis ◽  
The Relationship ◽  
Acute Pe

The relationship between inflammation and venous thrombosis is not well understood. An inflammatory response may be both the cause and consequence of venous thromboembolism (VTE). In fact, several risk factors of VTE modulate thrombosis through inflammatory markers. Acute pulmonary embolism (PE) is burdened by a remarkable mortality rate, up to 34% in severely ill patients presenting with hemodynamic instability. Initial mortality risk stratification is based on hemodynamic instability. Patients with a situation of hemodynamic stability require immediate further risk assessment based on clinical, imaging, and circulating biomarkers, as well as the presence of comorbidities. Some inflammatory biomarkers have shown potential usefulness in the risk stratification of patients with VTE, especially acute PE. C-reactive protein on admission is associated with 30-day mortality and bleeding in VTE patients. P-selectin is associated with right ventricle dysfunction in PE patients and might be associated with VTE recurrences and the extension of thrombosis. Tissue factor microparticles are associated with VTE recurrence in cancer-associated thrombosis. Other inflammatory biomarkers present scarce evidence (inflammatory cytokines, erythrocyte sedimentation rate, fibrinogen, leukocyte count). In this manuscript, we will review the prognostic role of different inflammatory biomarkers available both for clinical practice and research in VTE patients.

Neonatal Toxic Shock Syndrome–Like Exanthematous Disease in North America

2019 ◽  
Author(s):  
Megan Culler Freeman ◽  
Stephanie Mitchell ◽  
John Ibrahim ◽  
John V Williams
Keyword(s):  
North America ◽  
Diagnostic Criteria ◽  
Skin Rash ◽  
Toxic Shock Syndrome ◽  
Disease Process ◽  
Toxic Shock ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
First Case

Abstract Neonatal toxic shock syndrome (TSS)-like exanthematous disease (NTED) is a syndrome first reported in Japan. Neonates develop systemic exanthema, thrombocytopenia, and fever usually during the first week of life. The disease is distinguished from frank TSS because affected infants are not severely ill and do not meet TSS criteria. Most infants are confirmed to be colonized with TSST-1 producing strains of S. aureus. Suggested diagnostic criteria for NTED include a skin rash with generalized macular erythema and one of the following symptoms: fever >38.0°C, thrombocytopenia <150 x103uL, or low positive C-reactive protein (1-5 mg/dL) in the absence of another known disease process. NTED is common in Japanese NICUs, but outside Japan, only one case has been reported in France. We describe the first case of NTED reported in North America.

INFANTILE BERIBERI ASSOCIATED WITH WERNICKE'S ENCEPHALOPATHY

PEDIATRICS ◽  
1958 ◽  
Vol 21 (3) ◽  
pp. 409-420
Author(s):  
Ruth Alice Davis ◽  
Abner Wolf
Keyword(s):  
Case Report ◽  
Abdominal Distension ◽  
Acute Illness ◽  
Wernicke’S Encephalopathy ◽  
Vitamin Supplementation ◽  
Wernicke's Encephalopathy ◽  
Excessive Sweating ◽  
Dietary History ◽  
First Case ◽  
Pathologic Findings

An infant, 5½ months of age, died after a brief acute illness characterized by irritability and somnolence leading terminally to coma, and by excessive sweating, abdominal distension, tachypnea and tachycardia. Acidosis and azotemia were marked. He was found at necropsy examination to have pathologic findings compatible with both beriberi and Wernicke's encephalopathy. Investigation of the dietary history and analysis of the formula fed the patient confirmed the suspicion of deficient intake of thiamine. This is the first case report in which the coexistence of these two pathologic conditions in a child proven to have had an inadequate diet, has been documented. It lends further support to the thesis that Wernicke's encephalopathy is caused by nutritional deficiency. The importance of vitamin supplementation of restricted diets used in the therapy of infantile eczema is emphasized.

scholarly journals Acute abdomen due to late retroperitoneal extravasation from a femoral venous catheter in a newborn

2002 ◽  
Vol 120 (2) ◽  
pp. 59-61 ◽  
Author(s):  
Jaques Sztajnbok ◽  
Eduardo Juan Troster
Keyword(s):  
Parenteral Nutrition ◽  
Acute Abdomen ◽  
Neonatal Intensive Care ◽  
Vena Cava ◽  
Venous Catheter ◽  
Term Infant ◽  
Unusual Complication ◽  
Femoral Catheter ◽  
Catheter Migration ◽  
Venous Catheterization

CONTEXT: The use of parenteral nutrition via a central venous catheter is a common practice in the neonatal intensive care setting. Extravasation of the infusate leading to an acute abdomen is a complication that has only rarely been documented. This report describes the case of a premature infant with a femoral catheter placed in the inferior vena cava, who developed an acute abdomen as a result of late retroperitoneal extravasation of parenteral nutrition. CASE REPORT: A pre-term infant receiving total parenteral nutrition via a femoral venous catheter developed an acute abdomen five days after the catheter placement. Extravascular catheter migration to the retroperitoneal space and extravasation of the infusate was diagnosed by contrast injection. Withdrawal of the catheter was followed by prompt cessation of the signs and full recovery from the acute abdomen, without the need for surgery. A review of the literature is presented, emphasizing the clinical and therapeutic aspects of this unusual complication from femoral venous catheterization and parenteral nutrition.

scholarly journals The diagnostic value of white cell count, C-reactive protein and bilirubin in acute appendicitis and its complications

2013 ◽  
Vol 95 (3) ◽  
pp. 215-221 ◽  
Author(s):  
I G Panagiotopoulou ◽  
D Parashar ◽  
R Lin ◽  
S Antonowicz ◽  
AD Wells ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Cell Count ◽  
Inflammatory Markers ◽  
White Cell Count ◽  
Perforated Appendicitis ◽  
Diagnostic Value ◽  
White Cell ◽  
C Reactive Protein ◽  
Reactive Protein

Introduction Inflammatory markers such as white cell count (WCC) and C-reactive protein (CRP) and, more recently, bilirubin have been used as adjuncts in the diagnosis of appendicitis. The aim of this study was to determine the diagnostic accuracy of the above markers in acute and perforated appendicitis as well as their value in excluding the condition. Methods A retrospective analysis of 1,169 appendicectomies was performed. Patients were grouped according to histological examination of appendicectomy specimens (normal appendix = NA, acute appendicitis = AA, perforated appendicitis = PA) and preoperative laboratory test results were correlated. Receiver operating characteristic (ROC) curve area analysis (area under the curve [AUC]) was performed to examine diagnostic accuracy. Results ROC analysis of all laboratory variables showed that no independent variable was diagnostic for AA. Good diagnostic accuracy was seen for AA when all variables were combined (WCC/CRP/bilirubin combined AUC: 0.8173). In PA, the median CRP level was significantly higher than that of AA (158mg/l vs 30mg, p<0.0001). CRP also showed the highest sensitivity (100%) and negative predictive value (100%) for PA. CRP had the highest diagnostic accuracy in PA (AUC: 0.9322) and this was increased when it was combined with WCC (AUC: 0.9388). Bilirubin added no diagnostic value in PA. Normal levels of WCC, CRP and bilirubin could not rule out appendicitis. Conclusions CRP provides the highest diagnostic accuracy for PA. Bilirubin did not provide any discriminatory value for AA and its complications. Normal inflammatory markers cannot exclude appendicitis, which remains a clinical diagnosis.

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