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 Appendix in a Neonate: A Review of Literature and a Case Report from Northern Tanzania

2021 ◽  
Vol 18 (2) ◽  
pp. 115-118
Author(s):  
Lodhia Jay ◽  
Philemon Rune ◽  
Wapalila Daudi ◽  
Sadiq Adnan ◽  
Amsi Patrick ◽  
...  
Keyword(s):  
Clinical Features ◽  
Perforated Appendicitis ◽  
Abdominal Distension ◽  
Premature Neonate ◽  
Sudden Onset ◽  
Emergency Laparotomy ◽  
High Morbidity ◽  
Neonatal Appendicitis ◽  
Perforated Appendix ◽  
The Right

Acute perforated appendicitis is rare in neonates and is associated with high morbidity and mortality. This is mainly because the rarity of the pathology and the abnormal clinical features cause delays in diagnosis and definitive management. We report a case of a  premature neonate who presented with sudden onset of abdominal distension associated with an inability to pass stools. The initial abdominal X-ray showed free air under the right hemi-diaphragm. An emergency laparotomy was performed revealing a perforation at the appendicular tip. An appendectomy was done, and the neonate recovered well with a mild surgical site infection during the course of recovery. Neonatal perforated appendicitis is rare, and clinicians need to consider it as a differential diagnosis due to the atypicalpresentations. This preterm neonate presented with clinical features of intestinal obstruction and was found at laparotomy to have a perforated appendix at the tip due to neonatal appendicitis. Keywords: Neonate, Neonatal appendicitis, Neonatal perforated appendicitis

scholarly journals Study on clinical features and factors associated with thickness of chronic subdural hematoma in adult

2018 ◽  
Vol 11 (3) ◽  
pp. 209
Author(s):  
Ruhul Kuddus ◽  
M. Afzal Hossain ◽  
S. K. Sader Hossain ◽  
A. T. M. Mosharef Hossain ◽  
Haradan Debnath ◽  
...  
Keyword(s):  
Clinical Features ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Complete Recovery ◽  
Factors Associated ◽  
Co Morbidity ◽  
Axial Ct ◽  
The Mean ◽  
Specific Symptoms ◽  
Symptoms And Signs

<p class="Abstract">Patients with chronic subdural hematoma encounter certain difficulties in diagnosis, especially in elderly, due to the characteristically non-specific symptoms and signs. Early diagnosis and proper operative treatment, on the other hand, results in complete recovery in most of the cases. In this study, the clinical features and factors of 31 patients with chronic subdural hematoma, associated with the thickness of chronic subdural hematoma were analyzed. The mean age was 62 ± 13.9 years. The maximum hematoma thickness in the axial CT scan was 25 mm. The thickness of hematoma obtained from axial plain CT had a positive relationship with the patient’s age where r=0.895 and p&lt;0.001 signifies that the thickness of hematoma increased with the increasing age. But the hematoma thickness was not related to co-morbidity such as diabetes mellitus, hypertension and ischemic heart disease. The presentation of the patient with higher hematoma thickness with hemiparesis was statistically significant and with lower thickness with headache and vomiting.</p>

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.

Scrub typhus (Orientia tsutsugamushi), A rapidly spreading epidemic in Chennai - A standalone lab experience

2016 ◽  
Vol 5 (09) ◽  
pp. 4896
Author(s):  
Sripriya C.S.* ◽  
Shanthi B. ◽  
Arockia Doss S. ◽  
Antonie Raj I. ◽  
Mohana Priya
Keyword(s):  
Scrub Typhus ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Febrile Illness ◽  
Orientia Tsutsugamushi ◽  
The Past ◽  
Igm Elisa ◽  
The Mean ◽  
Specific Symptoms ◽  
Symptoms And Signs

Scrub typhus (Orientia tsutsugamushi), is a strict intracellular bacterium which is reported to be a recent threat to parts of southern India. There is re-emergence of scrub typhus during the past few years in Chennai. Scrub typhus is an acute febrile illness which generally causes non-specific symptoms and signs. The clinical manifestations of this disease range from sub-clinical disease to organ failure to fatal disease. This study documents our laboratory experience in diagnosis of scrub typhus in patients with fever and suspected clinical symptoms of scrub typhus infection for a period of two years from April 2014 to April 2016 using immunochromatography and IgM ELISA methods. The study was conducted on 648 patients out of whom 188 patients were found to be positive for scrub typhus. Results also showed that pediatric (0 -12 years) and young adults (20 – 39 years) were more exposed to scrub typhus infection and female patients were more infected compared to male. The study also showed that the rate of infection was higher between September to February which also suggested that the infection rate is proportional to the climatic condition. Statistical analysis showed that the mean age of the patients in this study was 37.6, standard deviation was 18.97, CV % was 50.45. 

Bone marrow necrosis and fat embolism syndrome: a near fatal complication in previously undiagnosed sickle beta + thalassaemia

2021 ◽  
Vol 14 (1) ◽  
pp. e238317
Author(s):  
Nibash Budhathoki ◽  
Sunita Timilsina ◽  
Bebu Ram ◽  
Douglas Marks
Keyword(s):  
Bone Marrow ◽  
Multiorgan Failure ◽  
Rare Condition ◽  
Altered Mental Status ◽  
Fat Embolism ◽  
Bone Marrow Necrosis ◽  
Embolism Syndrome ◽  
Hb S ◽  
High Index Of Suspicion ◽  
Specific Symptoms

Prevalence of haemoglobin sickle-β+ thalassaemia (Hb S/β+thal) is variable with geography ranging from 0.2% to 10% among sickle cell patients. Clinical presentation of Hb S/β+thal patients depends on HbA level, with milder disease often going undiagnosed. However, rarely these patients can present with a fulminant vaso-occlusive crisis (VOC). Given VOC can present with non-specific symptoms, the diagnosis and treatment is often delayed. Here, we present a patient who initially developed altered mental status, pancytopenia and multiorgan failure due a critical VOC resulting in bone marrow necrosis and fat embolism. Subsequent workup confirmed that our patient had Sickle-β+ thalassaemia, which had gone undiagnosed, despite subclinical evidence of haemolysis on routine lab work for years. Following diagnosis and initiation of RBC exchange, he improved significantly and was discharged home. High index of suspicion and bone marrow biopsy is vital for early diagnosis and management of this rare condition.

scholarly journals Early recognition of PIMS-TS: a single centre retrospective review

2021 ◽  
Vol 5 (1) ◽  
pp. e001011
Author(s):  
Roshni Mistry ◽  
Nicola Scanlon ◽  
James Hibberd ◽  
Fionnghuala Fuller
Keyword(s):  
Early Recognition ◽  
Febrile Illness ◽  
Final Diagnosis ◽  
University Hospital ◽  
Single Centre ◽  
Retrospective Case ◽  
Reactive Protein ◽  
Review Reports ◽  
Specific Symptoms

IntroductionResearch into paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) has focused on tertiary level management. This review reports on symptoms and investigations at presentation.MethodsSingle centre retrospective case note analysis of patients fulfilling PIMS-TS diagnostic criteria from March to May 2020 in a London district level university hospital.ResultsSix patients presented in the week prior to their final diagnosis with fever and non-specific symptoms. Raised C-reactive protein (CRP), lymphopenia and hyponatraemia were noted. Kawasaki-like symptoms were under-represented in all patients.InterpretationThe results suggest that a proportion of children with early PIMS-TS present with a non-specific febrile illness and abnormal blood results. Further research is needed to determine the most appropriate identification and follow-up of these children.

scholarly journals SARS-CoV-2 infection in an infant with non-respiratory manifestations: a case report

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Muhammad Adel ◽  
Ahmed Magdy
Keyword(s):  
Computed Tomography ◽  
Aplastic Anemia ◽  
Rt Pcr ◽  
Positive Real ◽  
Case Presentation ◽  
Chest Computed Tomography ◽  
High Incidence ◽  
Laboratory Investigations ◽  
High Index Of Suspicion ◽  
Specific Symptoms

Abstract Background Coronavirus disease (COVID-19) presents in children usually with less severe manifestations than in adults. Although fever and cough were reported as the most common symptoms, children can have non-specific symptoms. We describe an infant with aplastic anemia as the main manifestation. Case presentation We describe a case of SARS-CoV-2 infection in an infant without any respiratory symptoms or signs while manifesting principally with pallor and purpura. Pancytopenia with reticulocytopenia was the predominant feature in the initial laboratory investigations, pointing to aplastic anemia. Chest computed tomography surprisingly showed typical findings suggestive of SARS-CoV-2 infection. Infection was later confirmed by positive real-time reverse transcription polymerase chain reaction assay (RT-PCR) for SARS-CoV-2. Conclusions Infants with COVID-19 can have non-specific manifestations and a high index of suspicion should be kept in mind especially in regions with a high incidence of the disease. Chest computed tomography (CT) and testing for SARS-CoV-2 infection by RT-PCR may be considered even in the absence of respiratory manifestations.

scholarly journals Atypical presentation of testicular torsion: a case series

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Uzodimma Ejike Onwuasoanya
Keyword(s):  
Physical Examination ◽  
Testicular Torsion ◽  
Age Groups ◽  
Case Series ◽  
Atypical Presentation ◽  
Testicular Pain ◽  
Future Fertility ◽  
Urological Emergency ◽  
High Index Of Suspicion ◽  
Symptoms And Signs

Abstract Background Testicular torsion is a urological emergency and needs urgent intervention to prevent testicular loss and impaired future fertility. It is commonly seen in the neonatal and adolescent age groups. Testicular torsion can also present outside these common age groups with uncommon symptoms and signs. We report case series of patients managed at Lily Hospitals Limited, Warri, Delta State, Nigeria with atypical presentation of testicular torsion. Case Presentation The first patient was a 35-year-old male that presented with recurrent right testicular pain of 1-year duration, described as dull aching with no constitutional symptoms, physical examination findings were not pathognomonic of testicular torsion, he had scrotal exploration with right orchidectomy and left orchidopexy. The second patient was a 39-year-old male who presented with recurrent right testicular pain of 4-days duration, described as dull aching with no constitutional symptoms. Physical examination findings were not classical for testicular torsion, he had scrotal exploration with bilateral orchidopexy. Conclusion Testicular torsion although common in neonatal and adolescent age groups can also present outside these age groups with uncommon symptoms and signs, a high index of suspicion is thus invaluable in any patient presenting with testicular pain despite the age and severity to avoid missing the diagnosis as this can lead to testicular loss.

scholarly journals Clinical features and predictors of severity in COVID-19 patients with critical illness in Singapore

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ser Hon Puah ◽  
◽  
Barnaby Edward Young ◽  
Po Ying Chia ◽  
Vui Kian Ho ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Clinical Features ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Case Series ◽  
Plateau Pressure ◽  
Apache Ii Score ◽  
Multivariable Logistic Regression Model ◽  
Reactive Protein ◽  
Ventilatory Management

AbstractWe aim to describe a case series of critically and non-critically ill COVID-19 patients in Singapore. This was a multicentered prospective study with clinical and laboratory details. Details for fifty uncomplicated COVID-19 patients and ten who required mechanical ventilation were collected. We compared clinical features between the groups, assessed predictors of intubation, and described ventilatory management in ICU patients. Ventilated patients were significantly older, reported more dyspnea, had elevated C-reactive protein and lactate dehydrogenase. A multivariable logistic regression model identified respiratory rate (aOR 2.83, 95% CI 1.24–6.47) and neutrophil count (aOR 2.39, 95% CI 1.34–4.26) on admission as independent predictors of intubation with area under receiver operating characteristic curve of 0.928 (95% CI 0.828–0.979). Median APACHE II score was 19 (IQR 17–22) and PaO2/FiO2 ratio before intubation was 104 (IQR 89–129). Median peak FiO2 was 0.75 (IQR 0.6–1.0), positive end-expiratory pressure 12 (IQR 10–14) and plateau pressure 22 (IQR 18–26) in the first 24 h of ventilation. Median duration of ventilation was 6.5 days (IQR 5.5–13). There were no fatalities. Most COVID-19 patients in Singapore who required mechanical ventilation because of ARDS were extubated with no mortality.

scholarly journals Diagnosing gastric volvulus in chest X-ray: report of three cases

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Narendra Pandit ◽  
Abhijeet Kumar ◽  
Tek Narayan Yadav ◽  
Qamar Alam Irfan ◽  
Sujan Gautam ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Abdomen ◽  
Gastric Volvulus ◽  
X Ray ◽  
Pain Abdomen ◽  
Life Threatening ◽  
Chest X Ray ◽  
High Index Of Suspicion ◽  
Specific Symptoms ◽  
Prompt Diagnosis

Abstract Gastric volvulus is a rare abnormal rotation of the stomach along its axis. It is a surgical emergency, hence requires prompt diagnosis and treatment to prevent life-threatening gangrenous changes. Hence, a high index of suspicion is required in any patients presenting with an acute abdomen in emergency. The entity can present acutely with pain abdomen and vomiting, or as chronic with non-specific symptoms. Chest X-ray findings to diagnose it may be overlooked in patients with acute abdomen. Here, we report three patients with gastric volvulus, where the diagnosis was based on the chest X-ray findings, confirmed with computed tomography, and managed successfully with surgery.

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