Report Of A Case Of Abdominal Burkitt's Lymphoma Presenting As Localised Right Iliac Fossa Pain Mimicking Acute Appendicitis

Introductions: Cases of colic of the vermiform appendix have been rarely described or diagnosed. Appendicoliths cause acute appendicitis and appendicular perforation. It is still not clear whether appendicoliths cause appendicular colic in the absence of acute appendicitis. Methods: A cross sectional study that included appendectomy done for recurrent appendicitis or chronic right iliac fossa pain. Histology reports were reviewed. The presence of an appendicolith in the report was noted. Results: Thirty-two cases of recurrent appendicitis and chronic right iliac fossa pain were included. Twenty-four patients (75%) had fecoliths in the histology specimens. Eight patients (25%) who presented with appendicular colic without signs of appendicitis were further evaluated. Conclusions: Majority of patients with chronic or colicky right iliac fossa pain had appendicoliths.

Download Full-text

Minimally Invasive Treatment of Sporadic Burkitt’s Lymphoma Causing Ileocaecal Invagination

Case Reports in Surgery ◽

10.1155/2018/6265182 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5

Author(s):

Paolo Panaccio ◽

Michele Fiordaliso ◽

Domenica Testa ◽

Lorenzo Mazzola ◽

Mariangela Battilana ◽

...

Keyword(s):

Minimally Invasive ◽

Intestinal Obstruction ◽

Iliac Fossa ◽

Abdominal Distension ◽

Burkitt’S Lymphoma ◽

Right Hemicolectomy ◽

Burkitt's Lymphoma ◽

Invasive Treatment ◽

Diagnostic Dilemma ◽

Non Hodgkin Lymphoma

Introduction. Primary NHL (non-Hodgkin lymphoma) of the colon represents only 0.2% to 1.2% of all colonic malignancies. Burkitt’s lymphoma (BL) is usually a disease reported in children and young people, most of them associated with EBV or HIV infection. We describe a rare case of intestinal obstruction due to sporadic Burkitt’s lymphoma causing ileocaecal invagination explaining our experienceMethods. A 31-year-old man presented with diffuse colic pain and weight loss. Clinical examination revealed an abdominal distension with pain in the right iliac fossa. Colonoscopy documented a caecal large lesion with ulcerated mucosa. Computed tomography (CT) have shown a 60 × 50 mm right colic parietal lesion with signs of ileocolic intussusception.Results. Laparoscopic right hemicolectomy was performed. Postoperative period was uneventful. CD20+ high-grade B-cell Burkitt’s lymphoma was confirmed by immunohistochemistry (CD20+, CD79+, and CD10+) and FISH test (t (8;14) (q24; q32). The patient was subsequently treated with adjuvant combination chemotherapy (Hyper-CVAD) and is alive and disease-free at 8 months follow-up.Discussion. Adult sporadic Burkitt’s lymphoma (BL) causing intestinal obstruction due to ileocaecal intussusception is an extremely rare occurrence and a diagnostic dilemma. Despite the surgical approach is selected based on patient’s conditions and surgeon’s expertise, minimally invasive method could be preferred.

Download Full-text

Raised faecal calprotectin levels in pateints presenting with right iliac fossa pain warrant mandatory laparoscopy: A non-invasive predictor of acute appendicitis

Endoscopy ◽

10.1055/s-2005-868524 ◽

2005 ◽

Vol 37 (05) ◽

Author(s):

C Power ◽

H Al-Suwaidi ◽

K Muhammad ◽

M Floyd ◽

M Kell ◽

...

Keyword(s):

Acute Appendicitis ◽

Iliac Fossa ◽

Faecal Calprotectin ◽

Non Invasive ◽

Right Iliac Fossa Pain

Download Full-text

ACUTE APPENDICITIS

The Professional Medical Journal ◽

10.29309/tpmj/2016.23.03.1465 ◽

2016 ◽

Vol 23 (03) ◽

pp. 241-245

Author(s):

Javeria Farid ◽

Rizwanullah Junaid Bhambhro ◽

Sohail Soomro

Keyword(s):

Abdominal Pain ◽

Postoperative Complications ◽

Acute Appendicitis ◽

Epigastric Pain ◽

Iliac Fossa ◽

University Hospital ◽

Cross Sectional ◽

Clinical Pattern ◽

Rebound Tenderness ◽

Right Iliac Fossa Pain

Objectives: To determine the clinical presenting pattern and postoperativecomplications of acute appendicitis. Study design: Observational and cross-sectional study.Setting: Isra university hospital Hyderabad. Period: 7 months. Methodology: All the patientsabove 12 years of age and both genders male/female after diagnosis of acute appendicitishad integrated in the study. Complete clinical pattern and postoperative complications hadrecorded. Results: Symptoms/sign nausea, vomiting, anorexia, rebound tenderness, fever,constipation, diarrhea and leukocytosis were noted with the percentage 98.0%, 65.0%, 95.0%,90.0%, 85.0%, 58.0%, 30.0% and 89.0% respectively. Paraumblical pain was noted in 50.0%of the cases, right iliac fossa pain was in the 99.0%, epigastric pain was seen in 61.0% and theother abdominal pain was noted in the 39.0%. Postoperative complications found in 33.0% ofthe cases and majority was seen wound infection. Conclusion: In the conclusion of this studyclinical features nausea, vomiting, anorexia, rebound tenderness, fever, and leukocytosis wereseen as most common and the most important postoperative complication is infection whichprobably created with the uncompleted sterilization.

Download Full-text

EP.WE.641Spectrum of Right Iliac Fossa Pain Presentation and Management During the First COVID-19 Lockdown: A Single Institution Experience

British Journal of Surgery ◽

10.1093/bjs/znab308.081 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Ahmed Salman Bodla ◽

Chinedu Ndegbu

Keyword(s):

Acute Appendicitis ◽

Diagnostic Imaging ◽

Imaging Modality ◽

Iliac Fossa ◽

Management Approach ◽

Conservative Approach ◽

Diagnosis Rate ◽

Right Iliac Fossa Pain ◽

Management Approaches ◽

Surgical Unit

Abstract Aims Acute surgical presentations and management approaches have witnessed a changing pattern occasioned by COVID-19 pandemic and attendant lockdown. We report the spectrum of right iliac fossa (RIF) pain referrals and management trend within an acute surgical unit before and during the National lockdown. Methods A retrospective review of all patients referred to the acute surgical unit with RIF pain before and during first National lockdown was undertaken. Patients managed during these periods were segregated into Pre-Lockdown (January-2020) and Lockdown (April/May-2020) cohorts. Relevant data were obtained from patients’ electronic medical records and main outcome measures compared between both arms were definitive diagnosis, rate of acute appendicitis, diagnostic imaging modality utilised, management approach and post-operative 30-day complications. Results RIF pain referrals were fewer (17% vs. 23%, P = 0.045) but more likely to be related to acute appendicitis during the lockdown (52% vs. 28%, P = 0.002). However, the risk of presenting with complicated appendicitis did not alter significantly (26% vs. 19%, RR = 1.34, P = 0.56). Diagnostic imaging was increasingly deployed (for RIF pain: 91% vs. 74%, P = 0.07; for appendicitis: 77% vs. 42%, P = 0.007) especially computerised tomography scan (45% vs. 31%). Increased adoption of conservative approach in the management of acute appendicitis was significant (61% vs 23%, RR 2.65, P = 0.01) although other outcomes such as length of stay, post-operative complication and 30-day re-presentation rates were comparable to pre-lockdown phase. Conclusion Fewer RIF pain but more likelihood of acute appendicitis, increased use of radiological imaging and conservative approach to management reflect an evolving pattern during the lockdown phase.

Download Full-text

A comparative study of RIPASA and Alvarado score for the diagnosis of acute appendicitis

International Surgery Journal ◽

10.18203/2349-2902.isj20204930 ◽

2020 ◽

Vol 7 (12) ◽

pp. 4006

Author(s):

Praveena Suresh ◽

Rajan Janardhanan ◽

Deepak Paul

Keyword(s):

Acute Appendicitis ◽

Scoring System ◽

Prospective Observational Study ◽

Iliac Fossa ◽

Scoring Systems ◽

Alvarado Score ◽

Medical College ◽

Right Iliac Fossa Pain ◽

Sensitivity Specificity ◽

Ripasa Score

Background: Acute appendicitis is a common problem and can be difficult to diagnose at time. There are many scoring systems to predict the diagnosis of acute appendicitis. The most commonly used scoring system is Alvarado scoring system but, it is far from perfect. In this study we compare Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) scoring system to Alvarado scoring system in correctly diagnosing acute appendicitis.Methods: This prospective observational study was conducted in the department of general surgery, Sree Gokulam Medical College and Research Foundation. It comprised of 60 consecutive patients who were admitted with suspicion of appendicitis who had right iliac fossa pain. RIPASA and Alvarado scoring was done and compared to histopathology after surgery. Sensitivity, specificity and accuracy was calculated.Results: Majority of the patients were below 30 years of age majority were males 36 (60%). When Alvarado score predicted appendicitis in 31 (51.77%) and RIPASA in 54 (90%). When the RIPASA score was >7.5 the sensitivity was 100%, specificity 67% and accuracy was 95%.Conclusions: RIPASA scoring system is more accurate to diagnose acute appendicitis especially when RIPASA score is >7.5. literatures.

Download Full-text

A rare case of Valentino’s syndrome

International Surgery Journal ◽

10.18203/2349-2902.isj20183219 ◽

2018 ◽

Vol 5 (8) ◽

pp. 2933

Author(s):

Mohan C. P. ◽

Kabalimurthy J. ◽

Balamurugan E. ◽

Jayavarmaa R.

Keyword(s):

Acute Appendicitis ◽

Rare Case ◽

Iliac Fossa ◽

Duodenal Perforation ◽

Peptic Ulcer Perforation ◽

Gastric Contents ◽

Right Iliac Fossa Pain ◽

The Right ◽

Clinical Conditions

The pain in the right iliac fossa corresponds with many clinical conditions, most commonly Acute appendicitis. Rarely peptic ulcer perforation presents as pain in the right iliac fossa. This condition is called as Valentino’s syndrome. This is due to the leakage of the gastric contents from the stomach or duodenum during the perforation. This induces peritonitis and sometimes the fluids get collected in the right iliac fossa causing pain, hence mimicking appendicitis. This is the case study of a 17yr old boy with right iliac fossa pain and tenderness, vomiting, fever, all corresponding to acute appendicitis. But on surgical exploration, it was found to be duodenal perforation. Valentino’s syndrome is a very misleading condition which will lead to death if proper evaluation and timely management is not done. This study emphasis the fact that Valentino’s syndrome has to be considered as the differential diagnosis in symptoms suggestive of acute appendicitis.

Download Full-text

Role of Graded Compression Ultrasonography in Evaluation of Acute Appendicitis.

Medical Journal of Shree Birendra Hospital ◽

10.3126/mjsbh.v12i2.12929 ◽

2015 ◽

Vol 12 (2) ◽

pp. 49-53

Author(s):

Mukunda Singh Shrestha ◽

Hom Prasad Pant ◽

Shiv Bahadur Basnet ◽

Govinda Bhahadur Khadka ◽

Rajive Raj Shahi ◽

...

Keyword(s):

Acute Appendicitis ◽

Predictive Value ◽

Iliac Fossa ◽

Clinical Impression ◽

High Morbidity ◽

Emergency Setting ◽

Compression Technique ◽

Suspected Appendicitis ◽

Right Iliac Fossa Pain ◽

Compression Ultrasonography

Introduction: Acute appendicitis is common surgical emergency which can lead to high morbidity and mortalityin absence of timely treatment. Ultrasonography (USG) is commonly used to diagnose appendicitis and excludeother intraabdominal pathology leading to right iliac fossa pain in emergency setting. We aimed to Þ nd out thediagnostic value of graded compression USG in suspected appendicitis cases.Methods: Altogether 107 patients with clinical impression of acute appendicitis were followed. Four caseswere excluded because of other diagnosis established in USG. Appendicitis was diagnosed by standard criteriasof inß ammed appendix by graded compression technique. Informations of 103 cases were recorded in proformawhich was later entered in SPSS and statistical calculations done.Results: Out of 103 cases followed, 93 had appendicitis. Of those, 46 cases only showed inß ammed anddistended appendix, others showed ancillary features only. Males were more affected 61(65.6%) than females.Sensitivity, speciÞ city, positive predictive value, negative predictive value and accuracy of ultrasound indetecting appendicitis were 98.9%,90%,98.9%,90% and 97.1% respectively.Conclusions: Graded compression ultrasonography is good investigation modality in assessement of suspectedacute appendicitis.doi: http://dx.doi.org/10.3126/mjsbh.v12i2.12929

Download Full-text