scholarly journals Management of Appendicitis

2022 ◽  
Author(s):  
Vishal P. Bhabhor

Appendicitis is one of the most common causes of acute abdomen with life time risk between 6 and 8% and it’s a most common non obstetric surgical emergency during pregnancy. Appendicitis is claimed to be unknown in the villages of India and China in paper by A. M. Spencer. The reason is simply due to the fact that diagnostic facilities do not exist and cases are not recognized. So diagnosing acute appendicitis accurately and efficiently can reduce morbidity and mortality from perforation and other complications. Surgical intervention is the first choice for appendicitis with medical management being reserved for special situations.

2019 ◽  
pp. 66-76
Author(s):  
I. V. Platitsyn ◽  
A. V. Kondratyev ◽  
A. V. Panin ◽  
E. M. Shubarkina ◽  
A. L. Maslov

Uncomplicated diverticula of the small intestine are asymptomatic, extremely rare in everyday practice and, most often, are detected already with the development of complications such as perforation and abscess formation. Diagnosis of complicated diverticula of the small intestine is difficult due to many other, more common causes of acute abdomen, insufficient use of the capabilities of the methods of radiation diagnosis, the lack of application and correct interpretation of the results of instrumental and special research methods. The article presents a clinical case of perforation of the jejunum diverticulum. The results of effective MDCT diagnosis and successful surgical intervention are presented: laparoscopic resection of the jejunum with the formation of the primary hardware intracorporeal enteroentero-anastomosis side by side. 


2020 ◽  
Vol 2 (Number 2) ◽  
pp. 13-18
Author(s):  
Md. Rezwan Shah ◽  
Md Ataur Rahman ◽  
Tasnia Jukhrif worthy ◽  
Md. Zaki Shahriar Sourav ◽  
Afrina Sharmin ◽  
...  

Acute appendicitis is the most common surgical emergency, with16% of the population undergoing appendectomy. Burst appendix is one of the complications of acute appendicitis and occurs 25% cases that is associated with increased morbidity and mortality and hence regarded as a surgical emergency.1 This study focuses on the pattern of presentation, risk factors, accuracy of clinical diagnosis, morbidity and mortality of patients managed for perforated appendicitis in DMCH. This observational study was carried out in the department of surgery, Dhaka Medical College Hospital, Dhaka, from January 2012 to December 2012.Total 200 cases of suspected burst appendicitis were included in this study. Among the 200 cases of suspected burst appendix patients, majority of the cases 48% were of 25 – 34 years age group. Most of the cases 71% were male and 29% were female. Higher income group of patients are less sufferer 8%, origin of pain from umbilicus 74.50% and from RIF 25.50%, nausea in 71.89%, vomiting in 64.05%, anorexia in 32.67%, fever in 50.32%, diarrhea in 5.22% and abdominal distension in 8.49% cases. Tenderness over RIF was present in 100%cases, rebound tenderness was present 80.39% cases, rigidity over RIF was 84.96% patients, Cough test was positive 54.90% cases, Diffuse abdominal tenderness in 87.58% cases, Abdominal distention in 13.07% cases and absent of bowel sound in 40.52% cases. Maximum number of patients reported after 3-4 days of onset of symptoms. Ultrasonogram shows normal findings in 55.56% and suggesting ruptured appendicitis in 44.44% cases. Operative findings of those patients, 33.33% cases presented with only burst appendix without local sequel and 35.29% cases present with generalized peritonitis, 13.73% cases present with localized peritonitis, 10.46% cases present with localized abscess, 5.23% cases present with periappendiceal fluid collection and extraluminal appendolith present in 1.96% cases. Burst appendix present a challenge to the clinicians because it can be delay in diagnosis, result in delay in operation and can be developed fatal complication. So we emphasize on careful history taking and physical examination in such cases can make the difference between life and death.


2017 ◽  
Vol 4 (3) ◽  
pp. 1024 ◽  
Author(s):  
Sunil Kumar Maini ◽  
Neeraj Kumar Jain ◽  
Manjari Goel Jain ◽  
Vicky Khobragade

Background: Right lower abdominal pain management in children is a challenging task for the surgeon. Most of the time right lower abdominal pain ends up in acute appendicitis. For long time appendicetomy was the treatment of choice. However surgical intervention has its own disadvantages such as pain, scarring, adhesions, hernia development and venous thrombosis disease. Anxiety and fear of surgery were also two difficulties in obtaining consent for surgery. Parents often request and insist for medical management. Their unwillingness for surgical intervention was the most important reason for medical management of uncomplicated acute appendicitis.Methods: Our prospective observational study was conducted in the Department of General Surgery, R.K.D.F. Medical College and Research Centre, Bhopal, Madhya Pradesh, India during period of January 2014 to January 2016 and follow up was done till December 2016. Our target group was children under 16 years. A total of 92 children with complaint of right lower abdominal pain attended the hospital for treatment. Routine investigations including ultrasonography of abdomen were performed for all the patients. Out of 92 patients diagnosis of acute appendicitis was made in 74 patients, Surgery was performed in 32 patients, while remaining 42 patients were treated conservatively and the results were analyzed.Results: In this study of 92 patients of pain in right iliac fossa below 16 years, 74 (80.43%) were diagnosed as acute appendicitis. 32 (43.24%) Patients were operated earlier. 42 (56.75%) Patient were treated conservatively. Out of 42 patients, 12 (16.21%) patients were operated within 1 year, 30 (40.54%) Patients didn’t require any surgical intervention during 1 year follow up. In present study, significant role of antibiotic was found in conservative management of acute appendicitis in children. So it can be concluded that conservative management of acute appendicitis in children can be attempted under observation.Conclusions: Antibiotics are both effective and safe as primary treatment for patients with uncomplicated acute appendicitis. Initial antibiotic treatment merits consideration as a primary treatment option for early uncomplicated appendicitis. Appendicectomy should be done but conservative management of acute appendicitis in children can be attempted under observation.


2019 ◽  
Vol 12 (7) ◽  
pp. e217272 ◽  
Author(s):  
Umasankar Mathuram Thiyagarajan ◽  
Amirthavarshini Ponnuswamy ◽  
Alex Chung

Acute pancreatitis(AP) is one of the common causes of acute abdomen and known to be associated with high morbidity and mortality in severe cases. Though most common causes of AP are cholelithiasis and alcoholism, it has also been reported in association with diabetic ketoacidosis (DKA). Triad of AP, hypertriglyceridaemia (HTG) and DKA is rare co-association and here the causal factor of AP is still not fully established. We report a case of AP in a DKA patient with recent diagnosis of hyperlipidaemia and diabetes. Usually AP has been associated with severe HTG; interestingly, our patient showed only moderate raise in triglycerides but still suffered AP during DKA. Hence, it raises question about the real culprit in this enigmatic triad.


2009 ◽  
Vol 75 (12) ◽  
pp. 1203-1206 ◽  
Author(s):  
M. Wayne Causey ◽  
Michael P. Spencer ◽  
Scott R. Steele

Clostridium difficile infection of the colon is, unfortunately, a relatively common occurrence that typically follows treatment with antibiotics; however, C. difficile infection of the small bowel is a much more rare phenomenon with only 19 cases reported to date. We present three cases of isolated C. difficile enteritis after colectomy. Although all three patients were identified early and successfully treated with medical management without the need for surgical intervention, previous authors have suggested a much higher morbidity and mortality rate with this infection. This article reviews the current available literature on C. difficile enteritis to highlight this potentially serious condition in postoperative colectomy patients who present with low-grade fevers, abdominal or pelvic pain, and increased ileostomy output.


2008 ◽  
Vol 2 (2) ◽  
pp. 165
Author(s):  
Ana Lucia De Faria ◽  
Silvana Novaes ◽  
Monica Silva Gonçalves ◽  
Regina Celia C Peres

ABSTRACTAcute abdomen refers to a not traumatic disorder located in the bowels of the abdominal cavity and classifies itself in five syndromes named, inflammatory perforating, obstructive, hemorrhagic and vascular. The signs and symptoms are: abdominal pain that is installed of quick and sudden form, vomiting, fever, interruption of the elimination of gases and evacuation. The aim was identify the syndromes and the causes of surgeries resulting on acute abdomen in patients interned and submitted to a surgical intervention in a General Hospital of the Taubaté - SP. The research was the type retrospective, documentary, descriptive and quantitative, in the period 2004 to 2006. The results showed that the 91 (100%) cases studied prevailing male in the 55 (60,44%); the surgery occurred more in the age group of 40-49 years in 16 (17,58%); among the signs and symptoms abdominal pain was present in (100%) and vomiting in 41 (29,50%); due to the higher incidence of surgery was acute appendicitis with 45 (49,45%); the predominant syndrome was the inflammatory in 49 (53,85%), but perforating appeared in 23 (25,27%) to be obstructive in 18 (19,78%), vascular in 1 (1,10%) of the cases; the most frequent cause of death was septic shock in 10 (38,46%); the mortality prevailed in the age group between 80 to 89 years old with 5 (45,46%), with perforating syndrome in 6 (54,55%). It is concluded that the inflammatory syndrome and the cause appendicitis were the most frequent. Descriptors: acute abdomen; surgery; mortality.RESUMOAbdome agudo refere-se a uma afecção não traumática, localizada nas vísceras da cavidade abdominal, e classifica-se em cinco síndromes, nomeadas de: inflamatória, perfurativa, obstrutiva, hemorrágica e vascular. Os sinais e sintomas são: dor abdominal que se instala de forma súbita e rápida, vômito, febre, interrupção da eliminação de gases e fezes. O objetivo da pesquisa foi identificar as síndromes e as causas de cirurgias decorrentes do quadro de abdome agudo em pacientes internados e submetidos a uma intervenção cirúrgica em um Hospital Geral de Taubaté - SP. A pesquisa foi do tipo retrospectiva, documental, descritiva e quantitativa, no período de 2004 a 2006. Os resultados mostraram que, dos 91 (100%) casos estudados, o sexo masculino predominou em 55 (60,44%); as cirurgias ocorreram mais na faixa etária de 40-49 anos de idade, em 16 (17,58%); dentre os sinais e sintomas, a dor abdominal esteve presente em 100%, e o vômito, em 41 (29,50%); a causa cirúrgica de maior incidência foi a apendicite aguda, em 45 (49,45%); a síndrome predominante foi a inflamatória, em 49 (53,85%), a perfurativa apareceu em 23 (25.27%), a obstrutiva em 18 (19,78%),e a vascular, em 1 (1,10 %) dos casos; a causa de morte mais frequente foi o choque séptico, em 10 (38,46%); a mortalidade prevaleceu na faixa etária entre 80 e 89 anos de idade, em 5 (45,46%), com síndrome perfurativa em 6 (54,55%). Concluiu-se que a síndrome inflamatória foi predominante e que a apendicite foi a causa mais freqüente de cirurgia. Descritores: abdome agudo; cirurgia; mortalidade.RESUMENAbdomen agudo se refiere a un trastorno no traumático que se  encuentra en las vísceras de la cavidad abdominal y se clasifica en cinco síndromes nombrados de inflamatorio, perforativa, obstructiva, hemorrágica y vasculares. Las señales y síntomas son: dolor abdominal que se instalan de forma repentina y rápida, vómitos, fiebre, interrupción en la eliminación de gases y heces. El objetivo era determinar los síndromes y las causas de cirugías derivadas del cuadro de abdomen agudo en pacientes hospitalizados y sometidos a un procedimiento quirúrgico en el Hospital General del Taubate - SP. La investigación es del tipo retrospectivo, documental, descriptivo y cuantitativo, en el período de 2004 a 2006. Los resultados mostraron que de los 91 (100%) casos estudiados predominó el sexo masculino en 55 (60,44%); La cirugía ocurrieron en más frecuencia en el grupo de edad de 40 -49 años en 16 (17,58%); entre las señales y síntomas el dolor  abdominal estuvo presente en el (100%) y los vómitos en 41 (29,50%) la causa de cirugía de mayor incidencia fue apendicitis aguda con 45 (49,45%); El síndrome predominante  fue la inflamatoria en 49 (53, 85% ), Pero  perforativa apareció en 23 (25,27%), la obstructiva en 18 (19,78%), vasculares en 1 (1,10%) de los casos; la causa más frecuente de muerte fue el  choque séptico, 10 (38,46%); Prevaleció la mortalidad en el grupo de edad entre 80 a 89 años con 5 (45,46%), con síndrome  perforativa en 6 (54,55%). Se concluye que la síndrome inflamatoria y la causa apendicitis fueron las más frecuentes. Descriptores: abdomen agudo; cirurgía; mortalidad. 


Ultrasound ◽  
2005 ◽  
Vol 13 (2) ◽  
pp. 78-85 ◽  
Author(s):  
R.P. Guillerman ◽  
C. S. Ng

Acute appendicitis is a common cause for an 'acute abdomen' and is the most common abdominal condition requiring emergency surgical intervention. Misdiagnosis is fraught with morbid complications, ranging from unnecessary surgery to appendiceal perforation, peritonitis or sepsis. In this article, we discuss the application of ultrasound to the diagnosis of appendicitis. We detail the ultrasound imaging technique, including practical tips and pitfalls, describe the sonographic criteria for the diagnosis of appendicitis, discuss the relative strengths and weaknesses of ultrasound compared with other diagnostic approaches, and review the reported performance of ultrasound in the diagnosis of appendicitis.


2008 ◽  
Vol 15 (01) ◽  
pp. 120-124
Author(s):  
MUHAMMAD ASIF ◽  
JAVED SAJJAD HASHMI ◽  
DANISH ALMAS

Introduction: The term “acute abdomen” denotes any sudden spontaneousnon-traumatic disorder whose chief manifestation is in the abdominal area. There is frequently a progressive underlyingintra-abdominal disorder, the correct early diagnosis and treatment of which is essential for a favorable outcome.Objectives: (I) To find out the most common causes of acute abdomen. (II) To compare the preoperative assessmentwith postoperative diagnosis. Design: A Non-interventional Analytical (Comparative) study. Setting: Emergencydepartment of Combined Military Hospital Kharian. Period: Oct 2001 to Mar 2002. Patients & Methods: Total of 220patients who presented with acute abdomen. Results: The most frequent cause was found to be Acute Appendicitis,followed by Nonspecific abdominal pain, acute cholecystitis, acute intestinal obstruction and perforated duodenal ulcer.Preoperative diagnosis was wrong in 9.5% (n=21) of cases. Conclusion: Acute appendicitis was found to be the mostcommon cause of acute abdomen and the single most important cause of acute abdominal pain causing greatdiagnostic difficulties. the preoperative diagnostic accuracy can be increased especially in female of child bearing ageby using modern diagnostic tools especially laparoscopy.


2021 ◽  
pp. 11-14
Author(s):  
T.Babu Antony ◽  
S. Thirunavukkarasu ◽  
Gokul Prabhu ◽  
Madhan Kumar ◽  
S Kiran kumar

Acute appendicitis is a surgical emergency and requires surgical intervention. This is a study among 30 patients in tertiary care centre in south india to compare the efcacy of early oral feeding compared to traditional late oral feeding. Early oral feeding was found to be superior in all aspects over tradional oral feeding. Hence this can be promoted in all patients undergoing appendicectomy .


2019 ◽  
Vol 6 (4) ◽  
pp. 1408
Author(s):  
Anand Kishore ◽  
Anand Kumar Jaiswal

Acute appendicitis remains the most common acute condition often requiring surgical intervention. Obstruction of appendicular lumen by faecalith or lymphoid hyperplasia is the main cause of acute appendicitis. There is no possible way to prevent the development of acute appendicitis. The only way to reduce morbidity and mortality is by timely intervention and doing appendicectomy before perforation and gangrene of appendix occurs. We report a case of chronic appendicitis by a giant faecolith leading to chronic pain. This case is being reported is an example of how large an appendiceal faecalith can be.


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