scholarly journals Appendicitis in Children: Fundamentals and Particularities

2021 ◽  
Author(s):  
Alin Villalobos Castillejos ◽  
Carlos Baeza Herrera ◽  
Miguel Alejandro Sánchez Durán ◽  
Jhonatan Mata Aranda ◽  
Miguel Ángel Minero Hibert ◽  
...  
Keyword(s):  
Decision Making ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Clinical Picture ◽  
Pediatric Patients ◽  
Surgical Intervention ◽  
Clinical Signs ◽  
Good Sense ◽  
Diagnostic Challenge ◽  
Full Capacity

Acute appendicitis in children under 5 years of age is a diagnostic challenge, its delay is usually dramatic and leaves serious sequelae. It is one of the main causes of surgical intervention, it is common for other diseases to be associated with it and to simulate it. Acute appendicitis is of obstructive etiology and its pathophysiology, the bacteriology involved and the evolution of the disease progresses through its phases, from the simple to the complex, is addressed in each case. The typical abdominal pain of appendicitis, in addition to vomiting and fever at a young age, is most often accompanied by an atypical clinical picture such as diarrhea. Integrating the clinical signs at this age requires the full capacity and good sense of the pediatric surgeon. For a correct and timely diagnosis, unfortunately many pediatric patients present in complicated stages of the disease, which implies decision-making regarding the type of surgical intervention and subsequent treatments.

scholarly journals Torsion of cecal appendix. Report of the first Italian case and review of the literature

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
Salvatore Fabio Chiarenza ◽  
Lorenzo Costa ◽  
Cosimo Bleve
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Pediatric Patients ◽  
Clinical Presentation ◽  
Clinical Signs ◽  
Rare Condition ◽  
Vermiform Appendix ◽  
Lower Quadrant ◽  
Italian Case ◽  
Right Lower Quadrant

In pediatric patients appendicitis is the most common cause of abdominal pain and surgery. Torsion of vermiform appendix is a rare cause, clinically indistinguishable from appendicitis with usually an intraoperative diagnosis. The first description of vermiform appendix torsion was made by Payne in 1918. Clinical presentation is similar to acute appendicitis. Preoperative investigations play a minimal role. Etiology of this condition is unclear, but is possible to distinguish a primary and a secondary torsion. We report a case of 5-years-old boy who presented with right lower quadrant abdominal pain. His clinical signs, symptoms and investigations mimicked an acute appendicitis. Intraoperatively we found a 720° appendix torsion on its base with its mesentery rotated in counter-clockwise direction. The appendix was gangrenous in appearance. A video-assisted trans-umbilical appendectomy was performed. We describe clinical presentation and management of this rare condition reviewing the literature.

A COMPREHENSIVE STUDY ON ACUTE NON-TRAUMATIC ABDOMINAL EMERGENCIES

2021 ◽  
pp. 14-16
Author(s):  
Md. Quamar Zubair ◽  
A. K. Jha Suman
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Surgical Intervention ◽  
Age Groups ◽  
Diagnostic Procedures ◽  
Accurate Diagnosis ◽  
Postoperative Patient ◽  
Correct Treatment ◽  
Abdominal Emergencies ◽  
Comprehensive Study

Abdominal pain is one of the most common reasons for visit to the emergency room. Acute appendicitis is the commonest cause. An accurate diagnosis is essential for the correct treatment, which in many cases will prevent the death of the patient. Mainstay of diagnosis is history and physical examination. If this information is inadequate to establish a diagnosis and urgent or immediate operation is unnecessary, the periodic re-examination helps document the progression of the disease and often avoids unnecessary surgical intervention. Today the combination of improved diagnostic procedures, antibiotic and better anaesthesia and preoperative and postoperative patient care has led to a decrease in morbidity and mortality of patients with acute abdomen. The objective of this study was to determine the various causes of nontraumatic acute abdominal emergencies, their incidence, management and mortality in both sexes and all age groups >12 years age.

scholarly journals Acute Appendicitis Secondary to Appendiceal Endometriosis

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
João Paulo Nunes Drumond ◽  
André Luis Alves de Melo ◽  
Demétrius Eduardo Germini ◽  
Alexander Charles Morrell
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Clinical Picture ◽  
Acute Abdominal Pain ◽  
Rare Condition ◽  
Vermiform Appendix ◽  
Histopathological Analysis ◽  
Women Of Childbearing Age ◽  
Childbearing Age

Endometriosis in the vermiform appendix is a rare condition that affects women of childbearing age. The clinical picture can simulate inflammatory acute abdominal pain, especially acute appendicitis. Laboratory and imaging tests may assist in the diagnosis but are not conclusive. This article reports a case of acute appendicitis caused by appendiceal endometriosis for which laparoscopic appendectomy and diagnostic confirmation were performed after histopathological analysis.

A novel biomarker panel to rule out acute appendicitis in pediatric patients with abdominal pain

2013 ◽  
Vol 31 (9) ◽  
pp. 1368-1375 ◽  
Author(s):  
David S. Huckins ◽  
Harold K. Simon ◽  
Karen Copeland ◽  
David M. Spiro ◽  
Joseph Gogain ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Pediatric Patients ◽  
Biomarker Panel ◽  
Rule Out

scholarly journals Etiologies of abdominal pain emergencies in pediatrics

2021 ◽  
Author(s):  
Hala Atta Youssef ◽  
Aishah Mohammad Alkhaldi ◽  
Manar Mohammed Alshahrani ◽  
Abdullah Tariq Almalki ◽  
Amjad Ali Alahmari ◽  
...  
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Pediatric Patients ◽  
Surgical Intervention ◽  
Acute Abdominal Pain ◽  
Clinical Importance ◽  
Healthcare Settings ◽  
Common Causes ◽  
The Common ◽  
Attending Physicians

Reports showed that children usually complained of acute abdominal pain, which indicated the presence of severe underlying conditions and can have significant clinical importance. Serious challenges have been reported in healthcare settings where an urgent evaluation of the cases was necessary to adequately manage the patient before developing serious complications that might even end up with death. Some of these conditions included intussusception, appendicitis, volvulus and adhesions. Although estimates indicated that only around 1% of pediatric patients with acute abdominal pain usually required surgical intervention, concerns regarding the overlooking and misdiagnosis of significant conditions that might have severe prognostic outcomes were aroused among the different emergency departments. This study reviewed the common causes of acute abdominal pain among children admitted to the emergency department. Our results indicated that various etiologies can develop acute abdominal pain and therefore, establishing an adequate diagnosis by differentiating between the different etiologies should be done by the attending physicians to enhance the outcomes and adequately manage the admitted patients. Gastrointestinal causes of acute abdominal pain were the commonest to cause admissions to the emergency department. However, care should also be provided to the less common conditions, which might include genitourinary and pulmonary disorders and therefore, a thorough examination of children should be provided not to conduct a misdiagnosis of the underlying condition.

scholarly journals A study of correlation between clinical, radiological and pathological diagnosis of appendicitis: a retrospective analytic study

2018 ◽  
Vol 5 (9) ◽  
pp. 3011
Author(s):  
Prabhu R. ◽  
Vijayakumar C. ◽  
Balagurunathan K. ◽  
Senthil Velan M. ◽  
Kalaiarasi R. ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Scoring System ◽  
Acute Abdominal Pain ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Radiological Finding ◽  
Clinical Signs ◽  
Emergency Setting ◽  
Alvarado Score

Background: Acute appendicitis is the most common cause of acute abdominal pain in young adults requiring emergency surgery. Appendicectomy is the most frequently performed surgery. The diagnosis is often challenging and the decision to operate in an emergency setting is always debatable. A combination of clinical signs and symptoms with laboratory findings in many scoring systems are suggesting the probability of appendicitis and the possible subsequent management pathway. The aim was to evaluate accuracy of the clinical Alvarado scoring system, radiological finding and histopathological examination for the diagnosis of acute appendicitis.Methods: A retrospective study was conducted in the department of general surgery in a tertiary care centre in South India. Total of 237 patients with acute abdominal pain were included and evaluated with the clinical Alvarado scoring system, radiological finding with (USG/CT abdomen) and histopathological examination for the diagnosis of acute appendicitis. The data was collected and analyzed retrospectively.Results: Of the 237 patients, 164 patients were male (69.1%) and rest is female. The correlation of the Alvaroda score with histopathological findings in groups with score > 7 and ≤7 the correlation of Alvarado score and the ultrasound findings were comparable between the study groups. The sensitivity of ultrasound in diagnosing acute appendicitis in patients with Alvarado score >7 was 72.99%. The sensitivity of ultrasound in diagnosing acute appendicitis in patients with Alvarado score ≤7 was decreased to 27%.Conclusions: The diagnostic accuracy of clinical features is far better than radiological investigations in the diagnosis of acute appendicitis. Therefore, it is concluded that it is better to use radiological investigations only to confirm the diagnosis of acute appendicitis rather to diagnose it.

scholarly journals Double acute appendicitis: cecal and epiploic; literature review of a case report

2020 ◽  
Vol 8 (12) ◽  
pp. 4512
Author(s):  
Camilo Levi Acuna Pinzon ◽  
Jose Luis Chavaria Chavira ◽  
Jefferson Fabian Nieves Condoy ◽  
Claudia Ortiz Ledesma
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Acute Appendicitis ◽  
Blood Test ◽  
Unusual Case ◽  
Surgical Intervention ◽  
Simultaneous Presentation ◽  
Pelvic Cavity ◽  
Initial Blood ◽  
Suspected Diagnosis

Acute cecal appendicitis and appendagitis are two entities due to the inflammation of the cecal and epiploic appendix respectively. A case of a 34-year-old woman is presented, who is admitted for abdominal pain. Initial blood test and ultrasonography were not conclusive, subsequently with clinical deterioration, surgical intervention was required which noted acute appendicitis and appendicitis that were removed. This is an extremely unusual case, since the simultaneous presentation of these two entities has not been widely described and demonstrates the importance of exploring the abdominal and pelvic cavity in patients with suspected diagnosis of acute appendicitis.

scholarly journals Conservative management of early uncomplicated appendicitis in children

2017 ◽  
Vol 4 (3) ◽  
pp. 1024 ◽  
Author(s):  
Sunil Kumar Maini ◽  
Neeraj Kumar Jain ◽  
Manjari Goel Jain ◽  
Vicky Khobragade
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Conservative Management ◽  
Medical Management ◽  
Surgical Intervention ◽  
Lower Abdominal Pain ◽  
Primary Treatment ◽  
Research Centre ◽  
Uncomplicated Appendicitis

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.

Onyx embolization of a thoracolumbar perimedullary spinal arteriovenous fistula in an infant presenting with subarachnoid and intraventricular hemorrhage

2009 ◽  
Vol 3 (3) ◽  
pp. 211-214 ◽  
Author(s):  
Tyler J. Kenning ◽  
Eric M. Deshaies ◽  
Matthew A. Adamo ◽  
John B. Waldman ◽  
Alan S. Boulos
Keyword(s):  
Intraventricular Hemorrhage ◽  
Pediatric Patients ◽  
Surgical Intervention ◽  
Resonance Imaging ◽  
Diagnostic Challenge ◽  
Negative Results ◽  
Spinal Arteriovenous Fistula ◽  
Diagnostic Angiography ◽  
Spontaneous Subarachnoid Hemorrhage ◽  
The Brain

Identifying a source of spontaneous subarachnoid hemorrhage (SAH) or intraventricular hemorrhage (IVH) in patients with negative results on cranial angiographic imaging can be a diagnostic challenge. The authors present the case of a 14-month-old girl who presented with lethargy and spontaneous SAH and IVH, and later became acutely paraplegic. Except for the SAH and IVH, findings on neuroimages of the brain were normal. Magnetic resonance imaging revealed an intramedullary thoracolumbar spinal cord hemorrhage that was found to be associated with arterialized veins intraoperatively. Catheter-based diagnostic angiography identified a spinal perimedullary macroarteriovenous fistula (macro-AVF) that was completely embolized with Onyx, negating the need for further surgical intervention. The authors believe this to be the first reported case of a thoracolumbar perimedullary macro-AVF presenting with SAH and IVH. In addition, descriptions of Onyx embolization of a spinal AVF in the literature are rare, especially in pediatric patients.

Appendix

2020 ◽  
pp. 15-26
Author(s):  
Jad M. Abdelsattar ◽  
Moustafa M. El Khatib ◽  
T. K. Pandian ◽  
Samuel J. Allen ◽  
David R. Farley
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Clinical Diagnosis ◽  
Surgical Intervention ◽  
Open Appendectomy ◽  
Wound Dehiscence ◽  
Signs And Symptoms ◽  
Wound Infections ◽  
Deep Wound ◽  
Blind Ending

The appendix is an antimesenteric cecal outpouching that forms in the fifth month of gestation. It is a hollow, blind-ending tube approximately 11 cm in length and less than 6 mm in diameter. Obstruction of the appendiceal lumen with a fecalith, or less commonly foreign bodies, worms, and lymphadenopathy, may result in swelling of the appendix. Patients present with periumbilical abdominal pain. Acute appendicitis is a clinical diagnosis. The majority of patients with signs and symptoms of acute appendicitis should receive prompt surgical intervention. Laparoscopic or open appendectomy can be associated with ileus, superficial or deep wound infections, GI leak, bleeding or hematoma, wound dehiscence, or hernia.

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