scholarly journals Duplicate Appendix With Acute Ruptured Appendicitis: A Case Report

2015 ◽  
Vol 100 (4) ◽  
pp. 662-665 ◽  
Author(s):  
Sharique Nazir ◽  
Alex Bulanov ◽  
Mohammed Iyoob Mohammed Ilyas ◽  
Ibrahim I. Jabbour ◽  
Larry Griffith
Keyword(s):  
Diagnostic Laparoscopy ◽  
Medical Literature ◽  
The Other ◽  
Associated Anomalies ◽  
Blood Cell Count ◽  
Lower Quadrant ◽  
Rare Congenital Anomaly ◽  
Life Threatening ◽  
The Right ◽  
Right Lower Quadrant

Duplication of the appendix is a rare congenital anomaly that, in adults, is most often found incidentally during surgery for other reasons. Appendicitis in the duplicated appendix is very rare and has been reported less than 10 times in the medical literature. We describe a 33-year-old woman with worsening periumbilical pain, nausea, vomiting, and fever. Physical examination showed localized peritonitis in the right lower quadrant. She had an elevated white blood cell count with neutrophilia. Computed tomography showed acute ruptured appendicitis. Diagnostic laparoscopy showed 2 appendices attached via separate bases to a single cecum with no other concurrent anomalies. Both appendices were removed laparoscopically. Histopathology confirmed normal appendiceal tissue in one and severe acute transmural appendicitis in the other. Awareness of appendiceal duplication and a thorough intraoperative inspection are critical to assess the presence of significant associated anomalies and avoid life-threatening complications.

scholarly journals Appendiceal Endometriosis: A Rare Cause of Acute Appendicitis

2020 ◽  
Vol 3 (5) ◽  
pp. 01-03
Author(s):  
Georgios Koimtzis
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Laparoscopy ◽  
Reproductive Organs ◽  
Lymphoid Hyperplasia ◽  
Reproductive Age ◽  
Histologic Examination ◽  
Diagnostic Process ◽  
Lower Quadrant ◽  
The Right ◽  
Right Lower Quadrant

Background: Acute appendicitis is the most common cause of acute abdomen. The etiology has not been defined clearly but potential causes are fecoliths, lymphoid hyperplasia and malignancies. However, an extremely uncommon cause of acute appendicitis is endometriosis which leads to dilemmas in the diagnostic process. Case report: A 21-year-old Caucasian female patient presented in the Emergency department complaining of acute progressive abdominal pain in the right lower quadrant. The physical examination revealed signs consistent with acute appendicitis. The patient underwent diagnostic laparoscopy, which revealed early inflammation of the appendix and thus was subjected to appendicectomy. Histologic examination revealed endometriosis of the appendix. Conclusion: The presented case emphasizes on how endometriosis can affect only the appendix without any involvement of the reproductive organs. A high index of clinical suspicion is required especially in women of reproductive age who present with periodic chronic pain associated with their menstrual cycle. Nonetheless, this can only be confirmed through diagnostic laparoscopy and histologic examination, which also provides the definite cure of the disease.

scholarly journals Intestinal obstruction caused by pericecal internal herniation

2020 ◽  
Vol 2020 (2) ◽  
Author(s):  
Floris B Poelmann ◽  
Ewoud H Jutte ◽  
Jean Pierre E N Pierie
Keyword(s):  
Abdominal Pain ◽  
Intestinal Obstruction ◽  
Acute Abdominal Pain ◽  
Treatment Preference ◽  
Treatment Modalities ◽  
Internal Herniation ◽  
Lower Quadrant ◽  
Surgical History ◽  
The Right ◽  
Right Lower Quadrant

Abstract Intestinal obstruction caused by pericecal internal herniation are rare and only described in a few cases. This case describes an 80-year-old man presented with acute abdominal pain, nausea and vomiting, with no prior surgical history. Computed tomography was performed and showed a closed loop short bowel obstruction in the right lower quadrant and ascites. Laparoscopy revealed pericecal internal hernia. This is a viscous protrusion through a defect in the peritoneal cavity. Current operative treatment modalities include minimally invasive surgery. Laparoscopic repair of internal herniation is possible and feasible in experienced hands. It must be included in the differential diagnoses of every patient who presents with abdominal pain. When diagnosed act quick and thorough and expeditiously. Treatment preference should be a laparoscopic procedure.

Appendicitis: a rare adverse event in colonoscopy

2021 ◽  
Vol 14 (7) ◽  
pp. e242523
Author(s):  
Samer Al-Dury ◽  
Mohammad Khalil ◽  
Riadh Sadik ◽  
Per Hedenström
Keyword(s):  
Emergency Department ◽  
Adverse Event ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Physical Examination ◽  
De Novo ◽  
Perforated Appendicitis ◽  
Lower Quadrant ◽  
The Right ◽  
Right Lower Quadrant

We present a case of a 41-year-old woman who visited the emergency department (ED) with acute abdomen. She was diagnosed with perforated appendicitis and abscess formation on CT. She was treated conservatively with antibiotics and discharged. On control CT 3 months later, the appendix had healed, but signs of thickening of the terminal ileum were noticed and colonoscopy was performed, which was uneventful and showed no signs of inflammation. Twelve hours later, she developed pain in the right lower quadrant, followed by fever, and visited the ED. Physical examination and blood work showed signs consistent with acute appendicitis, and appendectomy was performed laparoscopically 6 hours later. The patient recovered remarkably shortly afterwards. Whether colonoscopy resulted in de novo appendicitis or exacerbated an already existing inflammation remains unknown. However, endoscopists should be aware of this rare, yet serious complication and consider it in the workup of post-colonoscopy abdominal pain.

Appendicitis

2016 ◽  
Author(s):  
David Scordino
Keyword(s):  
Antibiotic Therapy ◽  
Acute Inflammation ◽  
Surgical Intervention ◽  
Significant Risk ◽  
Disease Course ◽  
Lower Quadrant ◽  
Nonoperative Therapy ◽  
Atypical Presentations ◽  
The Right ◽  
Right Lower Quadrant

Appendicitis is caused by acute inflammation of the appendix (usually secondary to obstruction) and can result in perforation, leading to peritonitis, sepsis, and/or abscess formation. Symptomatology includes anorexia, nausea, vomiting, and periumbilical pain (later localizing to the right lower quadrant). Patients at the extremes of age and pregnant women may have atypical presentations and higher rates of perforation and complications. Most patients suspected of having appendicitis receive prompt surgical intervention (usually laparoscopic). Antibiotic therapy, initiated preoperatively, varies for perforated vs nonperforated appendicitis. In patients with evidence of a contained abscess, nonoperative therapy is considered, as abscess is evidence of a prolonged disease course (more than 5 days) prior to presentation. On imaging, patients may have a well-circumscribed abscess or phlegmon; if immediate surgical intervention is attempted, there is significant risk of morbidity due to adhesions to adjacent tissues.

scholarly journals Analysis of Answers to Queries among Anonymous Users with Gastroenterological Problems on an Internet Forum

2020 ◽  
Vol 17 (3) ◽  
pp. 1042 ◽  
Author(s):  
Mikołaj Kamiński ◽  
Michał Borger ◽  
Piotr Prymas ◽  
Agnieszka Muth ◽  
Adam Stachowski ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Weight Loss ◽  
Lower Quadrant ◽  
Diagnostic Interpretation ◽  
Related Information ◽  
Health Related ◽  
Life Threatening ◽  
Inflammatory Bowel ◽  
Internet Forums ◽  
Right Lower Quadrant

Internet forums are an attractive source of health-related information. We aimed to investigate threads in the gastroenterological section of a popular Polish medical forum for anonymous users. We characterised the following aspects in threads: the main problem of the original poster, declared ailments and rationale of the responses (rational, neutral, harmful or not related to the problem of the original poster). We analysed over 2717 forum threads initiated in the years 2010–2018. Users mostly asked for diagnosis of the problem [1814 (66.8%)], treatment [1056 (38.9%)] and diagnostic interpretation [308 (11.3%)]. The most commonly declared symptoms were abdominal pain [1046 (38.5%)], diarrhea [454 (16.7%)] and bloating [354 (13.0%)]. Alarm symptoms were mentioned in 309 (11.4%) threads. From the total 3550 responses, 1257 (35.4%) were assessed as rational, 693 (19.5%) as neutral, 157 (4.4%) as harmful and 1440 (40.6%) as not related to the user’s problem. The original poster’s declaration of blood in stool, dyspepsia, pain in the abdominal right lower quadrant, weight loss or inflammatory bowel disease was positively related to obtaining at least one potentially harmful response. Advice from anonymous users on Internet forums may be irrational and disregards alarm symptoms, which can delay the diagnosis of life-threatening diseases.

The Management of Terminal Ileum Diverticulitis

2009 ◽  
Vol 75 (12) ◽  
pp. 1199-1202 ◽  
Author(s):  
Hyoung-Chul Park ◽  
Bong Hwa Lee
Keyword(s):  
Clinical Features ◽  
Terminal Ileum ◽  
Nonoperative Management ◽  
Perforated Diverticulitis ◽  
Radiographic Evaluation ◽  
Lower Quadrant ◽  
Average Hospital ◽  
The Right ◽  
Right Lower Quadrant

Terminal ileum diverticulitis is a very rare disease that may lead to an acute abdomen mimicking appendicitis. Because of its rarity, an optimal treatment for this disease has not been established yet. In this study, we evaluated the clinical features and outcomes of nonoperative management of terminal ileum diverticulitis, including suspected perforation. From 2000 to 2007, 346 patients were treated for acute symptomatic right-sided diverticulitis. Radiographic evaluation revealed that nine patients (2.6%) had terminal ileum diverticulitis. All patients presented with pain in the right lower quadrant. The clinical features and outcomes, including recurrence, were evaluated from a collected database and by phone interview. The average age of the patients was 43.7 years. Radiographic imaging was used to diagnose diverticulitis in all patients. Two of nine patients had suspected perforated diverticulitis, and three patients had multiple diverticula. Nonoperative management was successfully carried out on these patients. The average hospital stay was 8 days and the duration of antibiotic treatment was 6.4 days. The median follow-up was 36 months, and patients showed no recurrence within this interval. Nonoperative management may be feasible to treat terminal ileum diverticulitis.

scholarly journals Isolated intestinal Ganglioneuromatosis: case report and literature review

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Angela Mauro ◽  
Letizia Zenzeri ◽  
Francesco Esposito ◽  
Giovanni Gaglione ◽  
Caterina Strisciuglio ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Polypoid Lesion ◽  
Occult Blood ◽  
Fecal Occult Blood ◽  
Ileal Loop ◽  
Lower Quadrant ◽  
Blood Tests ◽  
Fecal Occult ◽  
The Right ◽  
Right Lower Quadrant

Abstract Background Intestinal Ganglioneuromatosis (IG) is a rare disorder of the enteric nervous system. In pediatric age it is often associated with genetic syndromes such as Neurofibromatosis 1 (NF1), multiple endocrine neoplasia type 2B (MEN2B) and Cowden syndrome (PTEN mutation), and ganglioneuromas (GNs) may be sometimes the first sign of the disease. Isolated GNs are rare and sporadic. Clinical symptom vary and depend on the size and on the location of the GNs. This disorder affects intestinal motility and it, consequently, causes changes in bowel habits, abdominal pain, occlusive symptoms and rarely lower gastrointestinal bleeding secondary to ulceration of the intestinal mucosa. On the other hand, patients can remain asymptomatic for many years. Case presentation We describe a 9-year-old boy referred to our emergency department for right lower quadrant abdominal pain. No familial history for gastrointestinal disorders. No history of fever or weight loss. At physical examination, he had diffused abdominal pain. Abdominal ultrasonography showed a hypoechoic formation measuring 41.8 mm by 35 mm in the right lower quadrant of the abdomen. Routine blood tests were normal, but fecal occult blood test was positive. Abdominal TC confirmed the hypodense formation, of about 5 cm in transverse diameter, in the right hypochondrium that apparently invaginated in the caecum-last ileal loop. Colonoscopy showed in the cecum an invaginated polypoid lesion of the terminal ileal loop. Laparoscopic resection of the polypoid lesion was performed. Histological diagnosis of the large neoplasm observed in the terminal ileum was diffuse ganglioneuromatosis. NF1, RET and PTEN gene tests resulted negative for specific mutations. At the 1 year follow-up, the patient presented good general condition and blood tests, fecal occult blood test, esophagogastroduodenoscopy, colonoscopy and MR-enterography were negative. Conclusions Only few cases are reported in literature of IG in pediatric age. Although rare, the present case suggests that this disorder must be taken in consideration in every patient with GI symptoms such as abdominal pain, constipation, lower intestinal bleeding, in order to avoid a delayed diagnosis.

First report of the simultaneous occurrence of choroid plexus papilloma and meningioma in a dog

2009 ◽  
Vol 57 (3) ◽  
pp. 389-397 ◽  
Author(s):  
Luciano Espino ◽  
Maruska Suarez ◽  
German Santamarina ◽  
Mónica Vila ◽  
Natalia Miño ◽  
...  
Keyword(s):  
Choroid Plexus ◽  
Medical Literature ◽  
Choroid Plexus Papilloma ◽  
The Other ◽  
Simultaneous Occurrence ◽  
Falx Cerebri ◽  
History Of ◽  
The Central Nervous System ◽  
The Right ◽  
Plexus Papilloma

A 7-year-old spayed female English Cocker Spaniel was examined because of a 1-week history of lethargy, stumbling over objects and circling, and the presence of two tonic-clonic generalised seizures two days before presentation. The neurological signs suggested a lesion involving the right forebrain. Computed tomography revealed the presence of two intracranial masses, one located inside the right lateral ventricle and the other located in the right frontal lobe attached to the falx cerebri. Because of the poor prognosis, the owner refused to continue with the therapy and the dog was euthanised. On postmortem examination one mass was diagnosed histologically as a meningioma and the other as a papilloma of the choroid plexus. Information in the veterinary literature on multiple malignancies affecting the central nervous system is very limited. To the best of the authors’ knowledge, the association of meningioma and choroid plexus papilloma has never been reported either in the human or in the veterinary medical literature.

Leukopenie – ein diagnostischer Leitfaden für die Praxis

2017 ◽  
Vol 142 (23) ◽  
pp. 1744-1749 ◽  
Author(s):  
Deborah Christen ◽  
Tim Brümmendorf ◽  
Jens Panse
Keyword(s):  
Bone Marrow ◽  
Platelet Count ◽  
Blood Smear ◽  
Peripheral Blood Smear ◽  
Blood Cell Count ◽  
Essential Step ◽  
Cell Counts ◽  
Life Threatening ◽  
Red Blood Cell Count ◽  
The Right

AbstractReasons for leukopenia can be numerous. To get close to the diagnosis it’s always useful to check previous blood counts of the patient to get a feeling for the dynamic development of the leukopenia. Furthermore, it’s important to check the red blood cell count and platelet count as well; a bi- or a pancytopenia usually implies an insufficient production in the bone marrow. Nevertheless, a manual counted peripheral blood smear is an essential step towards the right diagnosis in leukopenia: Beside cell counts of the single subgroups of leucocytes it also provides information on potential causes such as dysplasia.Leukopenia can be life-threatening for the patient especially if the patient presents with an agranulocytosis and fever: In this case admission is mandatory and the patient has to be treated immediately with broad-spectrum antibiotics to reduce mortality.

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