scholarly journals Torsion of caecal appendices epiploicae: mimicking acute appendicitis

2020 ◽  
Vol 7 (7) ◽  
pp. 2407
Author(s):  
A. P. Roshini ◽  
Dattaprasad Samant ◽  
F. P. Noronha
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Iliac Fossa ◽  
Lower Abdominal Pain ◽  
Free Fluid ◽  
Normal Appendix ◽  
Menstrual Cycles ◽  
Rebound Tenderness ◽  
Appendices Epiploicae ◽  
The Right

Acute appendicitis is a common cause for pain in the right iliac fossa, which requires urgent surgical intervention. However, at the time of surgery, if the appendix is normal, the surgeon has to search for other causes of acute abdominal pain including rare etiologies, such as torsion of appendices epiploicae and subsequently its gangrene. We report the case of a 45 years old female who presented with right lower abdominal pain, rebound tenderness and guarding in right iliac fosse, with regular menstrual cycles and no urinary complaints. Investigation revealed leucocytosis and ultra-sonography abdomen was suggestive of an inflamed appendix in the right iliac fossa with free fluid. Intra-operatively, we found a normal appendix with gangrene of the appendices epiploicae which had undergone torsion. She underwent excision off appendices epiploicae with appendicectomy with uneventful post-operative period. Histopathology of the appendices was suggestive of congestion.  Preoperative diagnosis of this condition is rarely made.

scholarly journals Caecal Epiploic Appendagitis Masquerading Clinically as an Acute Appendicitis: A Case Report and Brief Literature Review

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Tallat Ejaz ◽  
Eltaib Saad ◽  
Andik Nabil ◽  
James Slattery
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Iliac Fossa ◽  
Lower Abdominal Pain ◽  
Good Health ◽  
Final Diagnosis ◽  
Epiploic Appendagitis ◽  
Rebound Tenderness ◽  
History Of ◽  
The Right

A 46-year-old female presented to our emergency department (ED) with a 2-day history of right lower abdominal pain which was associated with nausea and anorexia. Abdominal examination revealed tenderness in the right iliac fossa (RIF) with rebound tenderness and a localized guarding. Urine dipstick was normal, and the pregnancy test was negative. Her laboratory investigations were significant only for a CRP of 16.6. A presumptive clinical diagnosis of acute appendicitis was suggested based on the given history and relevant physical signs. However, an abdominal computed tomography (CT) scan revealed an epiploic appendagitis of the caecum with a normal-looking appendix. She was managed conservatively and responded well and was discharged after 2 days in good health. Though being a relatively rare case of acute localized right-sided lower abdominal pain, caecal epiploic appendagitis should be considered as one of the differential diagnoses with the final diagnosis reached usually by the radiological findings due to the nonspecific nature of clinical and laboratory features.

scholarly journals Idiopathic Omental Infarction, Diagnosed and Managed Laparoscopically: A Case Report

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Ahmed AbdulAziz ◽  
Tamer El Zalabany ◽  
Abdul Rahim Al Sayed ◽  
Ahmed Al Ansari
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Clinical Finding ◽  
Iliac Fossa ◽  
Sudden Onset ◽  
Free Fluid ◽  
Lower Quadrant ◽  
Omental Infarction ◽  
Rebound Tenderness ◽  
The Right

Idiopathic omental infarction is a rare cause of acute abdomen in adults, and the clinical finding can mimic acute appendicitis. Although idiopathic omental infarction is uncommon, the incidence of its detection has become more frequent as a result of advances in radiological technologies. We reported on a 21-year-old man who presented with sudden onset of intermittent right lower quadrant abdominal pain for seven days. The pain became more localized at the right iliac fossa (RIF) at day 2 before admission. A physical examination revealed a fever (38.2∘C), severe RIF tenderness, mass-like fullness, and positive rebound tenderness. A CT of the abdomen showed inflammatory changes and increased fat density mass in the right upper quadrant measuring5×4 cm representing focal panniculitis. However, the appendix was visualized normally and the findings were not in favor of acute appendicitis. Diagnosis was carried on laparoscopically. Serosanguinous free fluid was found in all abdominal quadrants. A6×4 cm gangrenous omental mass was noted. The omental mass was excised and an appendectomy was performed. In summary, omental infarction should be considered as a deferential diagnosis for acute right-sided abdominal pain, especially if the clinical finding does not correspond to appendicitis.

scholarly journals A Retrospective Analysis of Acute Appendicitis in Children Treated with Laparoscopic Appendectomies at a Single Center in Dubai, UAE

2021 ◽  
pp. 1-6
Author(s):  
Saad Syed ◽  
Hussein Naji
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Ct Scan ◽  
Laparoscopic Appendectomy ◽  
Pediatric Population ◽  
Iliac Fossa ◽  
Demographic Data ◽  
Free Fluid ◽  
Rebound Tenderness ◽  
The Right

<b><i>Background:</i></b> Appendicitis is one of the most common emergency conditions that occur in the pediatric population. The condition is usually suspected clinically, and the diagnosis is confirmed by radiological investigations such as ultrasound, CT scan, or MRI. This study was conducted to contribute to global databases by presenting data from the Middle East with an objective of identifying the clinical characteristics of children who were diagnosed with acute appendicitis and underwent laparoscopic appendectomy at a single pediatric surgery center in Dubai. <b><i>Methods:</i></b> A 2-year hospital-based retrospective cohort study was conducted at Mediclinic Parkview Hospital, Dubai, enrolling all patients younger than 14 years who were diagnosed with acute appendicitis and who underwent laparoscopic appendectomy. Demographic data, clinical presentation, laboratory, radiological and pathology findings, postoperative complications, and readmission rates were analyzed. <b><i>Results:</i></b> Fifty-six patients were operated on and enrolled in this study. All patients (56/56) presented with abdominal pain, while an associated fever was present in 44.6% (25/56); 78.5% (44/56) of the patients had nausea but 64.3% (36/56) had vomiting. On examination, all patients had abdominal tenderness, while rebound tenderness in the right iliac fossa (RIF) was found in 92.8% (52/56) of the patients. Laboratory investigations showed elevated leukocyte count in 76.7% (43/56) of patients. Appendicitis was diagnosed on ultrasound in 57.4% (31/54) of the patients, and free fluid was visualized in 40.7% (22/54) of the patients. Appendicitis was diagnosed on CT scan in all 25 patients, and free fluid was visualized in 64% (16/25) of the patients. The number of admission days ranged from 1 to 5 days, with a median of 2 days. And 62.5% (35/56) of patients were discharged in the first 2 days from admission. Major and minor complications after surgery were documented in 4 and 14 patients, respectively. Pathology reports showed features of acute appendicitis in all the resected appendices. <b><i>Conclusions:</i></b> Acute appendicitis in children should be suspected in all children with acute abdominal pain. This study can help guide the management of pediatric appendicitis and allow proper and standardized documentation of findings and judicious use of laboratory and radiological investigations.

scholarly journals Amyand's hernia and acute appendicitis: Case presentation in Basic Hospital of Chone

2020 ◽  
Vol 4 (2) ◽  
pp. 19-23
Author(s):  
Orelvis Rodríguez Palmero ◽  
Liseidy Ordaz Marin ◽  
María Del Rosario Herrera Velázquez ◽  
Agustín Marcos García Andrade
Keyword(s):  
Abdominal Pain ◽  
Inguinal Hernia ◽  
Acute Appendicitis ◽  
Physical Examination ◽  
Iliac Fossa ◽  
Amyand’S Hernia ◽  
Case Presentation ◽  
The North ◽  
History Of ◽  
The Right

Present the case of a 66-year-old male patient, with a history of right inguinal hernia, who was referred to the emergency room at the IESS de Chone Basic Hospital in the north of the Manabí province, Ecuador, with symptoms of Abdominal pain of more than 24 hours of evolution located in the right iliac fossa and inguinal region on the same side, in the physical examination the hernia was impossible to reduce, so he was taken to the operating room, in the intervention the cecal appendix was found swollen within the hernial sac, a condition known as Amyand's hernia.

Torsion of a parasitic leiomyoma: a rare but important differential in women presenting with lower abdominal pain

2021 ◽  
Vol 14 (1) ◽  
pp. e232797
Author(s):  
Clemmie Stebbings ◽  
Ahmed Latif ◽  
Janakan Gnananandan
Keyword(s):  
Abdominal Pain ◽  
Iliac Fossa ◽  
Lower Abdominal Pain ◽  
Sudden Onset ◽  
Greater Omentum ◽  
Caribbean Woman ◽  
History Of ◽  
Right Iliac Fossa Pain ◽  
The Right ◽  
Fat Stranding

A 39-year-old multiparous Afro-Caribbean woman attended the emergency department with sudden-onset severe right iliac fossa pain. Her inflammatory markers were mildly elevated. Computerised tomography of the abdomen demonstrated features of fat stranding in the right iliac fossa suspicious of acute appendicitis. The scan also noted uterine leiomyomas. The patient was taken to theatre for an emergency diagnostic laparoscopy where her appendix was found to be macroscopically normal. A necrotic heavily calcified parasitic leiomyoma was seen in the right adnexa, free of the uterus and adherent to the greater omentum on a long torted pedicle. The parasitic leiomyoma was successfully removed piecemeal laparoscopically. Complications of leiomyomas, namely, torsion and necrosis, are important differentials in women presenting with sudden-onset lower abdominal pain. A history of sudden-onset severe lower abdominal pain with a background of known leiomyoma should prompt the clerking surgeon to consider a complication of leiomyoma as part of the differential diagnoses.

scholarly journals Case Report. Appendiceal Recurrent Colic Due to Enterobius Vermicularis Infection in a 14-Year-Old Female Patient

2016 ◽  
Vol 9 (2) ◽  
pp. 159-162
Author(s):  
Toni I. Stoyanov ◽  
Emilio Corral-Fernadez ◽  
Antonio Melero-Abellan ◽  
Pablo Sarduy-Fernandez ◽  
Paloma Casado-Santamaria ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Young Female ◽  
Lower Abdomen ◽  
Enterobius Vermicularis ◽  
Laboratory Findings ◽  
Rebound Tenderness ◽  
Radiologic Findings ◽  
The Right ◽  
Oral Doses

Summary Acute appendicitis due to Enterobius vermicularis, usually known as pinworm, is very rare and affects mostly children.According to different authors, it is controversial whether pinworms cause inflammation of the appendix or appendiceal colic only.We presentacase ofa14-year-old female with three subsequent hospitalizations in 1 month due to abdominal pain in the right lower abdomen, with rebound tenderness, normal CTscan and laboratory findings. During the last hospitalization, laparoscopic appendectomy was performed. Intraoperatively multiple pinworms were found in the appendix. These were trapped byastercolith in the appendicular base inanoninflamed and histologically normal appendix. Two oral doses of mebendazole were administered postoperatively. Uneventful postoperative period and postoperative follow-up showed lack of symptoms six months after the operation. Despite the widespread idea that acute appendicitis due to Enterobius vermicularis is very rare, it should always be considered in young female patients with repeated abdominal pain in the right lower abdomen with normal laboratory and radiologic findings.

scholarly journals A féregnyúlvány diverticulosisa, diverticulitise. Esetismertetés és irodalmi áttekintés

2018 ◽  
Vol 159 (19) ◽  
pp. 768-772
Author(s):  
Tamás Vass ◽  
Attila Zaránd ◽  
Dániel Horányi ◽  
László Harsányi
Keyword(s):  
Acute Appendicitis ◽  
Preoperative Diagnosis ◽  
Histopathological Examination ◽  
Iliac Fossa ◽  
Abdominal Ultrasound ◽  
Vermiform Appendix ◽  
Review Of The Literature ◽  
Rebound Tenderness ◽  
History Of ◽  
The Right

Abstract: Diverticulitis of the vermiform appendix is a rare disease with clinical features often similar to conventional acute appendicitis. The importance of appendiceal diverticulosis is the fact that it can lead to an early and a higher incidence of perforation and therefore a higher mortality rate, in contrast to acute appendicitis alone. In this study we present the clinicopathology, diagnosis and therapy of the disease with a review of the literature. A 65-year-old woman presented to the emergency department with a 48-hour history of intermittent pain in the right iliac fossa. Abdominal ultrasound raised the possibility of acute appendicitis but because of the relative asymptomatic state of the patient, the lack of fever and rebound tenderness we started observation. After 2 days with episodic abdominal pain, the patient was taken to the operating theatre for laparoscopic exploration. Intraoperatively, multiple diverticula were noted on the appendix and appendectomy was performed. Histopathological examination revealed diverticulosis and inflammation of the appendiceal wall. Due to the possible complications, the difficult preoperative diagnosis and its frequent association with appendiceal neoplasm, appendiceal diverticulosis requires special attention. For asymptomatic cases, incidentally diagnosed intraoperatively or discovered by radiology prophylactic appendectomy is recommended. Orv Hetil. 2018; 159(19): 768–772.

scholarly journals ACUTE APPENDICITIS

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.

An Imaging Diagnostic Protocol in Children with Clinically Suspected Acute Appendicitis

2016 ◽  
Vol 82 (5) ◽  
pp. 390-396 ◽  
Author(s):  
Matias Epifanio ◽  
Marco Antonio De Medeiros Lima ◽  
Patricia Corrêa ◽  
Matteo Baldisserotto
Keyword(s):  
Acute Appendicitis ◽  
Predictive Value ◽  
Iliac Fossa ◽  
Correct Diagnosis ◽  
Signs And Symptoms ◽  
Clinical Findings ◽  
The Other ◽  
Free Fluid ◽  
Diagnostic Strategy ◽  
The Right

The objective of the present study is to evaluate a new diagnostic strategy using clinical findings followed by ultrasound (US) and, in selected cases, MRI. This study included 166 children presenting signs and symptoms suggesting acute appendicitis. Cases classified as suggesting appendicitis according to clinical exams had to be referred to surgery, whereas the other cases were discharged. Unclear cases were evaluated using US. If the US results were considered inconclusive, patients underwent MRI. Of the 166 patients, 78 (47%) had acute appendicitis and 88 (53%) had other diseases. The strategy under study had a sensitivity of 96 per cent, specificity of 100 per cent, positive predictive value of 100 per cent, negative predictive value of 97 per cent, and accuracy of 98 per cent. Eight patients remained undiagnosed and underwent MRI. After MRI two girls presented normal appendixes and were discharged. One girl had an enlarged appendix on MRI and appendicitis could have been confirmed by surgery. In the other five patients, no other sign of the disease was detected by MRI such as an inflammatory mass, free fluid or an abscess in the right iliac fossa. All of them were discharged after clinical observation. In the vast majority of cases the correct diagnosis was reached by clinical and US examinations. When clinical assessment and US findings were inconclusive, MRI was useful to detect normal and abnormal appendixes and valuable to rule out other abdominal pathologies that mimic appendicitis.

scholarly journals C-reactive protein as a diagnostic tool in acute appendicitis

2019 ◽  
Vol 6 (7) ◽  
pp. 2386
Author(s):  
Usharani Rathnam ◽  
Srivignesh Kumar K. ◽  
Lakkanna Suggaiah
Keyword(s):  
Acute Appendicitis ◽  
Iliac Fossa ◽  
Elevated Serum ◽  
Lower Abdominal Pain ◽  
High Serum ◽  
Pathological Examination ◽  
Female Ratio ◽  
Rebound Tenderness ◽  
Preoperative Serum ◽  
Serum Crp

Background: Appendicitis is inflammation of the appendix. Symptoms commonly include right lower abdominal pain, nausea, vomiting, and decreased appetite. However, approximately 40% of people do not have these typical symptoms. Severe complications of a ruptured appendix include widespread, painful inflammation of the inner lining of the abdominal wall and sepsis. The main objective is to compare C-reactive levels in diagnosis of acute appendicitis.Methods: In this study patients coming to General Surgery Department of ESIC Medical college, Rajajinagar, Bengaluru, from January 2017 to December 2017, who are diagnosed clinically as to have acute appendicitis form the source of study.Results: In the present study, maximum number of cases belongs to 21-30 year age group (22 cases) and male female ratio is 1.07:1. Most common site of pain being right iliac fossa (52 cases), vomiting as presenting complaint was seen in 51 cases, fever as a presenting complaint was present in 31 cases, Mc-Burneys point tenderness noted in 49 cases, rebound tenderness noted in 46 cases. In present series 53 patients had elevated serum CRP level (>2.5 mg/dl) which is 89% of total study group. In these patients only one patient had high serum CRP level in spite of normal appendix.Conclusions: An elevated serum CRP level supports the surgeon’s diagnosis and hence avoids chances of error in diagnosis, due to atypical presentations. Similarly a normal preoperative serum CRP level in patients with suspected acute appendicitis is most likely to be associated with a normal appendix on histo-pathological examination.

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