Perforated Appendicitis Presenting Research Articles

Perforated Subhepatic Appendix Presenting as a Gas under Diaphragm: Clinical Diagnostic Challenges for Surgical Residents: A Case Report

This study addresses the rarity of the subhepatic location of the appendix, found in only 0.08% of cases, and the infrequent occurrence of perforated appendicitis presenting with gas under the diaphragm. When these two uncommon conditions coincide in the context of one of the common causes of acute abdomen, namely acute appendicitis, it poses a diagnostic challenge for surgical residents in training. The case presented involves a patient with generalized abdominal pain, soft abdomen, and tenderness over all quadrants, particularly the right upper quadrant. Her chest x-ray findings indicated free gas under the right hemi-dome of the diaphragm and an inconclusive ultrasound for acute appendicitis, computed tomography confirmed the subhepatic appendix and pneumoperitoneum. Operative intervention revealed a perforated subhepatic appendix, and the patient recovered well, being discharged on the 4th postoperative day. The clinical discussion emphasizes the ability of surgical residents to safely perform appendectomies but highlights the crucial role of experienced surgeons in managing cases with atypical presentations. The conclusion underscores the diagnostic challenges posed by atypical presentations of acute appendicitis in a clinical setting.

Amyand’s Hernia with Perforated Appendicitis Presenting as Strangulated Hernia: A Rare Case Report

An inguinal hernia is one of the most common surgical conditions accounting for both elective and emergency cases. Amyand’s hernia is a rare entity and is often an incidental intraoperative finding but may present as strangulation or appendicitis in the hernia sac.

S3452 Missed Perforated Appendicitis Presenting as Flank Necrotizing Fasciitis - A Rare Phenomenon

S3452 Missed Perforated Appendicitis Presenting as Flank Necrotizing Fasciitis - A Rare Phenomenon

Asymptomatic Perforated Appendicitis Presenting as a Subepithelial Sigmoid Colon Lesion at Screening Colonoscopy

본 증례는 검진 ëª©ì ì˜ 대장내시경에서 충수돌기 개구부가 ì •ìƒ 소견을 보였지만, 구불결장의 ì ë§‰í•˜ 병변으로 나타난 충수염의 드문 증례이다. 화농성 배액이 보이는 ì ë§‰í•˜ 병변이 구불 결장에서 ê´€ì°°ë ë•Œ 충수염의 가능성 또한 감별진단으로 ê³ ë ¤í•´ ë³¼ 수 ìžˆê² ë‹¤. 중심 단어: 충수염; 대장내시경; 구불결장

Perforated Appendicitis in a Neonate Presenting with Intestinal Obstruction

We report a case of neonatal perforated appendicitis presenting with an early picture of intestinal obstruction secondary to entrapment of small bowel under inflamed appendix vermiformis.

Acute Appendicitis Presenting With a Painful Inguinal Mass

Appendicitis with or without perforation is a common pediatric emergency department diagnosis, as are the findings of patent processus vaginalis and cryptorchidism. We describe the unique presentation of perforated appendicitis complicated by a tender inguinal mass resulting from the presence of purulence as well as a cryptorchid but viable testis within a patent processus vaginalis. We describe our diagnostic approach and review the literature relevant to inguinoscrotal presentations of appendicitis.

Perforated Appendicitis Presenting as a Thigh Abscess

Perforated Appendicitis Presenting as a Thigh Abscess

Matched analysis of nonoperative management vs immediate appendectomy for perforated appendicitis

Background The role of nonoperative therapy vs immediate appendectomy in the management of children with perforated appendicitis remains undefined. The objective of this study was to rigorously compare these management options in groups of patients with matched clinical characteristics. Methods Multicenter case-control study was conducted from 1998 to 2003. We compared patients treated nonoperatively vs those undergoing appendectomy to identify differences in 12 clinical parameters. We then generated a second control group of patients matched for these variables and compared the following outcomes in these clinically similar groups: complication rate, abscess rate, and length of stay (LOS). Analysis was performed according to intention-to-treat principles, using χ 2, Fisher exact, and Student t tests. Results The only significant difference between patients treated nonoperatively and those treated by appendectomy was the duration of pain on presentation (6.8 vs 3.1 days of pain).We created a second control group of patients undergoing immediate appendectomy matched on duration of pain on presentation to patients treated nonoperatively. These groups continued to be clinically comparable for the other 11 parameters. Compared to this matched control group, the nonoperative group had fewer complications (19% vs 43%, P < .01), fewer abscesses (4% vs 24%, P < .01), and a trend for shorter LOS (6.5 ± 5.7 vs 8.8 ± 6.7 days, P = .08). Conclusions When nonoperative management for perforated appendicitis was studied using appropriately matched clinical controls, we found that it resulted in a lower complication rate and shorter LOS in the subset of patients presenting with a long duration of pain. Our data suggest that nonoperative management should be prospectively evaluated in children with perforated appendicitis presenting with a history of pain exceeding 5 days.

Perforated appendicitis presenting as appendicoumbilical fistula

Perforated appendicitis is one of the most common diagnoses treated by pediatric surgeons. Although rare, a perforated appendix can present with a cutaneous fistula. Here we present the second reported case of perforated appendicitis presenting as an appendicoumbilical fistula.

Perforated appendicitis presenting as an irreducible inguinal hernia

Perforated appendicitis presenting as an irreducible inguinal hernia

Perforated appendicitis presenting as torsion of spermatic cord

A case of perforated appendicitis presenting as acute scrotal swelling and erythema is reported. A hydrocele containing cloudy fluid was encountered on surgical exploration suggesting the intra-abdominal pathology.

Acute appendicitis presenting as acute left scrotal pain: Diagnostic considerations

To our knowledge this is the first case of acute perforated appendicitis presenting as acute left scrotal pain described in the literature. In addition, this case involved a unique false positive radionuclide scrotal scan for testicular torsion, which is also reported and discussed for the first time.

Perforated Appendicitis Presenting as a Focal Hepatic Defect

Perforated Appendicitis Presenting as a Focal Hepatic Defect

Empyema. A rare presentation of perforated appendicitis

EMPYEMA is an uncommon complication of intra-abdominal sepsis. 1-5 Although the protean manifestation of acute appendicitis is well recognized, its initial presentation as an empyema is distinctly rare. We report two cases of appendicitis that presented as empyema in which abdominal findings were minimal or absent. Report of Cases Case 1.— A previously healthy 50-year-old woman was seen in the emergency room 24 days before admission, complaining of a three-day history of generalized abdominal pain, nausea, and intermittent vomiting. The results of an examination of the abdomen demonstrated diffuse mild tenderness without rebound. No palpable masses were present, and the results of a rectal examination were unremarkable. She had a WBC count of 12,400/cu mm, with a differential cell count of 63 polymorphonuclear leukocytes, 15 band forms, ten lymphocytes, and 12 monocytes. She was discharged with a diagnosis of viral gastroenteritis. Her abdominal pain resolved during the subsequent 24 to