Periappendicular Abscess Research Articles

Perforated appendix and periappendicular abscess within an inguinal hernia

We report an extremely rare case of complicated Amyand's hernia. A 61-year-old male patient was admitted with clinical signs of incarcerated right inguinal hernia and localised tenderness in the right iliac fossa. He underwent emergency surgery and the operative findings included perforated appendix and periappendicular abscess within a right inguinal hernia sac. Appendectomy and Shouldice's herniorrhaphy without prosthetic mesh placement were performed. Histology revealed the presence of a villous adenoma near the base of the appendix. We point out that although Amyand's hernia is a very rare clinical entity, it should always be considered in the differential diagnosis in cases with clinical signs of incarcerated right inguinal hernia, especially when there are no pathological findings on the abdominal X-rays.

Cecum cancer underlying appendicular abscess. Case report and review of literature

Acute appendicitis represents a rare presentation of carcinoma of cecum. Neoplastic lesion of cecum may cause appendicitis by mechanical obstruction at the orifice of the vermiform appendix. The dilatation and perforation of appendix may produce a peri-appendicular abscess. A radical surgical approach of cecal masses, with intra-operative abscess drainage and resection should be performed in elderly patients, fit for surgery, to avoid the risk of unrecognising malignant lesion as well as to achieve a safe and adequate treatment. We describe a case of right iliac fossa abscess initially diagnosed with acute appendicitis that, at surgical exploration, resulted from a cecal tumour causing appendicitis for an obstructive mechanism.

Neonatal periappendicular abscess—Updated treatment

The authors present a case of periappendicular abscess in a 5-day-old full-term neonate. Prompt diagnosis enabled us to deliver conservative treatment followed by interval laparoscopic appendectomy, instead of a risky urgent laparotomy. This is the first description of an advanced imaging-guided drainage procedure, followed by minimal invasive surgery, for the treatment of periappendicular abscess at such a young age. J Pediatr Surg 38:E5. Copyright 2003, Elsevier Science (USA). All rights reserved.

Laparoscopic interval appendectomy for periappendicular abscess.

Laparoscopic appendectomy was first described in the early 1980s and is currently widely used for the treatment of acute appendicitis. The application of laparoscopic techniques to interval appendectomy and the value of this procedure as compared to open elective interval appendectomy remains uncertain. Therefore, we set out to assess the usefulness of interval laparoscopic appendectomy following periappendicular abscess. This study analyzes the data for 10 patients who underwent interval laparoscopic appendectomy 8-10 weeks following documented periappendicular abscess in the period between January 1996 and June 1998. Laparoscopic appendectomy was completed successfully in all 10 patients. Nine patients were discharged 1 day after the operation; one patient was discharged on the evening of the operative day. There were no complications and no wound infections. We conclude that the laparoscopic approach is the preferable treatment for interval appendectomy. It is associated with minimal or no morbidity and a very short hospital stay.

A CASE OF MALIGNANT LYMPHOMA OF THE SMALL INTESTINE WITH A SPECIFIC MORPHOLOGY

Malignant tumors of the small intestine lack in specific symptoms so that it is difficult to diagnose in an early stage. This paper reports a case of primary malignant lymphoma of the ileum which presented difficulty in differentiation from periappendicular abscess. A 20-year-old woman was occasionally febrile and had an abdominal pain scince November in 1996. In February, 1907 she noticed a mass in the right lower quadrant, and was admitted to the hospital because of right lower abdominal pain. On admission a hard tumor whose surface was smooth was palpated on the McBurney point where there were tenderness and Blumberg's sign. Anemia and inflammatory response were also noted. At first a periappendicular abscess due to acute appendicitis was suspected by clinical features and the findings of US and CT. Finally a primary tumor of the ileum, in particular malignant lymphoma was suspected and an operation was performed. Upon laparatory, a fist-sized tumor was placed in the ilececal junction and a right hemicolectomy was carried out. Histological diagnosis was diffuse and large cell type of malignant lymphoma. Postoperatively no legion was detected in the other organs. It was diagnosed as primary malignant lymphoma of the small intestine.

A CASE OF PERIAPPENDICULAR ACTINOMYCOSIS

A 71-year-old man was referred to the department because of a painful tumor of the right lower abdomen. Abdominal ultrasonography, barium enema study, and abdominal CT offered a suspecion of abdominal abscess caused by appendicitis or some malignant tumor of the large intestine. Emergency operation was carried out. The appendix was solid, swelled like a club, and was buried in the surrounding tissue. The excised specimen revealed no tumorous change. It was diagnosed as periappendicular abscess. On histopathological specimen an abscess formation around a grain of actinomycosis as the center was seen. Definitively the patient was diagnosed with periappendicular actinomycosis.

Acute appendicitis and diagnostic value of sonography: A prospective study of 77 surgically proven cases

We present the results of a prospective study on 122 patients referred for suspected acute appendicitis. In total, 77 patients had surgically proven appendicitis. Of these 77 patients, sonography showed typical signs of appendicitis and/or peri-appendicular abscess in 57 cases (true positives); in the remaining 20 patients neither the inflamed appendix nor any related abnormal finding could be detected pre-operatively (false negatives). Forty-five patients were subsequently shown to have other disorders (related to the urinary or digestive tract, or to the female reproductive system); the final diagnoses were based on surgical findings in 16 patients, and on a combination of clinical, imaging and laboratory findings in the remaining 29 patients. In all these patients, no sonographic evidence of appendicitis was detected (true negatives), whereas in 33 cases the US exam was able to detect abnormal findings related to other conditions, thus suggesting a correct diagnosis. In the authors' experience, sonography has a good accuracy in diagnosing acute appendicitis. The sensitivity (75%) and specificity (100%) values were similar among the different examiners and in overall agreement with the literature data.

Sonographic diagnosis of periappendicular abscess in pregnancy : Jaffe R; Gruber A; Abramowicz J; et al. Department of Obstetrics and Gynecology ‘A’, Meir General Hospital, Kfar-Sava 44281, Israel

Sonographic diagnosis of periappendicular abscess in pregnancy : Jaffe R; Gruber A; Abramowicz J; et al. Department of Obstetrics and Gynecology ‘A’, Meir General Hospital, Kfar-Sava 44281, Israel

Sonographic diagnosis of periappendicular abscess in pregnancy

The diagnosis of appendicitis in pregnancy is complex because of altered maternal physiology and anatomy, and definitive therapy is often delayed. Ultrasonic screening is important in either diagnosing or excluding many pathologic conditions that complicate pregnancy and present a clinical picture similar to that of appendicitis. Reported here is a case in which a periappendicular abscess due to a perforated appendix was diagnosed by sonographic screening.

Disinfection of surgical wounds without inhibition of normal wound healing.

The goal of disinfection of surgical wounds is to destroy as large a number as possible of the microbes that have made their way into the surgical wounds during the time of surgery, without disturbing the normal wound-healing process. It is not a substitute for preoperative disinfection of the skin or aseptic technique, but makes it possible to further decrease the rate of infection in slightly or moderately contaminated wounds. This was shown with a series of 294 pediatric surgical patients, 283 of whom had undergone appendectomy. A 5% povidone-iodine solution, especially in combination with excipients, was too strong, whereas a 1% povidone-iodine solution without excipients applied to the surgical wound was safe from the standpoint of wound healing, and decresed the number of wound infections in those patients with appendicitis in whom neither peritonitis nor periappendicular abscess had yet developed.

The significance of thermography in the diagnosis of acute abdominal disease.

Thermography appears to be a useful supporting aid to classical methods of examination in the clarification of the problems of acute abdominal disease. In a study of 100 patients thermography was in support of the true diagnosis in acute appendicitis in 63 per cent, in acute biliary tract disease in 59 per cent, and, in an attempt to differentiate between tumor and periappendicular abscess, assistance was rendered by thermography in 53 per cent of patients. However, some uncertainty exists because carcinoma often produces in its environment an inflammatory reaction, which causes an increase of temperature visible in the thermogram. In the present series thermography produced a finding supporting the correct diagnosis in 59 per cent. Errors occurred most often in obese patients, who have thick abdominal covers. Thermography also has an obvious application in the localizing of postoperative suppurative foci.

Incarcerated inguinal hernia with a perforated appendix and periappendicular abscess: report of a case.

A case of an incarcerated right inguinal hernia containing a perforated appendix with periappendicular abscess is reported. The rarity and diagnostic difficulties of such a case are emphasized. An emergency operation should be performed in every case in which there is a painful swelling of unknown cause in the groin. The literature on the subject is reviewed.

Case of peri-appendicular abscess in a muganda in entebbe civil hospital

Case of peri-appendicular abscess in a muganda in entebbe civil hospital