History Of Previous Appendectomy Research Articles

Stump appendicitis: challenging diagnosis with serious complication: a case report

Stump appendicitis is a rare complication of appendectomy because of recurrent inflammation of the residual appendix. The diagnosis is often delayed because of low index of suspicious, which may result in serious complications. Twenty-three-year-old male patient presented with right lower quadrant abdominal pain after 7month of appendectomy done at a hospital. On physical examination, he has right lower quadrant tenderness and rebound tenderness. Abdominal ultrasound was done with finding of blind-ended tubular noncompressible 2cm long part of appendix with wall-to-wall diameter of 10mm. There is also focal defect with surrounding fluid collection. With this finding, perforated stump appendicitis was diagnosed. He was operated with similar intra operative finding. The patient discharged improved after 5days of hospital. This is first reported case in Ethiopia as far as our search is concerned. Despite past medical history of appendectomy, the diagnosis was made by means of ultrasound scan. Stump appendicitis is a rare but important complication of appendectomy, often misdiagnosed. Prompt recognition is important to avoid serious complications. This pathologic entity should always be kept in mind in case of right lower quadrant pain in patient with previous history of appendectomy.

ACCURACY OF CLINICAL AND LABORATORY PARAMETERS IN THE DIAGNOSIS OF ACUTE APPENDICITIS

Introduction: The diagnosis of acute appendicitis is generally clinical and once it is diagnosed, operative management ensues. Abdominal pain is the main presenting complaint of patients with acute appendicitis. The diagnostic sequence of colicky central abdominal pain which is followed by vomiting with migration of the pain to the right iliac fossa. The site of maximal tenderness is often said to be over McBurney's point. Specialist investigations are rarely needed to confirm a diagnosis of acute appendicitis, and the diagnosis is predominantly a clinical one. Judicious use of urine and blood tests, for inflammatory response variables, allow exclusion of other pathologies and provide additional evidence to support a clinical diagnosis of appendicitis.
 Material and Methods: Every patient with acute onset of right lower quadrant abdominal pain and without previous history of appendectomy was considered as suspected of having acute appendicitis. Every patient with right iliac fossa pain and without history of appendectomy is suspected of having appendicitis until proven otherwise were included in the study. All Clinical and laboratory tests relevant to acute appendicitis were done among study participants. In Clinical parameters appetite, diarrhea, dysuria, vomiting, signs of localized peritonitis i.e. rebound tenderness and or guarding and pain migration was observed.in laboratory parameters, CRP, complete blood count (CBC) were measured and analysed. Patient’s demographic characteristics were noted.
 Results: A total of 100 patients were included in the study of which 50 were included in the control and 50 in case group. Mean age in control group was 29±7.23 years while in acute appendicetomy group was 29 ±8.77 years. In control group 44% were male and 56 % were female while in acute appendicitis 42% were male and 58 % were female. All clinical presentations were statistically significant in case and control group. CRP was positive in 8 (16%) in control group while in Acute appendicitis group it was 21 (42%) (P=0.0071).
 Conclusion: CRP did not contribute to the overall diagnostic accuracy. The successful diagnosis of acute appendicitis can be done through proper clinical examination and adequate evaluation of laboratory parameters
 Keywords: Acute Appendicitis, CRP, appendicetomy

The Association of Appendectomy, Adhesions, Tubal Pathology, and Female Infertility.

Background and Objectives:The aim of the study was to investigate a potential association between previous childhood appendectomy, tube pathology, and female infertility.Methods:We reviewed patients seeking care at the fertility clinic of our university medical center between 2006 and 2016. The history of previous appendectomy was extracted from hospital documentation and by telephone follow-up. Tubal patency was assessed by diagnostic laparoscopy and chromopertubation.Results:In our study cohort (N = 237), 24.9% (n = 59) had a history of previous appendectomy. Previous appendectomy, therefore, was about 3-fold more prevalent in women seeking fertility treatment than in the general population. Patients with previous appendectomy had more intra-abdominal adhesions (P < .001) and patients with adhesions tended to have compromised tubal patency (P = .05). However, there was no direct correlation between a previous appendectomy and tube pathology (P = .727).Conclusion:Because previous appendectomy was associated with intra-abdominal adhesions, and these were in turn associated with tube pathology, but appendectomy was not directly associated with compromised tubal patency, previous appendectomy may indirectly affect female fertility through mechanisms other than direct tubal obstruction. This is one of the largest study analyzing laparoscopic chromopertubation in association with previous childhood appendectomy.

Neuobičajena crevna malrotacija kod odraslih pacijenata - prikaz 4 slučaja

Rotation anomalies are usually anomalies seen in children. It is a rare condition in adults. In this article, 4 cases are presented. In the first case, reverse rotation anomaly and appendicitis perforation were detected in a patient who had laparotomy at the age of 22 with acute abdomen. It is a unique condition that the patient had a history of previous appendectomy. Ladd band may be the cause of acute abdomen due to ileus. The patient in our second case presented a concurrent biliary stone and malrotation with Ladd band. In addition, two elderly patients who underwent hemicolectomy due to intestinal ileus caused by malrotation were presented with literature review.

Appendiceal mucocele due to mucinous cystadenocarcinoma arising from the appendiceal stump: preoperative diagnosis based on the “onion skin sign”

Appendiceal mucocele is defined as enlargement of the appendix due to the intraluminal accumulation of mucoid material. It is an unusual lesion with variable, nonspecific clinical manifestations. Imaging plays an important role in the diagnosis and evaluation of the mucocele. Preoperative diagnosis is mandatory for proper surgical intervention to prevent perforation and spillage of the mucinous material into the peritoneal cavity, which otherwise results in pseudomyxoma peritonei [1–3]. Development of a mucocele in a patient who previously underwent an appendectomy is an extremely rare entity, with only a few case reports in the literature [2–5]. In this paper, we report a case of a mucocele due to mucinous cystadenocarcinoma in a patient with a history of previous appendectomy who presented with acute abdomen-like symptoms. Preoperative diagnosis was made based on the sonographic ‘‘onion skin sign.’’

Appendix perforation in appendix duplication in a man: a case report

IntroductionAlthough appendix duplication is diagnosed as a rare congenital anomaly of the alimentary tract in childhood, a few adult cases have also been reported. Here we report a case of appendix duplication with perforated appendicitis co-existing with acute appendicitis in an adult patient.Case presentationA 33-year-old Caucasian man was admitted to our Emergency Department with right-sided lower-quadrant pain that we explored for presumed complicated appendicitis. On exploration, a perforated inflamed appendix was found coexisting with a second inflamed appendix which was subserosal and retrocecal. Appendectomies were performed, and the pathological examination confirmed the signs of acute inflammation in both appendixes.ConclusionSurgeons in emergency services should be aware of anatomical anomalies such as duplication and malposition of the appendix, even in patients with a history of previous appendectomy, because misdiagnosis of appendix duplication may lead to a poor clinical outcome and medicolegal issues.

Polymorphisms in interleukin-10 gene according to mutations ofNOD2/CARD15gene and relation to phenotype in Spanish patients with Crohn’s disease

To examine the contribution of interleukin-10 (IL-10) gene polymorphisms to Crohnos disease (CD) phenotype, and the possible genetic epistasis between IL-10 gene polymorphisms and CARD15/NOD2 gene mutations. A cohort of 205 Spanish unrelated patients with Crohn's disease recruited from a single center was studied. All patients were rigorously phenotyped and followed-up for at least 3 years (mean time, 12.5 years). The clinical phenotype was established prior to genotyping. The correlation of genotype-Vienna classification groups showed that the ileocolonic location was significantly associated with the -1082G allele in the NOD2/CARD15 mutation-positive patients (RR=1.52, 95%CI, 1.21 to 1.91, P=0.008). The multivariate analysis demonstrated that the IL-10 G14 microsatellite allele in the NOD2/CARD15 mutation positive patients was associated with two risk factors, history of appendectomy (RR=2.15, 95%CI=1.1-4.30, P=0.001) and smoking habit at diagnosis (RR=1.29, 95%CI=1.04-4.3, P=0.04). In Spanish population from Madrid, in CD patients carrying at least one NOD2/CARD15 mutation, the -1082G allele is associated with ileocolonic disease and the IL-10G14 microsatellite allele is associated with previous history of appendectomy and smoking habit at diagnosis. These data provide further molecular evidence for a genetic basis of the clinical heterogeneity of CD.