scholarly journals Epiploic appendages' inflammation: appendagitis. Report of two cases and literature overview

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
Aldo Di Blasi ◽  
Luigi Zulli ◽  
Antonio Viscomi ◽  
Augusto Tricerri
Keyword(s):  
Acute Appendicitis ◽  
Venous Thrombosis ◽  
Ct Scan ◽  
Inflammatory Process ◽  
Surgical Intervention ◽  
Epiploic Appendagitis ◽  
Literature Overview ◽  
Epiploic Appendices ◽  
Central Regions ◽  
Colon And Rectum

Epiploic Appendagitis (EA) is an uncommon, benign, self-limiting inflammatory process of the epiploic appendices. Other, older terms for the process include appendicitis epiploica and appendagitis, but these terms are used less now in order to avoid confusion with acute appendicitis. Epiploic appendices are small, fat-filled sacs or finger-like projections along the surface of the lower colon and rectum. They may become acutely inflamed as a result of torsion (twisting) or venous thrombosis. The inflammation causes pain, often described as sharp or stabbing, located on the left, right, or central regions of the abdomen. There is sometimes nausea and vomiting. The symptoms may mimic those of acute appendicitis, diverticulitis, or cholecystitis. Initial lab studies are usually normal. EA is usually diagnosed incidentally on CT scan which is performed to exclude more serious conditions. Epiploic appendagitis usually does not require surgical intervention. It is self-limiting, the symptoms can be treated with analgesics and subsides in about a week.

Cecal Epiploic Appendagitis: A Diagnostic and Therapeutic Dilemma

2007 ◽  
Vol 73 (8) ◽  
pp. 828-830 ◽  
Author(s):  
Vijaykumar G. Patel ◽  
Arundathi Rao ◽  
Reginald Williams ◽  
Radha Srinivasan ◽  
James K. Fortson ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Ct Scan ◽  
Abdominal Ct ◽  
Lower Quadrant ◽  
Radiographic Findings ◽  
Epiploic Appendagitis ◽  
Abdominal Symptoms ◽  
Abdominal Ct Scan ◽  
Limiting Condition

Acute epiploic appendagitis (EA) is a rare and often misdiagnosed cause of acute abdominal pain. Though a benign and often self-limiting condition, EA's ability to mimic other disease processes makes it an important consideration in patients presenting with acute abdominal symptoms. Careful evaluation of abdominal CT scan findings is crucial in the accurate diagnosis of epiploic appendagitis, thus avoiding unnecessary surgical intervention. We report a case of a 29-year-old male presenting with a two day history of generalized abdominal pain. Physical exam revealed a diffusely tender abdomen with hypoactive bowel sounds. The patient had a leukocytosis of 18,000 and abdominal CT scan revealed right lower quadrant inflammatory changes suggestive of acute appendicitis. Laparoscopic exploration revealed an inflamed gangrenous structure adjacent to the ileocecal junction. Pathologic evaluation revealed tissue consistent with epiploic appendagitis. Retrospective review of the CT scan revealed a normal appearing appendiceal structure superolateral to the area of inflammation. The patient recovered uneventfully with resolving leukocytosis. We present a case of cecal epiploic appendagitis mimicking acute appendicitis and review the current literature on radiographic findings, diagnosis, and treatment of this often misdiagnosed condition. General surgeons should be aware of this self-limiting condition and consider this in the differential diagnosis.

scholarly journals Torsion of lesser omentum: A rare presentation of acute abdomen

2019 ◽  
Vol 1 (1) ◽  
pp. 41-43
Author(s):  
Muhammad Abdullah Khalid ◽  
Amina Amin ◽  
Mohammad Amir
Keyword(s):  
Laparoscopic Surgery ◽  
Acute Appendicitis ◽  
Ct Scan ◽  
Acute Abdomen ◽  
Epigastric Pain ◽  
Iliac Fossa ◽  
Rare Presentation ◽  
Epiploic Appendagitis ◽  
Omental Torsion ◽  
Focal Fat

Intraperitoneal Focal Fat Infarction is a rare cause of acute abdomen. There are two types, Omental Torsion and Epiploic Appendagitis. We present a case of 19 years old male who presented to ER with severe pain in epigastrium and right iliac fossa. Clinical diagnosis of acute appendicitis was made, but epigastric pain remained unexplained. CT scan was reported as non-significant. Diagnostic Laparoscopy picked lesser omental infarction and acute appendicitis. Patient was successfully managed by Laparoscopic Surgery. Symptoms not explained by a single pathology should be thoroughly investigated. CT Scan is the best investigation. Laparoscopic surgery is an effective and safe approach for small segmental omental torsion.

Adenocarcinoma of the Appendix in Elderly: Diagnostic dilemma

2020 ◽  
Vol 01 ◽  
Author(s):  
Heba Nofal ◽  
Hayder Al-Masari ◽  
Marwan Mohammed Rashed ◽  
Reham Ainawi ◽  
Desh Idnani ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Ct Scan ◽  
Laparoscopic Appendectomy ◽  
Signs And Symptoms ◽  
Morbidity And Mortality ◽  
Diagnostic Dilemma ◽  
Increased Risk

: Acute appendicitis in elderly continue to be a diagnostic dilemma as it raises both the suspicion of malignancy and increased risk of morbidity and mortality. Cancers of the appendix are rare and most of them are found accidentally on appendectomies performed for acute appendicitis. When reviewed, majority of the tumors were carcinoid, adenoma, and lymphoma. Adenocarcinomas of appendix are only 0.08% of all cancers and the treatment remains controversial. This paper presents a case of 75-year-old female presented to emergency (ER) with signs and symptoms mimicking acute appendicitis, laparoscopic appendectomy was planned after a CT scan was done as it was suggesting acute appendicitis. The specimen then was sent foe pathology lab and a diagnosis of adenocarcinoma of the appendix was made.

A COMPREHENSIVE STUDY ON ACUTE NON-TRAUMATIC ABDOMINAL EMERGENCIES

2021 ◽  
pp. 14-16
Author(s):  
Md. Quamar Zubair ◽  
A. K. Jha Suman
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Surgical Intervention ◽  
Age Groups ◽  
Diagnostic Procedures ◽  
Accurate Diagnosis ◽  
Postoperative Patient ◽  
Correct Treatment ◽  
Abdominal Emergencies ◽  
Comprehensive Study

Abdominal pain is one of the most common reasons for visit to the emergency room. Acute appendicitis is the commonest cause. An accurate diagnosis is essential for the correct treatment, which in many cases will prevent the death of the patient. Mainstay of diagnosis is history and physical examination. If this information is inadequate to establish a diagnosis and urgent or immediate operation is unnecessary, the periodic re-examination helps document the progression of the disease and often avoids unnecessary surgical intervention. Today the combination of improved diagnostic procedures, antibiotic and better anaesthesia and preoperative and postoperative patient care has led to a decrease in morbidity and mortality of patients with acute abdomen. The objective of this study was to determine the various causes of nontraumatic acute abdominal emergencies, their incidence, management and mortality in both sexes and all age groups >12 years age.

scholarly journals Case-based review: conservative management of appendicitis – are we delaying the inevitable?

2012 ◽  
Vol 94 (4) ◽  
pp. 232-234 ◽  
Author(s):  
S Davies ◽  
A Peckham-Cooper ◽  
A Sverrisdottir
Keyword(s):  
Acute Appendicitis ◽  
Conservative Management ◽  
Surgical Intervention ◽  
Primary Treatment ◽  
Spontaneous Resolution ◽  
Primary Treatment Modality ◽  
Uncomplicated Appendicitis ◽  
Recurrent Appendicitis ◽  
Appendiceal Inflammation ◽  
Surgical Presentation

Acute appendicitis is a common surgical presentation for which surgical intervention, an appendicectomy, has remained a largely unchallenged primary treatment modality. Traditionally, it has been felt that the pathophysiological progressive nature of appendicitis ultimately leads to perforation. A number of recent studies, however, suggest that the process of appendiceal inflammation may follow a more remitting nature with evidence indicating spontaneous resolution. It is hypothesised that the treatment of uncomplicated appendicitis may therefore be amenable to conservative management with antibiotics. This article aims to highlight some of the issues and challenges relating to the conservative management of acute appendicitis and further demonstrates potential diagnostic and treatment difficulties involved in managing the more unfamiliar condition of recurrent appendicitis.

scholarly journals A randomised placebo-controlled double-blind multicentre trial comparing antibiotic therapy with placebo in the treatment of uncomplicated acute appendicitis: APPAC III trial study protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e023623 ◽  
Author(s):  
Suvi Sippola ◽  
Juha Grönroos ◽  
Ville Sallinen ◽  
Tero Rautio ◽  
Pia Nordström ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Antibiotic Therapy ◽  
Ct Scan ◽  
Symptomatic Treatment ◽  
Spontaneous Resolution ◽  
University Hospital ◽  
Controlled Study ◽  
Double Blind ◽  
Uncomplicated Acute Appendicitis

IntroductionRecent studies show that antibiotic therapy is safe and feasible for CT-confirmed uncomplicated acute appendicitis. Spontaneous resolution of acute appendicitis has already been observed over a hundred years ago. In CT-confirmed uncomplicated acute diverticulitis (left-sided appendicitis), studies have shown no benefit from antibiotics compared with symptomatic treatment, but this shift from antibiotics to symptomatic treatment has not yet been widely implemented in clinical practice. Recently, symptomatic treatment of uncomplicated acute appendicitis has been demonstrated in a Korean open-label study. However, a double-blinded placebo-controlled study to illustrate the role of antibiotics and spontaneous resolution of uncomplicated acute appendicitis is still lacking.Methods and analysisThe APPAC III (APPendicitis ACuta III) trial is a multicentre, double-blind, placebo-controlled, superiority randomised study comparing antibiotic therapy with placebo in the treatment CT scan-confirmed uncomplicated acute appendicitis aiming to evaluate the role of antibiotics in the resolution of uncomplicated acute appendicitis. Adult patients (18–60 years) with CT scan-confirmed uncomplicated acute appendicitis (the absence of appendicolith, abscess, perforation and tumour) will be enrolled in five Finnish university hospitals.Primary endpoint is success of the randomised treatment, defined as resolution of acute appendicitis resulting in discharge from the hospital without surgical intervention within 10 days after initiating randomised treatment (treatment efficacy). Secondary endpoints include postintervention complications, recurrent symptoms after treatment up to 1 year, late recurrence of acute appendicitis after 1 year, duration of hospital stay, sick leave, treatment costs and quality of life. A decrease of 15 percentage points in success rate is considered clinically important difference. The superiority of antibiotic treatment compared with placebo will be analysed using Fisher’s one-sided test and CI will be calculated for proportion difference.Ethics and disseminationThis protocol has been approved by the Ethics Committee of Turku University Hospital and the Finnish Medicines Agency (FIMEA). The findings will be disseminated in peer-reviewed academic journals.Trial registration numberNCT03234296; Pre-results.

scholarly journals Usefulness of CT Scan in Diagnosing Acute Appendicitis in Patients with Low Alvarado Scores

2019 ◽  
Vol 8 (40) ◽  
pp. 3005-3009
Author(s):  
Khawaja Bilal Waheed ◽  
Waseem Jan Shah ◽  
Ali Salman Alshehri ◽  
Bilal Altaf ◽  
Muhammad Amjad ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Ct Scan

scholarly journals Вміст фактора некрозу пухлин α і трансформуючого фактора росту β1 у сироватці крові хворих на гострий апендицит та абдомінальний туберкульоз

2018 ◽  
Author(s):  
V. M. Akimova
Keyword(s):  
Differential Diagnosis ◽  
Immune System ◽  
Serum Level ◽  
Acute Appendicitis ◽  
Inflammatory Process ◽  
Abdominal Cavity ◽  
Abdominal Tuberculosis ◽  
Urgent Problem ◽  
Elisa Method ◽  
Chronic Inflammatory Process

Introduction. Differential diagnosis of acute appendicitis with abdominal tuberculosis is аn urgent problem of medicine. Тhe immune system is involved іn the pathogenesis of diseases, and cytokines are the regulators of inflammation.The aim of the study – to determine the level of cytokines with the pro- and anti-inflammatory potential of TNFα and TGFβ1 and their correlation in the blood of patients with acute appendicitis and abdominal tuberculosis in order to improve diagnosis and treatment tactics. Research Methods. 51 patients with urgent abdominal pathology were examined, 21 of them with phlegmonous form of acute appendicitis, 30 patients with histologically confirmed diagnosis of abdominal tuberculosis. The content of TNFα и ТGFβ1 in serum was examined by the ELISA method by the reagents “Diaclone” and “DRG Diagnostic”.Results and Discussion. The results of studies have shown that the development of acute and chronic inflammatory process in the abdominal cavity is determined by activation of the macrophage-monocytic system, manifested by a significant increase in the serum level of TNFα. It was established that in patients with abdominal tuberculosis on the background of increased serum level of TNFα ((17.57±1.05) vs. (4.97±0.18) pg/ml) the TGFβ1 level does not differ from the control ((16.52±1.15) vs. (17.94±0.71) ng/ml) at that time, as with acute appendicitis, its level decreased ((11.32±0.65) vs. (17.94±0.71) ng/ml). ТGFβ1/TNFα ratio during the abdominal inflammation was much lower than control, but in abdominal tuberculosis in 1.5 times higher than in acute appendicitis.Conclusions. The serum level and ratio of monocyte-macrofage derived TNFα and ТGFβ1 determines the type of inflammation and may be useful in differential diagnostic of acute appendicitis and abdominal tuberculosis.

scholarly journals EVALUATION OF DIAGNOSTICNASAL ENDOSCOPY AND CTSCAN IN VARIOUS SINONASAL DISEASES

2021 ◽  
Vol 9 (10) ◽  
pp. 1144-1149
Author(s):  
Ranjan Kumar ◽  
◽  
Rajeev Chandra ◽  
Om Prakash ◽  
◽  
...  
Keyword(s):  
Ct Scan ◽  
Surgical Intervention ◽  
Maxillary Sinusitis ◽  
Anatomical Variation ◽  
Cost Effective ◽  
Anatomical Variations ◽  
Nasal Endoscopy ◽  
Common Finding ◽  
Polyp Detection ◽  
Intervention Patient

Objective:To evaluate role of Diagnostic Nasal Endoscopy and CT scan in various Sinonasaldiseases with regards to diagnosis and surgical intervention. Patient and methods:This prospective study was carried out in Department of ENT, A.N.M.M.C.H., Gaya on 200 patients with clinical evidence of sinonasal disease who had presented between March 2016 to February 2019. All patients were evaluated with DNE using 0 degree 4mm endoscope and CT scan with 3 mm coronal cuts. Result: Female patients(56%) were more as compared to male(44%) with majority between 21 - 40 yrs. Most common finding on Diagnostic Nasal Endoscopy(DNE) was mucopurulent discharge in middle meatuswhile on CT Scan was maxillary sinusitis(60%). Sinonasal polyp detection was better with DNE.CT has better detection rate of anatomical variation of osteomeatal complex. Conclusion : DNE has become initial tool for diagnosis as it is cost effective and office based procedure. In patients where surgical intervention is required, CT scan has advantage as it provides detailed understanding of anatomical variations. So bothDNE and CT scan should be used in collaborative fashion. Source Of Support:Patients of A.N.M.C.H., Gaya. Conflict Of Interest:None.

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