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The Australian & New Zealand Journal of... Dec 2023In the most severe stage of endometriosis, Stage IV, intestinal involvement is common. The true prevalence of endometriotic disease of the appendix in this population is...
BACKGROUND
In the most severe stage of endometriosis, Stage IV, intestinal involvement is common. The true prevalence of endometriotic disease of the appendix in this population is not well described. A macroscopically normal looking appendix may harbour endometriosis.
AIMS
Our study aims to assess the role of routinely performing appendicectomy in Stage IV endometriosis surgery, and the histopathological prevalence of true appendiceal endometriosis in this population.
METHODS
This is a retrospective study of women undergoing surgery for Stage IV endometriosis between 2018 to 2022 in a tertiary public hospital in New South Wales, Australia. Patient demographics, age and post-operative complications were retrospectively retrieved from hospital medical records. Inclusion criteria were women with Stage IV endometriosis who underwent routine appendicectomy as part of their endometriosis surgery. Exclusion criteria were women who did not have Stage IV endometriosis, those who had cancer surgery or emergency surgery for endometriosis. The primary outcome of this study was to determine the incidence of appendiceal endometriosis. Secondary outcomes included post-operative complications and length of stay.
RESULTS
Sixty-seven patients were included. The mean age was 36 years. All patients also underwent bowel resection for colorectal endometriosis. There were 35.8% who had confirmed appendiceal endometriosis on histopathology. Post-operative complications included port site infections, colitis, urinary tract infection and ureteric injury. There were no complications related to appendicectomy. Mean length of stay was 4.4 days.
CONCLUSION
Laparoscopic appendicectomy can be safely performed at time of laparoscopic surgical excision of Stage IV endometriosis and should be routinely considered in a subset of Stage IV endometriosis patients with colorectal involvement undergoing surgery.
Topics: Humans; Female; Adult; Male; Appendix; Endometriosis; Retrospective Studies; Appendectomy; Laparoscopy; Postoperative Complications; Colorectal Neoplasms; Treatment Outcome
PubMed: 37427888
DOI: 10.1111/ajo.13730 -
Acta Medica Okayama Apr 2020A 76-year-old Japanese man was transferred to our hospital to undergo rehabilitation after traffic accident-related injuries. Seven days post-admission, he presented...
A 76-year-old Japanese man was transferred to our hospital to undergo rehabilitation after traffic accident-related injuries. Seven days post-admission, he presented with abdominal pain and an 8-cm lump in the right inguinal region. He was diagnosed with an incarcerated inguinal hernia and underwent elective surgery the day after manual reduction. He had a normal vermiform appendix which was observed to have adhered to the right indirect hernia sac. An appendectomy and hernia repair using lightweight mesh were performed. We discuss the surgical management of this rare incarcerated Amyand's hernia and the relevant literature.
Topics: Aged; Appendectomy; Appendix; Hernia, Inguinal; Herniorrhaphy; Humans; Male; Surgical Mesh
PubMed: 32341593
DOI: 10.18926/AMO/58277 -
ANZ Journal of Surgery Dec 2022
Topics: Humans; Appendicitis; Appendix; Diverticulosis, Colonic
PubMed: 35322525
DOI: 10.1111/ans.17600 -
Emergency Radiology Jun 2021Acute appendicitis is the most common disease of the appendix. However, the differential diagnosis for an abnormal appendix includes other conditions that often present... (Review)
Review
Acute appendicitis is the most common disease of the appendix. However, the differential diagnosis for an abnormal appendix includes other conditions that often present with symptoms and imaging features that overlap with acute appendicitis. In this pictorial essay, we review the normal anatomy of the appendix and outline the pathogenesis, clinical manifestations, and imaging findings that are characteristic of acute appendicitis and other less common appendiceal abnormalities. Inflammatory/non-neoplastic processes including appendiceal diverticulitis, stump appendicitis, foreign body appendicitis, Crohn's appendicitis, and appendiceal hernias are discussed. Neoplastic considerations include appendiceal neuroendocrine tumors, mucinous and non-mucinous (colonic type) epithelial neoplasms, and lymphoma. It is important for the radiologist to be able to differentiate these alternative diagnoses for the purpose of directing appropriate patient management.
Topics: Acute Disease; Appendiceal Neoplasms; Appendicitis; Appendix; Diagnostic Imaging; Humans
PubMed: 33517502
DOI: 10.1007/s10140-021-01908-3 -
The Urologist and the Appendix: A Review of Appendiceal Use in Genitourinary Reconstructive Surgery.Urology Jan 2022Recently, genitourinary reconstruction has experienced a renaissance. Over the past several years, there has been an expansion of the literature regarding the use of... (Review)
Review
Recently, genitourinary reconstruction has experienced a renaissance. Over the past several years, there has been an expansion of the literature regarding the use of buccal mucosa for the repair of complex ureteral strictures and other pathologies. The appendix has been an available graft utilized for the repair of ureteral stricture disease and has been infrequently reported since the early 1900s. This review serves to highlight the use of the appendix for reconstruction in urology, particularly focusing on the anatomy and physiology of the appendix, historical use, and current applications, particularly in robotic upper tract reconstruction.
Topics: Appendix; Humans; Urogenital System; Urologic Surgical Procedures
PubMed: 34695504
DOI: 10.1016/j.urology.2021.10.007 -
Clinical Imaging Jul 2024Visualization of the entire appendix, including the tip, is thought, but has not been demonstrated, to be important for exclusion of appendicitis by ultrasound.
BACKGROUND
Visualization of the entire appendix, including the tip, is thought, but has not been demonstrated, to be important for exclusion of appendicitis by ultrasound.
OBJECTIVE
To determine if incomplete visualization of the appendix has negative clinical ramifications including missed appendicitis.
METHODS
Under IRB approval we retrospectively reviewed right lower quadrant ultrasound reports from January 2017 to December 2020 to identify examinations with impressions of full visualization of the normal appendix, non-visualization of the appendix with and without secondary findings of appendicitis, and partial visualization of the appendix. Electronic health records were reviewed for follow-up imaging within 48 h, and surgery with pathology reports (if available).
RESULTS
12,193 examinations were included. 4171 (34.2 %) had full visualization of a normal appendix, 5369 (44.0 %) had non-visualization with no secondary findings, and 234 (1.9 %) had non-visualization with secondary findings, The frequencies of appendicitis in these three groups were 34 (0.8 %), 283 (5.3 %), and 127 (54.3 %) respectively. The appendix was partially visualized in 338 (2.8 %) patients with secondary findings present in 53 (15.6 %). Partial visualization without secondary findings had a similar frequency (4.9 %, 14/285) of appendicitis to non-visualized appendix without secondary findings (p = 0.797) and a higher frequency than full visualization of a normal appendix (p < 0.0001). Partial visualization with secondary findings had similar rates (54.7 %, 29/53) to non-visualized appendix with secondary findings (p = 0.953).
CONCLUSION
Partial visualization of the appendix with ultrasound (with and without secondary findings) is associated with similar frequencies of appendicitis as non-visualization of appendix (with and without secondary findings).
Topics: Humans; Appendicitis; Appendix; Ultrasonography; Retrospective Studies; Child; Female; Male; Adolescent; Child, Preschool; Diagnosis, Differential
PubMed: 38754179
DOI: 10.1016/j.clinimag.2024.110187 -
International Journal of Surgical... Apr 2020
Topics: Appendix; Cysts; Humans
PubMed: 31232137
DOI: 10.1177/1066896919857149 -
The Journal of Urology Jun 2020
Topics: Appendix; Constriction, Pathologic; Humans; Surgical Stomas
PubMed: 32191168
DOI: 10.1097/JU.0000000000000711.02 -
The Journal of Urology Oct 2019
Topics: Appendix; Ileum
PubMed: 31766088
DOI: 10.1097/01.JU.0000577664.71802.81 -
Future Microbiology Feb 2023To review studies examining the appendiceal microbiota and microbial changes in acute appendicitis. After a systematic literature search, 11 studies examining the... (Review)
Review
To review studies examining the appendiceal microbiota and microbial changes in acute appendicitis. After a systematic literature search, 11 studies examining the appendiceal microbiota (414 samples) using non-culture-based methods were included. The appendiceal microbiota showed decreased α-diversity compared with fecal microbiota. Inflamed and uninflamed appendices showed differences in β-diversity, and there was an increased abundance of oral-associated bacteria in inflamed versus uninflamed appendices. The appendiceal microbiota exhibits lower α-diversity than the fecal microbiota, with an increased abundance of oral-associated bacteria. Compared with uninflamed appendices, the appendix microbiota in acute appendicitis also showed increased abundance of oral-associated bacteria, but no bacterial profile unique to either complicated or uncomplicated appendicitis was found.
Topics: Humans; Appendix; Appendicitis; Appendectomy; Microbiota; Bacteria; Acute Disease
PubMed: 36916537
DOI: 10.2217/fmb-2022-0194