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The Pan African Medical Journal 2022Stump appendicitis is an acute inflammation of the residual appendix and one of the rare complications after appendectomy. Stump appendicitis is an under-reported and...
Stump appendicitis is an acute inflammation of the residual appendix and one of the rare complications after appendectomy. Stump appendicitis is an under-reported and poorly defined condition related to obstruction and inflammation of the residual appendix after an appendectomy, usually by a fecolith. It remains a clinical challenge because of delayed diagnosis and subsequent treatment with increased morbidity or mortality. Herein, we describe the case of a 42-year-old male who presented with periumbilical pain with progression to generalized abdominal pain and signs of peritonitis 14 months post appendectomy. An exploratory laparotomy revealed an inflamed, non-gangrenous perforated appendices stump. We discuss the challenges in the diagnosis and management thereof.
Topics: Male; Humans; Adult; Appendicitis; Appendectomy; Appendix; Fecal Impaction; Abdominal Pain; Inflammation
PubMed: 36523281
DOI: 10.11604/pamj.2022.43.43.37149 -
Medicinski Glasnik : Official... Aug 2020In contrast to classical appendectomy where the appendiceal stump is secured by a single or double ligature, in laparoscopic appendectomy various ways of securing the... (Review)
Review
In contrast to classical appendectomy where the appendiceal stump is secured by a single or double ligature, in laparoscopic appendectomy various ways of securing the stump are mentioned. Each of these methods has advantages and disadvantages. Since different possibilities exist for closing the stump, it is very important to find the optimum method for closure of the appendiceal stump, bearing in mind their simplicity, biocompatibility and price. The aim of this review article has been to present the problem of securing the base of the appendix during laparoscopic appendectomy.
Topics: Appendectomy; Appendix; Humans; Laparoscopy; Postoperative Complications
PubMed: 32253902
DOI: 10.17392/1131-20 -
Medicina 2022
Topics: Appendectomy; Appendicitis; Appendix; Humans; Laparoscopy; Postoperative Complications
PubMed: 35037879
DOI: No ID Found -
The Surgical Clinics of North America Dec 2021Nonoperative management (NOM) of acute appendicitis is becoming more popular, especially in resource-strapped locations, to minimize hospital system costs. In... (Review)
Review
Nonoperative management (NOM) of acute appendicitis is becoming more popular, especially in resource-strapped locations, to minimize hospital system costs. In uncomplicated cases of appendicitis, NOM can effectively treat the patient. It does carry a 39.1% risk of recurrence in 5 years, and operative management (OM) does not increase morbidity or risk of complication, so the authors recommend laparoscopic OM for uncomplicated appendicitis. For complicated cases of appendicitis, the authors recommend initial NOM with interval appendectomy in all patients. All appendicitis patients should undergo surveillance endoscopy if older than 40 years to rule out a contributing neoplasm.
Topics: Age Factors; Algorithms; Anti-Bacterial Agents; Appendectomy; Appendiceal Neoplasms; Appendicitis; Appendix; Clinical Decision-Making; Colonoscopy; Fecal Impaction; Humans; Laparoscopy; Time Factors
PubMed: 34774265
DOI: 10.1016/j.suc.2021.08.003 -
Minerva Obstetrics and Gynecology Oct 2021The prevalence of appendiceal endometriosis ranges from 0.4% to 22%. The carcinoid tumor is the most common neoplasm of the appendix, with incidence ranging from 0.3% to...
INTRODUCTION
The prevalence of appendiceal endometriosis ranges from 0.4% to 22%. The carcinoid tumor is the most common neoplasm of the appendix, with incidence ranging from 0.3% to 0.9%. Appendix lesions develop in up to 22% of women with deep infiltrative endometriosis. Even though these are most likely endometriosis, carcinoid tumors should always be considered. The aim of this review was to assess the prevalence of appendiceal carcinoid tumors and appendiceal endometriosis in patients undergoing gynecologic surgery, its association with endometriosis, and related symptoms.
EVIDENCE ACQUISITION
We included retrospective and prospective studies that assessed women who underwent appendicectomy in the past 20 years for appendiceal endometriosis and/or appendix carcinoid tumor confirmed by histological analysis. Results were reported as relative and absolute frequencies. Due to the heterogeneity of included studies, a statistical analysis (meta-analysis) was not performed.
EVIDENCE SYNTHESIS
The prevalence of appendiceal endometriosis was 15.2% in patients who underwent surgery for pelvic endometriosis and 11.4% in those who underwent benign gynecological surgery. Conversely, carcinoid tumors of the appendix were present in 2.4% of endometriosis patients and 1.3% of other benign gynecological surgeries.
CONCLUSIONS
The rates of carcinoid tumors in patients with endometriosis are the same as in the general population. Given the risk of a malignant appendiceal tumor, in all gynecological surgeries, especially those for endometriosis, the appendix should be inspected and removed if it has an abnormal appearance.
Topics: Appendiceal Neoplasms; Appendix; Carcinoid Tumor; Endometriosis; Female; Humans; Prospective Studies; Retrospective Studies
PubMed: 33904692
DOI: 10.23736/S2724-606X.21.04792-4 -
Journal of Gastrointestinal Cancer Jun 2021Appendiceal mucocele is a rarely seen disease which occurs when the appendix lumen is filled and obstructed by mucous. In our study, we aimed to reveal the surgical...
BACKGROUND
Appendiceal mucocele is a rarely seen disease which occurs when the appendix lumen is filled and obstructed by mucous. In our study, we aimed to reveal the surgical approach of our clinic, features of tumors, and clinical presentations in line with literature in cases of appendix mucocele.
METHODS
Fourteen appendix mucocele patients who were admitted in our hospital between 2012 and 2019 were examined retrospectively in the electronic recording medium. Our patients were evaluated in terms of age, gender, clinical status, operation, imaging results, and pathology results.
RESULTS
Of the fourteen patients, 12 applied to the emergency department and 2 to the general surgery clinic. All of our patients had abdominal pain at the time of admission. In the physical examination, 5 (35%) patients had defenses, 10 (71%) patients had rebound tenderness, and 12 (85%) patients had tenderness. In preoperative imaging studies, 11 patients were interpreted as having acute appendicitis and 3 patients were evaluated as having appendix mucocele. The pathological results were reported as 6 patients had appendiceal mucocele and 8 patients had appendiceal mucocele together with acute appendicitis.
CONCLUSION
Appendiceal mucocele is a disease which generally causes similar clinical findings of acute appendicitis. Ultrasound and CT may be useful in preoperative diagnosis. Surgical treatment options of mucocele are open or laparoscopic appendectomy, cecum resection, and right hemicolectomy. Although its incidence is low, due to pseudomyxoma peritonei, it is a pathology that requires careful surgery.
Topics: Adult; Appendectomy; Appendicitis; Appendix; Diagnosis, Differential; Female; Humans; Incidence; Laparoscopy; Male; Middle Aged; Mucocele; Pseudomyxoma Peritonei; Retrospective Studies; Young Adult
PubMed: 32700184
DOI: 10.1007/s12029-020-00462-4 -
European Journal of Surgical Oncology :... Feb 2023This study systematically reviewed the literature to investigate the value of secondary surgery for children with a high-risk neuroendocrine tumor (NET) of appendix. A... (Review)
Review
This study systematically reviewed the literature to investigate the value of secondary surgery for children with a high-risk neuroendocrine tumor (NET) of appendix. A systematic search was performed in PubMed, Embase and Web of Science. All randomized controlled trials, cohort studies, and case series reporting on the management and outcomes of patients (<20 years) with a histopathologically proven NET of the appendix were eligible for inclusion. Two authors independently selected eligible articles, assessed risk of bias, and extracted data. The outcomes of patients with a high-risk NET treated with secondary surgery were compared to those treated without secondary surgery. Primary outcomes were recurrence rate and disease-free survival. The literature search yielded 667 articles, of which 29 were included. These studies reported on 1112 patients, of whom 145 (13%) had high-risk NET. Heterogeneity between studies was large and risk of bias was serious in 26 and moderate in three studies. Secondary surgery after primary appendectomy was performed in 64 of 145 patients (44%). Length of follow-up ranged between 0 and 612 months. In both treatment groups no recurrences were reported, and thus disease-free survival was 100%. Based on current literature, the value of secondary surgery for pediatric high-risk NET of the appendix may be questioned. However, evidence is scarce, of low-quality, and heterogeneity between studies is large. Large international studies with adequate follow-up are needed to generate high-quality evidence on this topic.
Topics: Humans; Child; Appendix; Appendiceal Neoplasms; Neuroendocrine Tumors
PubMed: 36372617
DOI: 10.1016/j.ejso.2022.10.021 -
Minerva Pediatrics Feb 2022The main objective of this study was to investigate and compare chosen time laparoscopic surgery to traditional open surgery and to analyze whether laparoscopic surgery...
BACKGROUND
The main objective of this study was to investigate and compare chosen time laparoscopic surgery to traditional open surgery and to analyze whether laparoscopic surgery is safe and feasible for pediatric appendix abscess in emergency.
METHODS
This retrospective study consisted of three groups of patients designated as group A, group B, group C and the preoperative and postoperative clinical characteristics were analyzed and compared. Group A comprised of 63 patients of appendix abscess which has been treated by laparoscopic surgery from January 2011 to December 2014. Group B comprised of 60 patients who had undergone pediatric appendix abscess laparotomy and group C comprised of 35 cases who had undergone time-selective laparoscopic appendix ablation surgery after receiving anti-inflammatory treatment.
RESULTS
The average operation time during which all the appendix ablated successfully between group A and group B patients was not significantly different (P>0.05), meanwhile, operation time was significantly less for group C patients in comparison with group A patients (P<0.05). The incidence of postoperative complications among patients of group A was significantly lower than that of group B (P<0.05), while, these complications were similarly distributed between group A and group C (P>0.05). The duration of hospitalization among patients of group B (P<0.05) and group C (P<0.05) was significantly higher in comparison with group A patients.
CONCLUSIONS
As long as preoperative and perioperative periods are appropriately dealt with, laparoscopic surgery is safe and feasible to pediatric appendix abscess in emergency.
Topics: Abscess; Appendectomy; Appendix; Child; Humans; Laparoscopy; Retrospective Studies
PubMed: 27198494
DOI: 10.23736/S2724-5276.16.04638-7 -
The American Journal of Surgical... Dec 2021Data from previous studies suggest Crohn disease of the appendix accounts for ∼25% of granulomatous appendicitis cases. However, we have found that granulomatous...
Data from previous studies suggest Crohn disease of the appendix accounts for ∼25% of granulomatous appendicitis cases. However, we have found that granulomatous inflammation in appendectomy specimens rarely heralds Crohn disease. We suspect that appendiceal involvement by Crohn disease is uncommon, even when patients have severe ileocolonic inflammation. We performed this study to determine the prevalence and nature of appendiceal inflammation among patients with Crohn disease. We reviewed 100 ileocolic specimens with strictures and fistulizing Crohn disease for the nature and distribution of inflammatory changes in the appendix and compared them with 100 appendices on colectomy specimens from age-matched and sex-matched patients with ulcerative colitis. We also evaluated 27 additional cases of granulomatous appendicitis in appendectomy specimens to determine the frequency with which this finding represented Crohn disease. The appendix was usually normal (26%) or showed fibrous obliteration (50%) in ileocolic resection specimens from patients with Crohn disease. Mucosal inflammation was much less common in appendices from patients with Crohn disease than ulcerative colitis (6% vs. 28%, P<0.0001); only 4 cases contained epithelioid granulomata, 3 showed mural fibrosis and lymphoid aggregates, and 10 displayed only periappendiceal inflammation. None of the patients with granulomatous appendicitis in appendectomy specimens had, or developed, evidence of Crohn disease. We conclude that Crohn disease infrequently affects the appendix. Interval appendectomy and infection are more important considerations when appendectomy specimens feature granulomatous inflammation and/or mural lymphoid aggregates, especially if there is no history of idiopathic inflammatory bowel disease.
Topics: Adult; Appendectomy; Appendicitis; Appendix; Crohn Disease; Female; Granuloma; Humans; Male; Retrospective Studies; Risk Assessment; Risk Factors
PubMed: 33999557
DOI: 10.1097/PAS.0000000000001734 -
Gastrointestinal Endoscopy Feb 2024
Topics: Humans; Appendix; Endoscopy
PubMed: 38237969
DOI: 10.1016/j.gie.2023.08.014