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Clinical Gastroenterology and... Dec 2011
Topics: Appendix; Clostridioides difficile; Clostridium Infections; Female; Humans; Male
PubMed: 21893132
DOI: 10.1016/j.cgh.2011.08.025 -
International Journal of Surgery... Apr 2017Acute appendicitis is the most common condition that presents with an acute abdomen needing emergency surgery. Despite this common presentation, correctly diagnosing... (Meta-Analysis)
Meta-Analysis Review
Acute appendicitis is the most common condition that presents with an acute abdomen needing emergency surgery. Despite this common presentation, correctly diagnosing appendicitis remains a challenge as clinical signs or positive blood results can be absent in 55% of the patients. The reported proportion of missed diagnoses of appendicitis ranges between 20% and 40%. A delay or mis-diagnosis of appendicitis can result in severe complications such as perforation, abscess formation, sepsis, and intra-abdominal adhesions. Literature has shown that patients who had a negative appendectomy suffer post-op complications and infections secondary to hospital stays; there have even been reported cases of fatality. It is therefore crucial that timely and accurate diagnosis of appendicitis is achieved to avoid complications of both non-operating as well as unnecessary surgical intervention. The aim of this review is to systematically report and analyse the latest evidence on the different approaches used in diagnosing appendicitis. We include discussions of clinical scoring systems, laboratory tests, latest innovative bio-markers and radiological imaging.
Topics: Acute Disease; Adult; Appendectomy; Appendicitis; Appendix; Biomarkers; Diagnosis, Differential; Female; Humans; Male; Sensitivity and Specificity
PubMed: 28279749
DOI: 10.1016/j.ijsu.2017.03.013 -
Medical Ultrasonography Sep 2020This article aims to introduce a novel anatomical scanning method which requires scanning according to varied anatomic positions of the appendix based on the widely used... (Review)
Review
This article aims to introduce a novel anatomical scanning method which requires scanning according to varied anatomic positions of the appendix based on the widely used graded compression method. We suggest placing the probe longitudinally in the region of the terminal cecum and moving it laterally to explore the sub-cecal appendix. The probe should be placed transversely on the medial side of the cecum to explore the pre-ileal appendix or post-ileal appendix. Placing the probe perpendicularly along external iliac vessels can help explore the pelvic appendix. The probe should be placed transversely on the paracolic sulci, and moved along the paracolic sulci to observe the extra-peritoneal appendix. Using the cephalic end of the probe as a pivot, push and squeeze the cecum to make it move bilaterally as much as possible, in order to expose the retrocecal appendix behind the air-filled cecum. It is our belief that this anatomical scanning method will greatly improve appendix detection rate and diagnostic accuracy, and provide guidance for surgical localization.
Topics: Appendicitis; Appendix; Humans; Ultrasonography
PubMed: 32898205
DOI: 10.11152/mu-2541 -
Diagnostic and Interventional Imaging Jan 2014
Topics: Appendectomy; Appendiceal Neoplasms; Appendix; Cystadenoma, Mucinous; Humans; Image Enhancement; Image Processing, Computer-Assisted; Male; Middle Aged; Mucocele; Tomography, X-Ray Computed
PubMed: 24433760
DOI: 10.1016/j.diii.2013.07.015 -
Ulusal Travma Ve Acil Cerrahi Dergisi =... Apr 2022Acute appendicitis (AA) is a common cause of abdominal pain in developed countries. In patients with suspected AA, computed tomography (CT) is considered as the gold...
BACKGROUND
Acute appendicitis (AA) is a common cause of abdominal pain in developed countries. In patients with suspected AA, computed tomography (CT) is considered as the gold standard with the highest sensitivity and specificity, and it is also an im-portant modality, especially in patients with complicated AA. In this study, we aimed to evaluate age and laboratory findings, as well as specific CT findings in differentiating between perforated and non-perforated appendicitis.
METHODS
We retrospectively analyzed 252 patients diagnosed with AA and underwent appendectomy between November 2015 and December 2019 in Somalia Mogadishu Recep Tayyip Erdogan Education and Research Hospital. Patients under 18 years of age and those with no pre-operative CT scans were excluded from the study. The demographic, laboratory, CT findings, and pathological data of all patients were evaluated.
RESULTS
This study included 80 patients, 32 (40%) classified as perforated appendicitis (Group-1) and 48 (60%) as non-perforated appendicitis (Group-2). The C-reactive protein value was found to be statistically higher in Group-1 than in Group-2 (177.5±118.9 and 100.2±87.3 mg / L, respectively; p=0.001). The appendix lumen diameter (p=0.002), appendix wall defect (p<0.001), peritoneal thickening and enhancement (p<0.001), ascites (p=0.031), intra-abdominal abscess (p=0.003), jejunal thickening (p=0.019), ileal thick-ening (p=0.008), and ileus (p=0.035) values were significantly higher in Group-1. In the binominal logistic regression analysis performed with statistically significant data, an appendiceal wall defect (OR: 0.069, 95% CI=0.014-0.327, p=0.001) and peritoneal thickening and enhancement (OR: 0.131, 95% CI=0.024-0.714, p=0.019) were identified as independent variables for perforated appendicitis.
CONCLUSION
Among CT findings, appendix wall defects and peritoneal thickening and enhancement play an important role in detecting perforation.
Topics: Acute Disease; Adolescent; Appendectomy; Appendicitis; Appendix; Humans; Retrospective Studies
PubMed: 35485514
DOI: 10.14744/tjtes.2020.58991 -
Ulusal Travma Ve Acil Cerrahi Dergisi =... Mar 2019The purpose of the present study was to investigate the diagnostic value of the appendiceal sphericity index (SI) and appendix diameters in cases of perforated and...
BACKGROUND
The purpose of the present study was to investigate the diagnostic value of the appendiceal sphericity index (SI) and appendix diameters in cases of perforated and non-perforated acute appendicitis.
METHODS
Eighty-one patients who underwent computed tomography (CT) in our clinic and who were diagnosed with acute appendicitis after histopathological assessment between January 2015 and August 2017 were included in the study. According to their histopathological findings, the patients were divided into two groups: perforated and non-perforated appendicitis. The patients' CT images were re-evaluated with respect to perforation. Long axis and short axis of the appendix and the SI obtained by their proportions were calculated from the appropriate plane on CT. Their parameters and other CT findings as defined in the current literature were analyzed for statistical significance in the detection of perforation.
RESULTS
The perforated and non-perforated appendicitis groups consisted of 20 and 61 patients, respectively. For wall defect, abscess, extraluminal air, free fluid, and appendicolith, the sensitivity values were 25%, 15%, 25%, 55%, and 50%, respectively, and the specificity values were 100%, 100%, 100%, 77%, and 70.5%, respectively. Sensitivity and specificity for the SI and long axis of the appendix were calculated as 85% and 90% and 85.2% and 73.8%, respectively (p<0.001).
CONCLUSION
Although there are many findings with high specificity in the diagnosis of perforation, their sensitivity is very low when evaluated separately. We consider that the measurement of long-axis length with high sensitivity and the evaluation of SI with high specificity and sensitivity will contribute significantly to the diagnosis of perforation.
Topics: Appendicitis; Appendix; Humans; Retrospective Studies; Sensitivity and Specificity; Tomography, X-Ray Computed
PubMed: 30892666
DOI: 10.5505/tjtes.2018.29266 -
Internal Medicine (Tokyo, Japan) May 2021Acute appendicitis is an important differential diagnosis in patients with right lower quadrant pain during pregnancy. Endometriosis, a hormone-related pathology, is...
Acute appendicitis is an important differential diagnosis in patients with right lower quadrant pain during pregnancy. Endometriosis, a hormone-related pathology, is another possibility. Patients with endometriosis are typically symptomatic before pregnancy. Stromal endometriosis is a variant of endometriosis that presents no symptoms before pregnancy but which occasionally presents with the new onset of symptoms during pregnancy. We report the case of a 35-year-old woman in her 8th month of pregnancy who presented with impending appendiceal rupture due to deciduosis of the appendix, a progesterone-related condition, during pregnancy. This case suggests that deciduosis/stromal endometriosis should be considered as a differential diagnosis of acute abdomen during pregnancy, even if the patient is asymptomatic before pregnancy.
Topics: Abdomen, Acute; Adult; Appendicitis; Appendix; Decidua; Diagnosis, Differential; Endometriosis; Female; Humans; Pregnancy; Pregnancy Complications
PubMed: 33361675
DOI: 10.2169/internalmedicine.5960-20 -
United European Gastroenterology Journal Dec 2021
Topics: Appendix; Colitis, Ulcerative; Humans; Inflammation
PubMed: 34855290
DOI: 10.1002/ueg2.12181 -
JPMA. the Journal of the Pakistan... Apr 2021Mucinous cystadenoma is a rare tumour of the appendix. It accounts for only 0.4% of the gastrointestinal tract malignancies and is reported rarely in the literature....
Mucinous cystadenoma is a rare tumour of the appendix. It accounts for only 0.4% of the gastrointestinal tract malignancies and is reported rarely in the literature. Therefore, surgical management is not yet established. Here we report the case of a 65-year-old female who presented with a dragging sensation and a feeling of a mass in the right iliac fossa. Her computed tomography (CT) suggested formation of an abscess in the parietal peritoneum. She was scheduled for laparotomy and upon exploration, a mass was found arising from the tip of the retroperitoneal appendix. The whole of the appendix was studded with mucoid material. Right hemicolectomy was performed and histopathology of the appendix showed mucinous cystadenoma with no evidence of malignant changes. The recovery was uneventful and the patient was discharged on the fourth post-operative day. The unusual presentation of retroperitoneal pseudomyxoma without any intraperitoneal pathology prompted us to report this case.
Topics: Aged; Appendiceal Neoplasms; Appendix; Colectomy; Cystadenoma, Mucinous; Female; Humans; Mucocele
PubMed: 34125785
DOI: 10.47391/JPMA.01 -
Toxins Sep 2020Deoxynivalenol (DON) is a mycotoxin found in grains that poses a potential threat to human and animal health, and the gastrointestinal tract is the primary target organ....
Deoxynivalenol (DON) is a mycotoxin found in grains that poses a potential threat to human and animal health, and the gastrointestinal tract is the primary target organ. There are few studies focused on the toxicology of DON to rabbits, especially on the relation among DON, microbiota, and the gut-associated lymphoid tissue. A total of 30 weaned rabbits (35 d) were evenly divided into the control group and DON group (1.5 mg/kg bodyweight (BW)) based on their body weight. After a 24-day trial, the ultrastructures of the and were observed using a scanning electron microscope and transmission electron microscopy. The morphology and microflora in the ileum, caecum, and colon were also examined. The results proved that the ultrastructure of the and , as well as the integrity of the intestinal barrier (especially for the ileum), were impaired after DON was administrated to the rabbits. Compared to the control group, the relative abundance and diversity of the microflora decreased in all three intestinal segments in the DON group, particularly in the ileum and caecum. In conclusion, the toxic effect of DON on weaned rabbits may be performed by destroying the structure of the and , as well as affecting the structure and diversity of the intestinal flora.
Topics: Animals; Appendix; Bacteria; Dysbiosis; Gastrointestinal Microbiome; Microscopy, Electron, Scanning; Microscopy, Electron, Transmission; Rabbits; Ribotyping; Trichothecenes; Weaning
PubMed: 32899719
DOI: 10.3390/toxins12090569