Acute appendicitis is a clinical diagnosis, so it's impossible to have a definitive diagnosis by gold standard (histopathology) pre operatively. The treatment being surgical, negative appendicectomy rates are high. Present study was conducted to evaluate Alvarado scoring system for diagnosis of acute appendicitis and its co relation by histopathology. Retrospective study of consecutive patients admitted with suspected acute appendicitis during the period March 2005 to March 2007. The Alvarado scoring system was computed from admission notes and records and correlated with the histopathology reports. Out of 155 patients, 92 underwent appendicectomy with the intention to treat appendicitis and diagnosis was confirmed in 80 patients. Reliability of scoring system was assessed by calculating negative appendicectomy rate and positive predictive value. The normal appendicectomy frequency was 13% and positive predictive value was 86%. Alvarado scoring system is easy, simple, cheap, useful tool in pre operative diagnosis of acute appendicitis and can work effectively in routine practice.
Here we report a case of pseudoaneurysm of distal posterior tibial artery following closed fracture of calcaneous. Association of pseudoaneurysm of posterior tibial artery with fracture of calcaneous is extremely uncommon. It is always suggested that pseudoaneurysm be treated by reconstruction, but here we present the case treated by ligation, obliteration and excision as it was situated distally and the plantar arch circulation was maintained. The purpose of this case report is to bring attention to this complication of vascular trauma, which may cause delayed symptoms long time after the injury as well as the rare incidence of posterior tibial artery involvement with fracture calcaneous.
A 40-year-old man presented with a progressively increasing swelling over the ventral aspect of the right wrist of 23 days duration following a laceration. The swelling was soft, pulsatile and was intermittently bleeding, with poor distal capillary filling and cold distal extremity. Clinically it was diagnosed as pseudoaneurysm of the radial artery and was sent for a duplex scan for confirmation. The lesion ruptured in the radiology department before the scan was done, and the patient went into hypovolaemia. In view of this, the patient underwent exploration of the pseudoaneurysm under brachial block, and the radial artery was found to be transected just proximal to the dorsal branch. It was decided to repair the artery as there was no evidence of adequate circulation supply or the patency of the ulnar artery preoperatively. Doppler study at 15 and 45 days postoperatively showed good flow through, with no evidence of thrombus.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.