Acute appendicitis following blunt abdominal trauma in children: by chance or a cause?

Gupta, Rahul; Mathur, Vaibhav; Bansal, Juhi; Bhandari, Anu; Mathur, Praveen; Sharma, Shreya; Gupta, Arun Kumar

doi:10.1016/j.fjs.2016.05.005

Cited by 6 publications

(9 citation statements)

References 12 publications

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“…While appendicitis can independently lead to amputation of the appendix, trauma is a rare but reported cause of appendicitis [ 4 ]. A review of the literature showed that pediatric cases of traumatic appendiceal amputation were in response to the primary impact of the injury, which may or may not occur as sequelae with traumatic appendicitis [ 5 , 6 ]. However, the present scenario was different in terms of the occurrence of appendicular amputation as a post-trauma, postoperative event, further leading to its complications.…”

Section: Discussionmentioning

confidence: 99%

Floating appendix: post-traumatic amputation of the appendix as sequela or complication?: a case report

et al. 2021

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Background Appendicitis following trauma is a well-documented sequela of blunt trauma to the abdomen, while appendiceal transection following trauma is extremely rare. Literature reports have documented appendicitis and appendiceal transection as the presenting pathology in a trauma setting. This is first report of auto-amputation of the appendix as a delayed presentation with peritonitis, which was detected during the second surgery in a child with blunt abdominal trauma. Case presentation A 11-year-old Asian boy presented to our center with a 2-day history of blunt abdominal trauma and chief complaint of severe abdominal pain. On evaluation, a computed tomography scan showed gross pneumoperitoneum. The child underwent emergency laparotomy, where a jejunal perforation was noted, which was repaired. The rest of the bowel and solid organs were healthy. The child was managed in the intensive care unit postoperatively, when he developed a burst abdomen. During the second surgery, pyoperitoneum and free-floating appendix were found in the left paracolic gutter. After peritoneal wash, the bowel was noted to be healthy and the previous jejunal repair was intact. The child was allowed oral intake of food and discharged on postoperative days 4 and 8, respectively. At the 1-year follow-up, he remained asymptomatic. Conclusions This case report is unique as it describes auto-amputation of the appendix as a delayed event in the course of treatment for blunt trauma of the abdomen. Although a remote event, the possibility of amputation of the appendix should be retained as a differential diagnosis and unusual complication in cases of delayed peritonitis.

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Section: Discussionmentioning

confidence: 99%

Floating appendix: post-traumatic amputation of the appendix as sequela or complication?: a case report

et al. 2021

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“…5 Another mechanism has been described is that violent trauma with increased cecal pressure can result in displacement of an asymptomatic appendicolith deeply into the appendix leading to obstruction of the appendiceal lumen or its perforation. 1,2,5 Moreover, deceleration forces expose to microvascular tears causing ischemia with subsequent perforation. 6 In the present case, acute appendicitis was caused by an impacted appendicolith into the appendiceal lumen which is the most common mechanism reported in the literature especially in pediatric population.…”

Section: Discussionmentioning

confidence: 99%

“…2,3 It was also suggested that trauma may cause an obstruction of the appendiceal lumen because of edema formation, appendiceal intramural hematomas and/or intrinsic lymphoid tissue hyperplasia with enlarged mesenteric lymph node. 5 Another mechanism has been described is that violent trauma with increased cecal pressure can result in displacement of an asymptomatic appendicolith deeply into the appendix leading to obstruction of the appendiceal lumen or its perforation. 1,2,5 Moreover, deceleration forces expose to microvascular tears causing ischemia with subsequent perforation.…”

Section: Discussionmentioning

confidence: 99%

“…7 Due to their vulnerability to direct trauma, their small abdominal cavity and the less muscular abdominal wall, children are more affected than adults and particularly older children who participate in more outdoor activities and can rarely protect themselves against trauma compared with adults. 3,5 The clinical presentation of traumatic appendicitis is similar to that of non traumatic appendicitis, beginning from the inception of trauma and persists till the surgical confirmation. Leucocytosis is not consistent.…”

Section: Discussionmentioning

confidence: 99%

“…8 Diagnostic laparoscopy can be also used in patients who are haemodynamically stable when there is a high index of clinical suspicion and equivocal imaging findings. 5 Delay in diagnosis leads to appendiceal perforation with peritonitis requiring a laparotomy with a high rate of morbidity.…”

Section: Discussionmentioning

confidence: 99%

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