Chronic appendicitis: uncommon cause of chronic abdominal pain

Kothadia, Jiten P.; Katz, Seymour; Ginzburg, Lev

doi:10.1177/1756283x15576438

Cited by 31 publications

(39 citation statements)

References 8 publications

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“…Chronic appendicitis should also be considered in the differential diagnosis of patients with recurrent or chronic right lower quadrant pain. Computed tomography is the best test for its diagnosis, and appendectomy can be an effective treatment for these patients [27]. In our current study, of the three patients reported as having chronic appendicitis, two had a history of recurrent abdominal pain and one had chronic abdominal pain.…”

Section: Discussionmentioning

confidence: 89%

Incidental Findings in Routine Histopathological Examination of Appendectomy Specimens; Retrospective Analysis of 1970 Patients

et al. 2016

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Diseases and tumors of the appendix vermiformis are very rare, except for acute appendicitis. This study aimed to examine rare findings in the histopathologic examinations of specimens of patients undergoing appendectomy due to the diagnosis of acute appendicitis. The files of 1970 patients undergoing appendectomy due to the diagnosis of acute appendicitis between March 2012 and March 2016 were retrospectively investigated. Rare findings were found in 59 (3 %) patients, and these were evaluated in detail. Patients' age, gender, pathology reports, and postoperation follow-ups were recorded. The rare histopathological findings of 59 patients were examined. Of these, 31 were female (52.5 %) and 28 were male (47.5 %). The average age was 33.1 ± 18.2 years. The unusual findings were as follows: 16 fibrous obliteration, 11 , 2 schistosomiasis, 3 appendiceal neuroma, 2 granulomatous appendicitis, 1 Crohn's disease, 3 chronic appendicitis, 1 endometriosis, 2 hyperplastic polyps, 9 mucinous cystadenoma (+mucocele), 8 carcinoid tumors, and 1 lymphoma. All of the malignant tumors were localized in the distal end of the appendix, and all of the patients were treated with appendectomy. Patients with parasitic diseases also underwent anthelmintic treatment, while chemotherapy was administered to the patient with lymphoma. All of the patients diagnosed with malignancy were alive reported no problems at their follow-ups. Although all of the appendectomy samples were normal macroscopically, data from this study suggest that all specimens should be sent for routine investigation.

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Section: Discussionmentioning

confidence: 89%

Incidental Findings in Routine Histopathological Examination of Appendectomy Specimens; Retrospective Analysis of 1970 Patients

et al. 2016

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“…Unlike acute appendicitis, recurrent appendicitis is not considered a surgical emergency [ 19 ]. Diagnosis can be missed or delayed secondary to atypical presentation or prior treatment with antibiotics, which may lead to resolution of the infection [ 20 ]. A missed diagnosis can have serious complications such as perforation, abscess formation and peritonitis [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

A case report on recurrent appendicitis: An often forgotten and atypical cause of recurrent abdominal pain

Mengesha¹,

Teklu

2018

Annals of Medicine and Surgery

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IntroductionRecurrent appendicitis is a disease process, distinct from acute appendicitis, which occurs with an approximate incidence of 10%. This clinical entity can pose diagnostic and therapeutic dilemma for clinicians resulting in delayed diagnosis and severe complications.Presentation of caseHerein, we described a case of recurrent appendicitis with a history of 18 years of right lower quadrant (RLQ) abdominal pain with very mild tenderness that we encountered in our hospital in January 2016, which has been misjudged as other abdominal conditions and got complete relief after appendectomy. The case report could help to improve the awareness of medical practitioners who come across similar cases so that they can consider recurrent appendicitis in their differential diagnosis; and hence outline appropriate diagnosis as well as early medical interventions.DiscussionRecurrent appendicitis can be missed or delayed secondary to atypical presentation or prior treatment with antibiotics, which may lead to resolution of the infection. Missed diagnosis can lead to serious complications such as perforation, abscess formation and peritonitis. Medical practitioners who encounter patients with recurrent right flank pains with an extended duration should suspect for recurrent appendicitis and carefully analyze patient history as well as line up their diagnosis.ConclusionTherefore, recurrent appendicitis should be considered as differential diagnosis in patients with recurring right lower quadrant abdominal pain and mild/or no tenderness.

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“…Eosinophilic infiltration of muscularis propria has been seen in acute appendicitis and it is postulated that acute appendicitis is triggered by Type I hypersensitivity [6]. Hence mast cells and eosinophils have important role to play in the pathogenesis of appendicitis as concluded by many studies [4,5,6,7,8,9,10,11,12].…”

Section: Discussionmentioning

confidence: 99%

Study of mast cell and eosinophil count in surgically resected appendix

Priya

Giriyan

2019

Trop J Pathol Microbiol

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Introduction:Appendix is a normal true diverticulum of the caecum that is prone to acute and chronic inflammation. Mast cells are present in chronic inflammatory reactions and they secrete cytokines that promote inflammation. Eosinophils are abundant in immune reactions mediated by IgE and in parasitic infection. Objective: To evaluate mast cell and eosinophil count variation in appendicitis and to suggest their possible role in pathogenesis of appendicitis. Materials and Methods: It is a two-year prospective study done on 470 resected specimens of appendices received for histopathology. Results: Mast cells and eosinophils were present in all the appendicular lesions studied. Mean mast cell count was highest in chronic appendicitis and lowest in acute appendicitis. Mucosa of chronic appendicitis showed highest count, lowest was seen in the muscularis propria of acute appendicitis compared to normal / unremarkable appendix taken as controls. Correlation between mast cell density, fibrosis and neural ganglia hypertrophy was seen in chronic appendicitis. Mean eosinophil count was highest in acute suppurative appendicitis and lowest in chronic appendicitis, with highest count in the mucosa of acute suppurative appendicitis and lowest in the muscularis propria of chronic appendicitis. Conclusion: The presence of mast cells and eosinophils in cases of appendicitis supports the allergic theory of appendicitis in which the Type I hypersensitivity reaction leads to recruitment of eosinophils and discharge of primary and secondary mediators of inflammation by degranulation of mast cells which play a role in pathogenesis of appendicitis.

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Chronic appendicitis: uncommon cause of chronic abdominal pain

Cited by 31 publications

References 8 publications

Incidental Findings in Routine Histopathological Examination of Appendectomy Specimens; Retrospective Analysis of 1970 Patients

Incidental Findings in Routine Histopathological Examination of Appendectomy Specimens; Retrospective Analysis of 1970 Patients

A case report on recurrent appendicitis: An often forgotten and atypical cause of recurrent abdominal pain

Study of mast cell and eosinophil count in surgically resected appendix

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