Faecaliths do not predict severity of acute appendicitis

Hawkins, Samuel; Miller, Mitchell; Zhu, Hongfa; Shi, Meiyi; Zielonka, Tania; Blatt, Melissa; Kuo, Yen-Hong; Cohn, Stephen M.

doi:10.1093/bjs/znac118

Cited by 2 publications

(4 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this case report however, the appendix measured 18mm in AP dimension (Figure 1B) with some vascularity evidently seen around it, and it contained heterogeneous cystic components within its lumen which were seen as fluid on CT. A tiny appendicolith was visualised on CT (Figure 3B) but not on ultrasound where it could have been obscured by the heterogeneous cystic luminal component. The presence of an appendicolith within the appendix on imaging does not denote inflammation, as appendicoliths have been reported in normal appendices [15] . Nonetheless, appendicoliths triggering an obstruction of the appendix lumen have been reported to cause increased failure rates of non-operative management of appendicitis [1] .…”

Section: Discussionmentioning

confidence: 85%

Perforated Appendicitis

2023

J Mod Med Imag

View full text Add to dashboard Cite

Background: Globally, nearly 100 in 100,000 adults develop appendicitis every year. When the wall of the inflamed appendix gets compromised, this leads to perforation, abscess, and peritonitis, which if left unmanaged can cause sepsis and potentially death.The Case: This is a case of a 51-year old male that presented to the Surgical Triage Unit with right lower quadrant pain ongoing for four days, and some intermittent sharp pain. Ultrasound revealed an inflamed appendix in the right iliac fossa measuring 18mm in AP dimension with an irregular wall outline, loss of wall stratification, and a heterogeneous luminal content. Furthermore, a small amount of fluid was seen close to the compromised wall of the appendix near its fundal tip in keeping with complicated appendicitis with possible perforation. Computed tomography (CT) revealed a dilated and fluid-filled appendix measuring 17mm in AP dimension with a tiny appendicolith at the tip of the appendix. However, there was no evidence of free gas or periappendiceal abscess seen on CT to suggest perforation. The patient underwent laparoscopic appendectomy the following day and this revealed perforated appendicitis (PAp) with four quadrants peritonitis. Histopathology revealed a transmural acute inflammation with an overlying serosal reaction, ulcerated epithelium, and loss of the muscularis propria layer. Conclusion:This case report highlights the features of PAp seen on ultrasound imaging and also discusses the role of ultrasound, CT, and haematology in the diagnosis of PAp based on recent works of literature.

show abstract

Section: Discussionmentioning

confidence: 85%

Perforated Appendicitis

2023

J Mod Med Imag

View full text Add to dashboard Cite

show abstract

“…The exact cause of acute appendicitis remains unknown in approximately 60% of cases [17][18][19][20][21]. In the remaining cases, it is caused by lumen obstruction.…”

Section: Introductionmentioning

confidence: 99%

“…In the remaining cases, it is caused by lumen obstruction. Obstruction of the lumen is most commonly caused by fecal matter or lymphoid hyperplasia; rarely, appendicitis is caused by tumors, intestinal parasites, or foreign bodies [18][19][20]. In the majority of cases, ingested foreign bodies pass through the gastrointestinal tract without causing symptoms.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Bizarre Cause of Acute Appendicitis in a Pediatric Patient: An Ingested Tooth

Pogorelić

Čohadžić

2023

Children

View full text Add to dashboard Cite

(1) Background: Among all possible causes, foreign bodies are the rarest cause of appendicitis in the pediatric population. In the majority of cases, ingested foreign bodies pass through the gastrointestinal tract without causing symptoms. However, those foreign bodies that pass through the lumen of the vermiform appendix cannot re-enter the colon and may cause acute appendicitis. So far, various foreign bodies have been described to enter the appendix and cause acute appendicitis, such as seeds, needles, toothpicks, plant material, or even hair. Tooth or dental implants as a cause of acute appendicitis have been described in only a few cases. To our knowledge, this is the first described case of the tooth causing acute appendicitis in the pediatric population. (2) Case presentation: A 14-year-old male patient presented to the emergency department complaining of pain in the right lower quadrant of the abdomen and vomiting that persisted for approximately 24 h. Until then, the patient was healthy and had no concomitant diseases. Physical examination revealed guarding and tenderness in the right lower abdominal quadrant. The white blood cell count was 17.1 × 109/L with a neutrophil count of 91.1% and a C-reactive protein of 39.3 mg/dL. Ultrasonography of the abdomen revealed a thickened, inflamed appendix with a diameter of 11 mm and free periappendicular fluid. A 9 × 6 mm foreign body at the base of the appendix was visualized. The patient was diagnosed with acute appendicitis, and an emergency laparoscopic appendectomy was performed on the same day. Intraoperatively, gangrenous appendicitis was noted and removed without complications. Upon examination of the removed specimen, it was determined that the patient’s appendicitis had been caused by an ingested tooth. As it later turned out, the patient had broken a lateral incisor while playing sports the day before admission without knowing that he had swallowed it. The patient recovered well and was discharged the day after surgery. (3) Conclusion: Although an extremely rare event, acute appendicitis can be caused by a swallowed tooth. This case highlights the importance of a thorough history in pediatric patients who present to the emergency department with suspected acute appendicitis to determine if there is a precipitating event that may have caused acute appendicitis.

show abstract

Faecaliths do not predict severity of acute appendicitis

Cited by 2 publications

References 3 publications

Perforated Appendicitis

Perforated Appendicitis

A Bizarre Cause of Acute Appendicitis in a Pediatric Patient: An Ingested Tooth

Contact Info

Product

Resources

About