The sonographic features of neonatal appendicitis

Abstract

Rationale:Neonatal appendicitis is extremely rare, and preoperative diagnosis is challenging. This study aimed to investigate the utility of ultrasound for the diagnosis of neonatal appendicitis.Patient concerns:Four cases of neonatal appendicitis were included in this case series. One was a female infant and the other 3 were male infants; they were aged from 10 to 17 days.Diagnoses:Neonatal appendicitis.Interventions:Four newborns in our hospital were diagnosed with neonatal appendicitis by abdominal ultrasound. Their sonographic features were summarized and compared with surgical and pathological findings.Outcomes:In these infants, abdominal ultrasound demonstrated ileocecal bowel dilatation, intestinal and bowel wall thickening, and localized encapsulated effusion in the right lower quadrant and the abscess area, which was assumed to surround the appendix.Lessons:Ultrasound is helpful for the diagnosis of neonatal appendicitis.

Perforated Neonatal Appendicits With Associated Intraperitoneal Abscess and Bacterial Meningitis: The Case of the Baby Who Would Not Stay Well

“…The typical location of an intra-abdominal abscess associated with neonatal appendiceal rupture is restricted to the right abdomen or underneath the liver due to its high position during the neonatal period. 15 The operative report describes fibrous strands adherent to the abdominal wall and a stump where the appendix would normally be located indicating a chronic, rather than acute, process at the time of exploratory laparotomy (8 weeks of life). No pathological samples were obtained during surgery to confirm appendicular tissue.…”

A Rare Case of Chronic Suppurative Appendicitis in Neonatal Presenting as Intestinal Malrotation

“…In this case, the procalcitonin slightly increased but blood culture was normal so sepsis could be resolved. It is recommended to undergo an abdominal X-ray or Doppler ultrasound after the physical examination because NA has an unpredictable and highly variable clinical presentation [5]. Abdominal radiograph may show abnormal gas pattern, free peritoneal fluid and air, thickened abdominal wall, a right scoliosis, and obliteration of psoas margin [10].…”

“…Abdominal radiograph may show abnormal gas pattern, free peritoneal fluid and air, thickened abdominal wall, a right scoliosis, and obliteration of psoas margin [10]. On abdominal USG, the presence of intra-abdominal abscess, absence of gas in appendix lumen, or evidence of fluid in right iliac fossa strongly suggests acute appendicitis [5]. Abdominal X-ray of this patient revealed gas distribution in the gastric and third part of the duodenum followed by minimal gas in the distal part of the duodenum.…”

“…Ultrasonography (USG) is useful but not always conclusive for appendicitis. Plain radiograph, although is not the gold standard for diagnosing appendicitis, is helpful in detecting complications [5]. Histopathology examination enables us to confirm the diagnose.…”

Apendicitis aguda perforada con diagnóstico prequirúrgico y hernia inguinal bilateral en recién nacido de pretérmino

“…Sin embargo, y a pesar de los avances, los reportes son escasos en recién nacidos 17,18 . En un reporte de cuatro casos de recién nacidos con diagnóstico ecográfico pre-operatorio de apendicitis, los hallazgos descritos fueron dilatación ileocecal, engrosamiento de la pared intestinal y ciego, líquido localizado y encapsulado en el cuadrante inferior derecho 19 . Aunque la ecografía tiene limitaciones, ha demostrado ser más efectivo que las radiografías simples para evidenciar líquido libre intraabdominal, evaluar el grosor de la pared intestinal y la perfusión de tubo digestivo 13 .…”