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Appendiceal Abscess

Appendix Abscess


Presentation

  • We discuss the case of a young man who presented with acute urinary retention, subsequently found to be caused by undiagnosed appendicitis with appendiceal abscess formation.[ncbi.nlm.nih.gov]
  • A 10-year-old girl presented with fever and right-lower-quadrant pain. Computed tomography showed a multiloculated mass.[ncbi.nlm.nih.gov]
  • However, we present a case where a 30-year-old, gravida 1, para 0, female complained of persistent right abdominal pain during her 25th week of pregnancy.[ncbi.nlm.nih.gov]
  • Abstract Laparoscopic appendectomy (LA) has become well accepted, but the role of LA for appendicitis upon presentation with an abscess remains undefined.[ncbi.nlm.nih.gov]
  • Abstract A patient with cystic fibrosis who developed appendicitis, rupture, and a periappendiceal abscess is presented.[ncbi.nlm.nih.gov]
Massive Splenomegaly
  • Splenomegaly 387 C Laparoscopic Splenectomy 389 D MinimalAccess Open Splenectomy 392 E Preoperative Splenic Artery Embolization 399 F Conclusions 400 32 Insulinoma of Tail of Pancreas 405 C Laparoscopic Distal Pancreatectomy Without Splenectomy 406 D[books.google.de]
Fever
  • A 10-year-old girl presented with fever and right-lower-quadrant pain. Computed tomography showed a multiloculated mass.[ncbi.nlm.nih.gov]
  • A seven-month-old male infant was admitted because of fever and diarrhea. Anemic conjunctiva and mild abdominal distension were the only physical findings on arrival.[ncbi.nlm.nih.gov]
  • Treatment of an Abscess in the Appendix Patients with abscess larger than 4 cm size and a high fever are usually managed with drainage of abscess. The abscess is drained after localizing it radiologically.[healthhype.com]
  • Child starts high fever. Particularly temperature swings are typical: in the morning a slight fever, and by the evening it rises to 39-40 C. There sweating, increases toxicosis, deteriorating appetite.[survinat.com]
  • However, if the abscess is larger than four centimeters and the patient has high fever, draining the abscess becomes necessary.[phaa.com]
Splenectomy
  • […] for Massive Splenomegaly 387 C Laparoscopic Splenectomy 389 D MinimalAccess Open Splenectomy 392 E Preoperative Splenic Artery Embolization 399 F Conclusions 400 32 Insulinoma of Tail of Pancreas 405 C Laparoscopic Distal Pancreatectomy Without Splenectomy[books.google.de]
Abdominal Pain
  • Three case histories illustrate the diagnostic dilemma encountered whenever a patient with CF who is receiving antibiotics is evaluated for abdominal pain.[ncbi.nlm.nih.gov]
  • However, we present a case where a 30-year-old, gravida 1, para 0, female complained of persistent right abdominal pain during her 25th week of pregnancy.[ncbi.nlm.nih.gov]
  • She had a 10-month history of intermittent abdominal pain in the right lower quadrant. Initial laparotomy revealed an abscess in that quadrant. The abscess was drained.[ncbi.nlm.nih.gov]
  • An 8-year-old boy presented with fever, abdominal pain, and a right-lower-quadrant abscess (noted by ultrasonography). During laparotomy, the abscess was drained and the appendix was not found.[ncbi.nlm.nih.gov]
  • Even though the initial non-surgical treatment of her complicated acute appendicitis was successful, an interval appendectomy was indicated because of persistent abdominal pain in the right lower quadrant (RLQ).[websurg.com]
Abdominal Mass
  • On the fourth day of admission, a palpable right lower quadrant abdominal mass with local tenderness was found. Appendiceal abscess was diagnosed by both ultrasonography and computed tomography.[ncbi.nlm.nih.gov]
  • Appendiceal Abscess (or Late Appendicitis) This term refers to perforated appendicitis resulting in a walled off pocket of pus (abscess) characterized by fever and an abdominal mass.[innerbody.com]
Pelvic Mass
  • Two boys with acute urinary retention were found to have a persistent pelvic mass after bladder decompression. Evaluation in each disclosed a large pelvic abscess secondary to a ruptured appendix.[ncbi.nlm.nih.gov]
Hypertrophic Pyloric Stenosis
  • Pyloric Stenosis 507 C Open Pyloromyotomy 508 D Laparoscopic Pyloromyotomy 510 E Conclusions 515 41 Variceal Bleeding 518 C Endoscopic Sclerotherapy 521 D Endoscopic Band Ligation 523 E Conclusions 526 42 Laparoscopic or Endoscopic Management of Gastroesophageal[books.google.de]
Scrotal Pain
  • Inguinal scrotal pain and septic fever appeared 30 days before the admission to our Department. Suspecting urinary infection, his clinician had prescribed antibiotic therapy which proved partially effective.[springerplus.springeropen.com]

Workup

  • They’ll also order tests, which may include: blood workup urine analysis ultrasound X-ray MRI CT scan To distinguish among cellulitis, abscess, and phlegmon, your doctor may use intravenous gadolinium with MRI to show the outline of an abscess “wall”[healthline.com]

Treatment

  • This nonsurgical treatment, based on intravenous administration of antibiotics, is successful in about 93% of the patients. Failure of nonsurgical treatment is a reliable indication of percutaneous drainage.[ncbi.nlm.nih.gov]
  • Nonsurgical treatment fails in 7.2% (CI: 4.0-10.5). The need for drainage of an abscess is 19.7% (CI: 11.0-28.3). Immediate surgery is associated with a higher morbidity compared with nonsurgical treatment (odds ratio, 3.3; CI: 1.9-5.6; P 0.001).[ncbi.nlm.nih.gov]
  • CONCLUSIONS: Laparoscopic surgery in experienced hands is safe and feasible first-line treatment for appendiceal abscess.[ncbi.nlm.nih.gov]
  • METHODS: We identified 1225 patients under 18 years of age who had non-surgical treatment for an appendiceal abscess between 2007 and 2012 in a Taiwan CCHIA dataset. The treatment included percutaneous drainage with antibiotics or antibiotics alone.[ncbi.nlm.nih.gov]
  • OBJECTIVE: To evaluate the feasibility of treatment for children with appendiceal abscess by laparoscopic surgery and investigate its superiorities to conventional treatments.[ncbi.nlm.nih.gov]

Prognosis

  • Treatment and prognosis Previously it was believed that early surgical intervention increases the mortality in patients with appendicular abscess and hence the well known Ochsner Sherren regime was followed.[radiopaedia.org]
  • Prognosis of the abscess is good with antibiotics and percutaneous drain and resolves without the need for appendectomy, but it is recommended to follow and appendicular abscess by interval appendectomy after 8-12 weeks to prevent recurrence.[wikidoc.org]

Etiology

  • ABSTRACT In contrast to children, intussusception is rare in adults, and its etiology differs. A demonstrated organic lesion as the cause of intussusception is found 90% of adult cases, and about 65% are caused by primary or secondary neoplasms.[ekjm.org]
  • In cases with a high index of clinical suspicion for a perforated appendix, presence of loculated pericecal fluid even in the absence of visualization of the appendix should raise concern for the diagnosis, however other etiologies which could result[sonoworld.com]

Pathophysiology

  • Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis, 9e. Philadelphia, PA: Elsevier; 2010. Appendicitis. Mayo Clinic website. . Accessed April 16, 2014. Appendicitis.[innerbody.com]
  • Pathophysiology An appendicular abscess is a complication of acute appendicitis. It is resulted due to the invasion of the appendix by bacteria following an obstruction.[wikidoc.org]

Prevention

  • Correct recognition of the mucocele prevented a potentially disastrous percutaneous drainage.[ncbi.nlm.nih.gov]
  • OBJECTIVE: A systematic review of the nonsurgical treatment of patients with appendiceal abscess or phlegmon, with emphasis on the success rate, need for drainage of abscesses, risk of undetected serious disease, and need for interval appendectomy to prevent[ncbi.nlm.nih.gov]
  • This is to prevent the rupture of the large appendicular abscess, which would lead to a highly dangerous infection in the peritoneum.[phaa.com]
  • Metrics Metrics A systematic review of the nonsurgical treatment of patients with appendiceal abscess or phlegmon, with emphasis on the success rate, need for drainage of abscesses, risk of undetected serious disease, and need for interval appendectomy to prevent[journals.lww.com]
  • This prevents the pus from leaking and the infection spreading throughout the peritoneal cavity. How doe an appendicular abscess forms? When the appendix become inflamed (appendicitis), complications arise if the infection is not treated promptly.[healthhype.com]

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