Presentation
A 10-year-old girl presented with fever and right-lower-quadrant pain. Computed tomography showed a multiloculated mass. [ncbi.nlm.nih.gov]
Presented at the SAGES 2017 Annual Meeting in Houston, TX. Abstract ID: 79679 Program Number: P073 Presentation Session: Poster (Non CME) Presentation Type: Poster Post Views: 11 « Return to SAGES 2017 abstract archive [sages.org]
Entire Body System
- Fever
A 10-year-old girl presented with fever and right-lower-quadrant pain. Computed tomography showed a multiloculated mass. [ncbi.nlm.nih.gov]
- Vomiting, nausea, and anorexia - Afebrile or has a low-grade fever, 38 º C Higher fevers are associated with a perforated appendix 10 Special maneuvers it is only the area McBurney sign McBurney's point of greatest tenderness Blumberg sign Rovsing [slideplayer.com]
Presentation Lower abdominal pain and fever. Patient Data Age: 30 years Gender: Female Loading images... [radiopaedia.org]
- Recurrent Inflammation
These abscesses tend to heal badly and often lead to recurrent inflammation with stenosis eventually requiring elective surgery. [radiologyassistant.nl]
Gastrointestinal
- 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]
Suerte Elena Chronic appendicitis was assumed in 42 women with long-term or recurrent lower abdominal pain, and appendectomy was performed when two or all three of the following pathologic changes, which were highly predictive of the diagnosis, were present [proz.com]
- Acute Abdomen
Acute appendicitis is one of the most common diseases causing acute abdomen. Many cases are easy to diagnose, although some involve diagnostic difficulties caused by a large number of factors. [giejournal.org]
Discussion Acute abdomen remains one of the major challenges for the general surgeon. [ispub.com]
[…] to treat “acute abdomen” [1]. [smw.ch]
DEFINITIONS Acute appendicitis is inflammation of the vermiform appendix and remains the most common cause of the acute abdomen in young adults. [wjgnet.com]
Worldwide, there is a large variation of who performs the US examination of the acute abdomen. [radiologyassistant.nl]
- 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]
DISCUSSION The palpable mass associated with acute appendicitis may consist of phlegmon or abscesses of various sizes 4 ). 2–3% of the patients with appendicitis who are admitted to the hospital have abdominal masses 4, 6 – 8 ) and appendiceal abscesses [kjim.org]
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]
- Rovsing's Sign
- Vomiting, nausea, and anorexia - Afebrile or has a low-grade fever, 38 º C Higher fevers are associated with a perforated appendix 10 Special maneuvers it is only the area McBurney sign McBurney's point of greatest tenderness Blumberg sign Rovsing [slideplayer.com]
- Tenderness at McBurney's Point
There was moderate tenderness over McBurney's point and under this was a palpable mass about 2 inches in diameter, spherical, smooth and resilient. This mass was also palpated vaginally. [pubs.rsna.org]
Workup
METHODS: All subjects of this comparative study underwent a complete obstetrical clinical workup comprising history, general physical examination, abdominal and pelvic examination, and relevant investigations. [ncbi.nlm.nih.gov]
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]
(See Workup, Computed Tomography.) Sequential, multiple organ failure is the main cause of death. [emedicine.medscape.com]
Inpatient Considerations Patients with suspected placental abruption should be admitted for workup until deemed clinically stable and ready for discharge/outpatient follow-up or delivered for medical indication. [unboundmedicine.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]
Prognosis
The presence of associated concurrent fetal bradycardia carries a poorer prognosis. [radiopaedia.org]
Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Appendicular abscess from other Diseases Epidemiology and Demographics Risk Factors Screening Natural History, Complications and Prognosis [wikidoc.org]
Evolution and prognosis. Rev Esp Enferm Dig. 2000, 92 (5): 326-333. PubMed Google Scholar Chen HS, Sheen-Chen SM: Obstruction and perforation in colorectal adenocarcinoma: an analysis of prognosis and current trends. [wjes.biomedcentral.com]
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]
Etiologic factors were a stump inch in length and a fecalith. Differential diagnosis was between neoplasm, granuloma and abscess. [americanjournalofsurgery.com]
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]
Risk of placental abruption is higher if: History placental abruption in first pregnancy Hypertensive disorders in the index pregnancy At extremes of age in the reproductive window Etiology and Pathophysiology Acute Etiology of bleeding at the decidua [unboundmedicine.com]
Fifth month of gestation -Several lymphoid follicles. 3 Etiology: Obstruction of the lumen appendix followed by infection Catarrhal appendicitis. [slideplayer.com]
Epidemiology
Abscess Main Page Appendicular abscess Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Appendicular abscess from other Diseases Epidemiology and Demographics Risk Factors Screening [wikidoc.org]
Neuroendocrine tumor epidemiology: contrasting Norway and North America. Cancer. 2008;113:2655–64. View Article PubMed Google Scholar Quaedvlieg PF. Epidemiology and survival in patients with carcinoid disease in the Netherlands. [wjes.biomedcentral.com]
The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol. 1990;132(5):910–925. Becker T, Kharbanda A, Bachur R. Atypical clinical features of pediatric appendicitis. Acad Emerg Med. 2007;14(2):124–129. [medcraveonline.com]
"National epidemiology of cutaneous abscesses: 1996 to 2005". The American Journal of Emergency Medicine. 27 (3): 289–92. doi : 10.1016/j.ajem.2008.02.027. PMID 19328372. ^ a b c Elston, Dirk M. (2009). Infectious Diseases of the Skin. [en.wikipedia.org]
Pathophysiology
The key factor in the pathophysiology is hemorrhage at the decidual-placental interface. [ncbi.nlm.nih.gov]
Abscess Main Page Appendicular abscess Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Appendicular abscess from other Diseases Epidemiology and Demographics Risk Factors Screening [wikidoc.org]
Associated pathophysiologic effects may become life threatening or lead to extended periods of morbidity with prolonged hospitalization. [emedicine.medscape.com]
[…] foreign body / parasites (4%) - tumors (1%) 4 Pathophysiology Wangensteen proposed Closed loop obstruction Increase in luminal pressure. [slideplayer.com]
Prevention
Correct recognition of the mucocele prevented a potentially disastrous percutaneous drainage. [ncbi.nlm.nih.gov]
The surgical approach can be either laparoscopic or open (laparotomy) Prevention There are no primary preventive measures available for appendicular abscess. [wikidoc.org]
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 is to prevent the rupture of the large appendicular abscess, which would lead to a highly dangerous infection in the peritoneum. [phaa.com]