Presentation
A 10-year-old girl presented with fever and right-lower-quadrant pain. Computed tomography showed a multiloculated mass. [ncbi.nlm.nih.gov]
Entire Body System
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Pseudotumor
Conversion to open laparotomy during operation was made because of a fragmented appendix where the appendiceal base and psoas abscess cavity could not be identified well and a dense inflammatory mass which seemed to be creating a pseudotumor around the [omicsonline.org]
Gastrointestinal
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Abdominal Pain
Three patients had only one episode of abdominal pain, but had pathologic evidence of subacute inflammation. [ncbi.nlm.nih.gov]
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Acute Abdomen
Clinical science Summary Appendicitis refers to acute inflammation of the appendix, and is the most common cause of acute abdomen requiring emergency surgery. [amboss.com]
Karger AG, Basel References Silen W: Appendicitis and the differential diagnosis of appendicitis; in Cope’s Early Diagnosis of the Acute Abdomen, ed 19. New York, Oxford University Press. 1996, pp 70–110. [karger.com]
We present two cases of AA which were clinically mimicking complicated appendicitis and manifested with symptoms of acute abdomen. [go.galegroup.com]
Sometimes the inflamed appendix becomes surrounded by omentum which adheres and localises the infection more effectively, forming an appendix mass or appendix abscess. [ 1 ] Epidemiology Appendicitis is the most common cause of an acute abdomen in the [patient.info]
Likewise, other patients initially appear ill with an "acute abdomen" only to improve dramatically during their ED stay and ultimately be discharged with gastritis or constipation as the cause. [ahcmedia.com]
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Recurrent Abdominal Pain
Recurrent abdominal pain due to chronic appendiceal disease. South Med. J. 1991;84(7):913-66. Leardi S, Delmonaco S, Ventura T, Chiominto A, De Rubeis G, Simi M. Recurrent abdominal ain and "chronic appendicitis"; Minerva Chur. 2000;55(1-2):39-44. [ijsurgery.com]
Presentation Recurrent abdominal pain attacks. Patient Data Age: 4 years Gender: Male Loading images... [radiopaedia.org]
In some cases, however, people may develop chronic appendicitis, which causes mild, recurrent abdominal pain that often subsides on its own. These patients usually don't realize they have appendicitis until an acute episode strikes. [everydayhealth.com]
Chronic appendicitis: an often forgotten cause of recurrent abdominal pain. Am J Med 2013;126:e7–e8. 95. See TC, Watson CJ, Arends MJ, Ng CS. Atypical appendicitis: the impact of CT and its management. J Med Imaging Radiat Oncol 2008;52:140–147. 96. [clinicalultrasound.org]
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Severe Abdominal Pain
Case Report We report the case of a 43 year old male who presented with sudden onset of severe abdominal pain. His symptoms were consistent with acute cholecystitis. He was unable to speak English and communicated via an interpreter. [casesjournal.biomedcentral.com]
When people discuss appendicitis, they're typically referring to acute appendicitis, which is marked by severe abdominal pain that quickly spreads and worsens over a matter of hours. [everydayhealth.com]
pain that comes on quickly. [en.wikipedia.org]
abdominal pain deserves special attention. [ahcmedia.com]
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Rovsing's Sign
sign : deep palpation of the LLQ causes RLQ referred pain Psoas sign : RLQ pain with extension of the right leg against resistance (secondary to inflammation of a retrocecal appendix ) Obturator sign : RLQ pain with flexion and internal rotation of the [amboss.com]
Rovsing's sign may be positive: palpation of the left lower quadrant increases the pain felt in the right lower quadrant. [patient.info]
Physical signs classically associated with acute appendicitis include Rovsing sign, psoas sign, and obturator sign. Rovsing, N.T. (1907). "Indirektes Hervorrufen des typischen Schmerzes an McBurney's Punkt. [en.wikipedia.org]
’s sign 5 Palpable mass 5 Mean Temperature 37.9 C ____________________________________________________ The fact that the appendix can be found in a variety of anatomic locations helps explain some of this variability. [ahcmedia.com]
Musculoskeletal
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Limping Gait
Unfortunately, 4 months later, she was readmitted with a 2-day history of fever, limping gait and pain in the right groin. [omicsonline.org]
Urogenital
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Right Adnexal Tenderness
adnexal tenderness. 100 Many authors have tried to identify features that would differentiate these two diseases, and have suggested the following. [ahcmedia.com]
Workup
The existence of chronic appendicitis has been controversial in decades past, and contemporary debate surrounds the definition and workup of this condition. 10 – 12 In one hospital in Altenburg, Germany, the rate of appendectomies increased dramatically [cfp.ca]
The rate of negative appendectomies has declined significantly (around 6%) in the US largely due to the high rate of utilization of CT scan in the diagnostic workup. [clinicaladvisor.com]
Imaging Obtain standard anteroposterior and lateral radiographs to rule out bony involvement or a foreign body. [1] See Workup for more detail. [emedicine.medscape.com]
Treatment
CONCLUSIONS: Since the recurrence rate is similar between NPA and PA, nonoperative treatment can be used for PA patients. Roughly 20% of the adult patients selected for nonoperative treatment experienced recurrence. [ncbi.nlm.nih.gov]
We took this case to review the literature concerning the treatment of appendiceal abscess and appendiceal mass, and consecutively redesigned our own treatment concept. [unboundmedicine.com]
Prognosis
Factors affecting the prognosis of pyogenic flexor tenosynovitis. J Bone Joint Surg Am. 2007 Aug;89(8):1742-8. [PubMed: 17671013] 12. Kennedy CD, Lauder AS, Pribaz JR, Kennedy SA. [ncbi.nlm.nih.gov]
MRI Increased fluid within tendon sheath: T1: low or intermediate if debris within tendon sheath T2: high T1 C (Gd): tendon sheath thickening and peritendinous subcutaneous contrast enhancement Treatment and prognosis Treatments may include non-steroidal [radiopaedia.org]
Prognosis Special patient groups Appendicitis in pregnancy Children, the elderly, and pregnant women are at higher risk of perforation! References: [8] [9] [10] [amboss.com]
Cases of infectious FT that present early and have no comorbidities have a good prognosis. [emedicine.medscape.com]
The five-year survival rate for AA is 49 - 60%, and the prognosis is favorable when the tumor is diagnosed at an early stage of the disease [4]. [go.galegroup.com]
Etiology
Etiology Clinical features Subtypes and variants De Quervain tenosynovitis Thickening of the abductor pollicis longus and extensor pollicis brevis due to myxoid degeneration Epidemiology Sex: Age: 30–50 years Often seen in new mothers Etiology Repetitive [amboss.com]
Leu SY, Leonard MB, Beart RW Jr, Dozois RR (1986) Psoas abscess: Changing patterns of diagnosis and etiology. Dis Colon Rectum 29: 694-698. Procaccino JA, Lavery IC, Fazio VW, Oakley JR (1991) Psoas abscess: difficulties encountered. [omicsonline.org]
Contrast should be a consideration in cases concerning for infectious etiologies for abscess visualization. [ncbi.nlm.nih.gov]
The synovial membrane is part of a fluid-filled sheath that surrounds a tendon. joint swelling pain in the affected area and pain moving a joint reddening along the length of the affected tendon difficulty moving the joint Etiology Tenosynovitis can be [radiopaedia.org]
Epidemiology
The epidemiology of appendix & appendicectomy in the US. Am J Epiodemiol. 1999;132:910-25. Koep Sell TD, Inue TS, Farewell VT. Factors affecting perforation in Acute Appendicitis. Surg. Gynaecol. Obstet. 1981;153:508-10. [ijsurgery.com]
Declarations Authors’ Affiliations (1) Department of Surgery, Saint Luke's Hospital, Kilkenny, Ireland References Addiss DG, Shaffer N, Fowler BS, Tauxe RV: The epidemiology of appendicitis and appendectomy in the United States. [casesjournal.biomedcentral.com]
Epidemiology Common cause of acute abdomen Lifetime risk : 8% Peak incidence : 10–19 years of age References: [1] [2] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]
The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol. 1990;132:910-925. [go to PubMed] 2. Hardin DM Jr. Acute appendicitis: review and update. Am Fam Physician. 1999;60:2027-2034. [go to PubMed] 3. [psnet.ahrq.gov]
Pathophysiology
Abstract Cite This Article as Corresponding Author The pathophysiology and morphology of recurrent appendicitis has not been well studied. [journalijar.com]
Etiology Pathophysiology Early : mucosal hyperemia with edema and ulceration due to obstruction of the appendix ; reversible phase Suppurative : transmural spread of infection within the appendix Gangrenous : diffuse inflammatory changes in the entire [amboss.com]
Introduction Infection of the synovial sheath that surrounds the flexor tendon Epidemiology incidence 2.5 to 9.4% of all hand infections risk factors diabetes IV drug use immunocompromised patients Pathophysiology mechanism penetrating trauma to the tendon [orthobullets.com]
The pathophysiology of chronic appendicitis is thought to be related to a partial or chronic appendiceal obstruction, and diagnosis is frequently made following an appendectomy and based on histologic findings of chronic inflammatory changes. 6, 12 It [cfp.ca]
[…] infections of the hand, only 2.5% to 9.4% of patients will go on to develop infectious tenosynovitis.[7] Individuals with rheumatoid arthritis are significantly at risk of tenosynovitis, with 55% of patients reporting symptoms averaging 3.1 tendons.[8] Pathophysiology [ncbi.nlm.nih.gov]
Prevention
Tendon sheath inflammation is preventable if you avoid excessive movements or motions that are repetitive or forceful. [healthline.com]
Can de Quervain’s tenosynovitis be prevented or avoided? The best way to prevent de Quervain’s tenosynovitis is to avoiding repetitive movements. Change your actions to reduce the stress on your wrists. [familydoctor.org]