CONCLUSIONS: More than half of patients with ascending retrocecal appendicitis presented with atypical clinical presentation. [ncbi.nlm.nih.gov]

Here we present a patient of acute subhepatic-retrocaecal appendicitis in whom clinical and US findings mimicked acute cholecystitis. [tjtes.org]

• Gastric Lavage

  Without having shown great attention to pregnancy of the patient when appendicitis demands special vigilance, the duty infectiologist of a reception undertook a number of risky medical actions — a gastric lavage and a cleansing enema. [infomeds.net]

• Decreased Breath Sounds

  His lungs were clear to auscultation except for decreased breath sounds over the right base, and there was a grade II-VI systolic ejection murmur along the left sternal border. [journals.lww.com]

• Abdominal Pain

  Keywords: Computed tomography Retrocecal appendicitis Upper abdominal pain Issue Date: 2009 Citation: Ong, E.M.W., Venkatesh, S.K. (2009). Ascending retrocecal appendicitis presenting with right upper abdominal pain: Utility of computed tomography. [scholarbank.nus.edu.sg]

  RESULTS: Patients presented with right lower abdominal pain (49%, 16/33), right flank pain (24%, 8/33), right upper abdominal pain (18%, 6/33), and periumbilical pain (15%, 5/33). [ncbi.nlm.nih.gov]

  In patients presented with right abdominal pain with atypical clinical, laboratory and ultrasound (US) findings, acute appendicitis should be eliminated with computed tomography (CT). [tjtes.org]

• Acute Abdomen

  Clinical science Physician Summary Appendicitis refers to acute inflammation of the appendix, and is the most common cause of acute abdomen requiring emergency surgery. [amboss.com]

  […] emergency with acute pain in right upper abdomen. [ispub.com]

  She was transferred to our hospital, with an acute surgical abdomen. [academic.oup.com]

  Contrast-enhanced CT has reasonable accuracy in diagnosing appendicitis and can also reveal other causes of an acute abdomen. [msdmanuals.com]

• Obturator Sign

  Obturator sign The obturator internus and nearby muscles Differential diagnosis (obturator internus muscle irritation) due to appendicitis The obturator sign or Cope's obturator test is an indicator of irritation to the obturator internus muscle.[1] The [en.wikipedia.org]

  […] rebound tenderness at McBurney's point Psoas/Obturator sign raise the patient's right leg with the knee flexed rotate the leg internally at the hip increased abdominal pain indicates a positive obturator sign Rovsing's sign pressure over the descending [medbullets.com]

  Anatomic basis for the obturator sign: inflamed appendix in the pelvis is in contact with the obturator internus muscle, which is stretched by this maneuver. [aafp.org]

  O bturator (Cope’s obturator) sign: Flexion and medial rotation at hip produces pain due to irritation of obturator muscle in pelvic appendicits. 5. [medchrome.com]

• Right Flank Pain

  A 3-year-old girl presented with high fever and right flank pain for more than 1 week. Ultrasonography showed a right perinephric fluid collection with normal renal parenchyma and collecting system. [ncbi.nlm.nih.gov]

  All rights reserved. World J Gastroenterol. Jul 28, 2009; 15(28): 3576-3579 Published online Jul 28, 2009. doi: 10.3748/wjg.15.3576 Figure 3 A 34-year-old man with colicky right flank pain and clinical diagnosis of right ureteric colic. [wjgnet.com]

  Two years later, she presented with fever, limping gait, and right flank pain. Ultrasound revealed fixed dilated bowel loops, a fecalith and a heterogeneous hypoechoic lesion (3.7×3.6×3.3 cm) at right psoas muscle, suspecting PA. [omicsonline.com]

• Right Lower Quadrant Tenderness

  Appendicitis in a patient with a retrocecal appendix may present atypically, with less or poorly localized pain, discomfort on coughing or walking, or flank, rather than right lower quadrant, tenderness. [acuteabd.weebly.com]

  Rovsing sign is positive when pain is felt with pressure at a point on the left side of the abdomen corresponding to McBurney point on the right. Rectal examination will detect tenderness in the right lower quadrant in more than half of patients. [clinicaladvisor.com]

  The most important physical examination finding is right lower quadrant tenderness to palpation. [aafp.org]

  Due to the location of the retrocecal appendix, right lower quadrant tenderness may not be observed. Therefore, there could be difficulties in the diagnosis (4). [turkjsurg.com]

• Pelvic Pain

  Atypical pain may present in various ways. Pelvic appendix – pain initially felt in RLQ, no visceral symptoms and pain on urination, may cause suprapubic pain (5). May present with profuse diarrhoea and pelvic pain. [teachmepaediatrics.com]

  McBurney sign) pelvic pain, diarrhea and tenesmus (pelvic appendix) flank pain (retrocecal appendix) groin pain - appendix within an inguinal hernia (Amyand hernia) or a femoral hernia (De Garengeot hernia) right upper quadrant pain (subhepatic appendicitis [radiopaedia.org]

  The pain is not as severe as that associated with abdominal or pelvic appendicitis and the pain rarely localises well to the right iliac fossa. [surgwiki.com]

  Because many gynecologic conditions can mimic appendicitis, a pelvic examination should be performed on all women with abdominal pain. [aafp.org]

• Foul Smelling Urine

  She also complained of foul-smelling urine and vaginal discharge. She had a termination of pregnancy 4 d earlier. The pain was increasing in severity and aggravated by movement and coughing. [ncbi.nlm.nih.gov]

Most often, however a workup including lab tests and imaging is required. Workup Laboratory studies There is no single lab test specific for the diagnosis of appendicitis. [cdemcurriculum.com]

Before his extensive GI tract workup, he had undergone investigations to exclude cardiac, renal and liver disease. In addition, mucosal disease of the GI tract had been excluded. [ncbi.nlm.nih.gov]

• Pericardial Effusion

  Her hospital course was complicated with empyema, peritonitis, and pericardial effusion. A 6-year-old girl had lower abdominal pain for 3 days and high fever on the day of admission. [ncbi.nlm.nih.gov]

Significant updates on bariatric surgery, Barrett's esophagus, endoscopic ultrasound, endosonography, treatment of liver disease, and much more keep you current on the latest advances. [books.google.com]

A combined treatment of ultrasound or CT-guided percutaneous drainage and systemic antibiotics for psoas abscess has been successfully recently and has become the preferred method for treatment [27]. [omicsonline.org]

Prognosis Most appendicitis patients recover easily with treatment, but complications can occur if treatment is delayed or if peritonitis occurs secondary to a perforated appendix. [academickids.com]

This leads to delayed diagnosis and hospitalisation, and delayed treatment. [patient.info]

This video demonstrates the laparoscopic treatment of a retrocaecal appendicitis performed by a resident in general surgery. The retrocaecal position of the appendix is found in 25% of cases. [websurg.com]

Prognosis Special patient groups Appendicitis in pregnancy Children, the elderly, and pregnant women are at higher risk of perforation! [amboss.com]

Prognosis Most appendicitis patients recover easily with treatment, but complications can occur if treatment is delayed or if peritonitis occurs secondary to a perforated appendix. [academickids.com]

PID, ovarian torsion, gyn disorders, volvulus, gastroenteritis, ectopic pregnancy, pyelonephritis, diverticulits, colorectal cancer, IBD, cholecystitis, Meckel's, mesenteric ischemia Treatment Laparoscopic Appendectomy CT guided drainage of abscess Prognosis [medbullets.com]

Treatment and prognosis The mainstay of treatment is supportive, as the disease is typically self-limiting. If severe or protracted medical therapy with corticosteroids, cyclophosphamide or azathioprine can be contemplated 2. [radiopaedia.org]

Etiology Pathophysiology Clinical features Nonspecific symptoms Progressive fever Anorexia (hamburger sign ) Nausea, vomiting, diarrhea;, and/or constipation Abdominal pain: classical presentation Initially, dull migratory periumbilical pain (due to visceral [amboss.com]

If left lower quadrant pressure by the examiner leads only to left-sided pain or pain on both the left and right sides, then there may be some other pathologic etiology. [en.wikipedia.org]

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]

Introduction Increased frequency 10-30 years of age More common in US due to low fiber diet Most common etiologies are lymphoid hyperplasia fecolith obstruction Presentation Symptoms loss of appetite, nausea, vomiting fever pain moves from periumbilical [medbullets.com]

Laparoscopy can be used for diagnosis as well as definitive treatment of appendicitis; it may be especially helpful in women with lower abdominal pain of unclear etiology. [msdmanuals.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]

Epidemiology and pathophysiology Peak incidence at 10-30yo Thought to result from obstruction of the lumen of the appendix, e.g. due to stool, lymphoid hyperplasia, vegetable matter, parasites, or neoplasm) End result is mucosal ischemia and ulceration [faculty.washington.edu]

The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol 1990;132:910. PubMed Google Scholar Browne DS. Laparoscopic-guided appendicectomy. A study of 100 consecutive cases. Aust N Z J Obstet Gynaecol 1990;30:231–233. [link.springer.com]

[…] appendicitis with generalized peritonitis ICD-10: K35.3 - acute appendicitis with localized peritonitis ICD-10: K35.8 - other and unspecified acute appendicitis ICD-10: K35.80 - unspecified acute appendicitis ICD-10: K35.89 - other acute appendicitis Epidemiology [pathologyoutlines.com]

Addiss DG, Shaffer N, Fowler BS (1990)The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol 132:910. Alvarado A (1986) A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med 15:557. [transbiomedicine.com]

Etiology Pathophysiology Clinical features Nonspecific symptoms Progressive fever Anorexia (hamburger sign ) Nausea, vomiting, diarrhea;, and/or constipation Abdominal pain: classical presentation Initially, dull migratory periumbilical pain (due to visceral [amboss.com]

Pathophysiology • Distention of this magnitude  reflex nausea and vomiting • Capillaries and venules are occluded, but arteriolar inflow continues engorgement and vascular congestion • inflammatory process soon involves the serosa of the appendix parietal [slideshare.net]

Epidemiology and pathophysiology Peak incidence at 10-30yo Thought to result from obstruction of the lumen of the appendix, e.g. due to stool, lymphoid hyperplasia, vegetable matter, parasites, or neoplasm) End result is mucosal ischemia and ulceration [faculty.washington.edu]

[…] and young adults, most commonly occurring between early teens and 25 but may occur at any age; higher incidence in younger subjects likely related to increased lymphoid tissue More common with a low bulk Western diet, less common in Africa and Asia Pathophysiology [pathologyoutlines.com]

Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets [books.google.com]

To prevent conversion due to hemodynamic instability, it is mandatory to work with an ultralow intra-abdominal pressure under 8mmHg. [websurg.com]

Timely surgical intervention by exploratory laparotomy and drainage of the abscess by single or multiple incisions can prevent morbidity and mortality. [medresearch.in]

The most crucial aspect of treatment is timely intervention (laparoscopic or conventional open appendectomy) to prevent progression to perforation and sepsis, as well as antibiotics. [amboss.com]