Cargando…
Chronic Appendicitis—From Ambiguous Clinical Image to Inconclusive Imaging Studies
A six-year-old boy visits a general practitioner due to diarrhea and abdominal pain with a moderate fever of up to 39 °C for 2 days. Treatment is initiated; however, the recurrence of abdominal pain is observed. Physical examination of the child at the emergency department reveals abdominal guarding...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9028538/ https://www.ncbi.nlm.nih.gov/pubmed/35453865 http://dx.doi.org/10.3390/diagnostics12040818 |
_version_ | 1784691644225814528 |
---|---|
author | Brodzisz, Agnieszka Kuczyńska, Maryla Zbroja, Monika Cyranka, Weronika Cielecki, Czesław Woźniak, Magdalena Maria |
author_facet | Brodzisz, Agnieszka Kuczyńska, Maryla Zbroja, Monika Cyranka, Weronika Cielecki, Czesław Woźniak, Magdalena Maria |
author_sort | Brodzisz, Agnieszka |
collection | PubMed |
description | A six-year-old boy visits a general practitioner due to diarrhea and abdominal pain with a moderate fever of up to 39 °C for 2 days. Treatment is initiated; however, the recurrence of abdominal pain is observed. Physical examination of the child at the emergency department reveals abdominal guarding and visible, palpable, painful intestinal loops in the left iliac and hypogastric regions—this is referred to as an ‘acute abdomen’. An X-ray shows single levels of air and fluid indicative of bowel obstruction. Ultrasound reveals distended, fluid-filled intestinal loops with diminished motility. The intestinal wall is swollen. Laboratory tests indicate increased inflammatory indices. Contrast-enhanced computed tomography examination of the abdominal cavity and lesser pelvis shows intestinal dilation. The loops were filled with liquid content and numerous collections of gas. The patient is qualified for a laparotomy. An intraoperative diagnosis of perforated gangrenous appendicitis with autoamputation was made. In addition, numerous interloop and pelvic abscesses, excessive adhesions, signs of small intestine micro-perforation, and diffuse peritonitis are found. The patient’s condition and laboratory parameters significantly improve during the following days of hospitalization. Despite the implementation of multidirectional, specialized diagnostics in the case of acute abdomen, in everyday practice we still encounter situations where the final diagnosis is made intraoperatively only. |
format | Online Article Text |
id | pubmed-9028538 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-90285382022-04-23 Chronic Appendicitis—From Ambiguous Clinical Image to Inconclusive Imaging Studies Brodzisz, Agnieszka Kuczyńska, Maryla Zbroja, Monika Cyranka, Weronika Cielecki, Czesław Woźniak, Magdalena Maria Diagnostics (Basel) Case Report A six-year-old boy visits a general practitioner due to diarrhea and abdominal pain with a moderate fever of up to 39 °C for 2 days. Treatment is initiated; however, the recurrence of abdominal pain is observed. Physical examination of the child at the emergency department reveals abdominal guarding and visible, palpable, painful intestinal loops in the left iliac and hypogastric regions—this is referred to as an ‘acute abdomen’. An X-ray shows single levels of air and fluid indicative of bowel obstruction. Ultrasound reveals distended, fluid-filled intestinal loops with diminished motility. The intestinal wall is swollen. Laboratory tests indicate increased inflammatory indices. Contrast-enhanced computed tomography examination of the abdominal cavity and lesser pelvis shows intestinal dilation. The loops were filled with liquid content and numerous collections of gas. The patient is qualified for a laparotomy. An intraoperative diagnosis of perforated gangrenous appendicitis with autoamputation was made. In addition, numerous interloop and pelvic abscesses, excessive adhesions, signs of small intestine micro-perforation, and diffuse peritonitis are found. The patient’s condition and laboratory parameters significantly improve during the following days of hospitalization. Despite the implementation of multidirectional, specialized diagnostics in the case of acute abdomen, in everyday practice we still encounter situations where the final diagnosis is made intraoperatively only. MDPI 2022-03-26 /pmc/articles/PMC9028538/ /pubmed/35453865 http://dx.doi.org/10.3390/diagnostics12040818 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Brodzisz, Agnieszka Kuczyńska, Maryla Zbroja, Monika Cyranka, Weronika Cielecki, Czesław Woźniak, Magdalena Maria Chronic Appendicitis—From Ambiguous Clinical Image to Inconclusive Imaging Studies |
title | Chronic Appendicitis—From Ambiguous Clinical Image to Inconclusive Imaging Studies |
title_full | Chronic Appendicitis—From Ambiguous Clinical Image to Inconclusive Imaging Studies |
title_fullStr | Chronic Appendicitis—From Ambiguous Clinical Image to Inconclusive Imaging Studies |
title_full_unstemmed | Chronic Appendicitis—From Ambiguous Clinical Image to Inconclusive Imaging Studies |
title_short | Chronic Appendicitis—From Ambiguous Clinical Image to Inconclusive Imaging Studies |
title_sort | chronic appendicitis—from ambiguous clinical image to inconclusive imaging studies |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9028538/ https://www.ncbi.nlm.nih.gov/pubmed/35453865 http://dx.doi.org/10.3390/diagnostics12040818 |
work_keys_str_mv | AT brodziszagnieszka chronicappendicitisfromambiguousclinicalimagetoinconclusiveimagingstudies AT kuczynskamaryla chronicappendicitisfromambiguousclinicalimagetoinconclusiveimagingstudies AT zbrojamonika chronicappendicitisfromambiguousclinicalimagetoinconclusiveimagingstudies AT cyrankaweronika chronicappendicitisfromambiguousclinicalimagetoinconclusiveimagingstudies AT cieleckiczesław chronicappendicitisfromambiguousclinicalimagetoinconclusiveimagingstudies AT wozniakmagdalenamaria chronicappendicitisfromambiguousclinicalimagetoinconclusiveimagingstudies |