Atypical Presentations of Appendicitis

Moniruddin, Abm; Chowdhury, Shafiqul Alam; Hasan, Tanvirul; Ferdous, Baikaly; Khan, Rahmat Ullah

doi:10.3329/kyamcj.v12i2.55444

Cited by 2 publications

(2 citation statements)

References 10 publications

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“…Moreover, pregnant patients may present with a series of uncommon symptoms, including gastroesophageal reflux, malaise, pelvic pain, epigastric discomfort, indigestion, flatulence, dysuria, and altered bowel habits [7,23,24]. Thus, diagnosing acute appendicitis is a challenging task in which clinicians must be aware of anatomical variations of the appendix, take into consideration both typical and atypical symptoms, and confirm their suspicions with appropriate imaging studies to provide treatment promptly [25].…”

Section: Inflammatory Pathologies Of the Vermiform Appendixmentioning

confidence: 99%

The Vermiform Appendix and Its Pathologies

Constantin,

Petrescu,

Mătanie

et al. 2023

Cancers

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The vermiform appendix is a muscular cylindrical structure originating near the junction of the cecum and ileum, averaging 9 cm (5–35 cm) in size. As the most mobile viscera, it can adopt several positions, the most common being the retrocecal position. Perceived as an atavistic organ lacking physiological relevance, the vermiform appendix appears to be involved in immune function, serving in the maturation of B lymphocytes and the production of immunoglobulin A, in endocrine function, excreting amines and hormones in the 2–3 mL of mucus secreted daily, and in digestive function, by storing beneficial bacteria from where they can recolonize the colon. With a lumen of about 6 mm, the vermiform appendix has a reduced storage capacity, so any blockage of the appendix with fecoliths (fecaliths), seeds derailed from the colon, or enlarged lymph nodes prevents drainage and intraluminal accumulation of secreted mucus. Unable to relax, the appendix wall severely limits its intraluminal volume, so mucus accumulation leads to inflammation of the appendix, known generically as appendicitis. In addition, the vermiform appendix may be the site of the development of neoplastic processes, which may or may not involve mucus production, some of which can significantly affect the standard of living and ultimately lead to death. In general, mucinous tumors may have a better prognosis than non-mucinous tumors. This review takes a comprehensive path, starting by describing the anatomy and embryology of the vermiform appendix and further detailing its inflammatory pathologies, pathologies related to congenital anomalies, and appendix tumors, thus creating an up-to-date framework for better understanding, diagnosis, and treatment of these health problems.

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Section: Inflammatory Pathologies Of the Vermiform Appendixmentioning

confidence: 99%

The Vermiform Appendix and Its Pathologies

Constantin,

Petrescu,

Mătanie

et al. 2023

Cancers

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“…Acute appendicitis is the most common abdominal surgical emergency during childhood. 44% of pediatric appendicitis have atypical presentations with a relatively high perforation rate up to 30% [1]. While ectopic anatomic location of appendix is usually the cause of atypical presentation of appendicitis in adults, many causes are possible in children.…”

Section: Etiologymentioning

confidence: 99%

Atypical Appendicitis in Children: Clinical Presentation, Imaging Features, and Management Plan

Alsaeed,

Alassiri,

Rizk

et al. 2023

AJP

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Atypical appendicitis is not uncommon in pediatrics. Factors that are usually seen in such presentations include: Age less than five years, developmental delay, ectopic anatomic location of the appendix, subacute or chronic appendicitis, and symptomatic treatment in addition to early inconclusive investigations. Children with Autistic spectrum disorder often suffer from communication problems, which might affect their ability to deliver their complaints effectively. It is usually parent's interpretation that physicians will rely on as they are the best to delineate minor changes of their children's behavior and body language signs, so that a correct diagnosis may be reached. Atypical appendicitis is usually a delayed diagnosis with increased morbidity and mortality. In this paper we illustrate the possible causes of atypical appendicitis in childhood, and review its clinical presentation, radiologic findings, and management plan as mentioned in medical literature. We also present a rare case of subacute appendicitis in a 5 years old autistic girl with atypical presentation, misleading imaging features, and re-admission after successful laparoscopy. Our aim is to present the importance of clinical assessment and suggest an approach to improve practice regarding childhood appendicitis which can be an endless trap for both patients and practitioners.

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Atypical Presentations of Appendicitis

Cited by 2 publications

References 10 publications

The Vermiform Appendix and Its Pathologies

The Vermiform Appendix and Its Pathologies

Atypical Appendicitis in Children: Clinical Presentation, Imaging Features, and Management Plan

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