Empyema and lung abscess as complication of a perforated appendicitis in a pregnant woman

Dietrich, Alexander; Nicolás, Matías; Iniesta, José; Smith, David

doi:10.1016/j.ijscr.2012.08.015

Cited by 13 publications

(15 citation statements)

References 8 publications

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“…In an article which investigated diagnostic accuracy of MRI, rates of negative appendectomy, and perforation were indicated as 0, and 8%, respectively [3]. In cases where US does not yield net results, MR is a gold standard [10]. Computed-tomography strikingly protect normal population from undergoing negative appendectomies.…”

Section: Discussionmentioning

confidence: 99%

Acute appendicitis in pregnancy: case series and review

Burcu

Ekinci

Atak

et al. 2015

North Clin Istanbul

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OBJECTIVE:Acute appendicitis is one of the most common acute surgical pathology we encountered. In this study we investigated our pregnant cases of appendicitis, and reviewed literature.METHODS:A total of 21 pregnant women who underwent appendectomy with the initial diagnosis of acute appendicitis in Istanbul Medeniyet University Clinics of General Surgery between January 2012, and December 2014 were retrospectively analyzed. The patients’s ages, trimesters, complaints, abdominal examination, laboratory, and ultrasonographic findings, surgical techniques, complications and hospital stay were noted.RESULTS:The patients were in their first (n=12; 57.1%), second (n=5; 23.8%), and third trimesters (n=4; 19.0%) of their pregnancies Median age was 23.9 years. All of the patients had abdominal pain. Median value of WBC count was 13.297/mm³. Ultrasound was positive in 12 patients (57.1%). In 14 (66.6%) patients McBurney incision, and in 6 (28.6%) cases right paramedian incision were used. One patient (4.8%) underwent laparoscopic appendectomy. Nineteen cases were acute appendicitis (90.5%), and two cases were perforated appendicitis (9.5%). Average hospital stay was 3.8 days. Two cases with perforated acute appendicitis developed wound infection and treated conservatively. There were no fetomaternal mortality.CONCLUSION:Physiologically anatomic and biochemical changes occurring during pregnancy can delay the diagnosis of acute appendicitis threaten the lives of both the mother and the fetus Therefore, rapid diagnosis and appropriate treatment convey importance.

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Section: Discussionmentioning

confidence: 99%

Acute appendicitis in pregnancy: case series and review

Burcu

Ekinci

Atak

et al. 2015

North Clin Istanbul

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“…For example, the pressure gradient between both compartments may cause a valve effect that favors the mobilization of intra-abdominal content to the thorax. Additionally, unilateral lymphatic flow is another factor described to play a role in the dissemination of pus across the diaphragm [4, 13]. Therefore, subhepatic, subdiaphragmatic, and more distant abscesses can spread to the thorax not only by contiguity but also by the anatomical and physical properties between these cavities [5, 14–16].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, pregnancy confers a special risk for thoracic empyema due to the relative immunosuppressive state associated to it and the displaced location of the cecum. For example, an appendiceal abscess in a pregnant woman may result in retroperitoneal collections that can gain access to the thorax through the retrocrural space and can result in extensive thoracic empyema [4]. …”

Section: Discussionmentioning

confidence: 99%

“…For example, Wong and Kumar [7] and Tokat et al [8] reported patients with marked peritoneal signs that were diagnostic for appendicitis but who developed empyema postoperatively. On the other hand, patients with ruptured appendix can present with an inconclusive abdominal evaluation and respiratory distress due to thoracic empyema [4, 5, 6, 15]. In the later scenario, respiratory distress can be the most prominent manifestation of the disease, and physicians may skip further investigation of the abdomen.…”

Section: Discussionmentioning

confidence: 99%

“…Common complications include appendicular phlegmon (appendicular mass), appendicular abscess, and peritonitis. Shock, sepsis, or atelectasis in the postoperative period has been associated with respiratory disease in this group of patients [3, 4]. However, empyema has rarely been reported as a complication of appendicitis.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Thoracic Empyema as Rare Complication of an Appendicular Mass: A Case Study and Review of the Literature

Vasquez-Rios

Calixto-Aguilar

Pajuelo

et al. 2018

Case Reports in Pediatrics

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Introduction Thoracic empyema is an infrequent complication of appendicitis that has rarely been reported in the literature. Case Presentation and Review of the Literature The case of a 11-year-old boy who was admitted for medical management of an appendicular mass is presented. His clinical course was complicated by the development of an appendicular abscess and an extensive right-sided empyema. A comprehensive review of the literature was conducted including the most representative cases. The data were collected and analyzed by two independent investigators. Ten cases were found. Most patients were young individuals (mean age: 25.1 years; male : female ratio: 0.5). Risk factors for thoracic empyema included pregnancy (10%) and age (60%). The most frequent organisms isolated were Escherichia coli, Bacteroides spp., and Klebsiella spp. The survival rate was 100%. Conclusion Thoracic empyema should be considered a potential cause of respiratory distress in patients with appendicitis. Furthermore, the abdomen should be carefully evaluated as a source of infection in patients with thoracic empyema without an underlying lung disease.

Empyema and lung abscess as complication of a perforated appendicitis in a pregnant woman

Abstract: When an empyema is developed in absence of lung disease or other intrathoracic cause, intra-abdominal origin should be considered.

Cited by 13 publications

References 8 publications

Acute appendicitis in pregnancy: case series and review

Acute appendicitis in pregnancy: case series and review

Thoracic Empyema as Rare Complication of an Appendicular Mass: A Case Study and Review of the Literature

Perforated retrocecal appendicitis presenting with lung abscess—A case report

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