Intestinal Obstruction due to Acute Appendicitis

Đức, Phạm Hồng; Xuan, Ngo Minh; Thuyet, Nguyen Huu; Huy, Huynh Quang

doi:10.1159/000508435

Cited by 3 publications

(1 citation statement)

References 13 publications

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“…However, there are many patients who present very late with localised or generalised peritonitis and even with intestinal obstruction where surgical intervention becomes mandatory. [ 11 12 ]…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Outcome of Right Subumbilical Transverse Incision Approach for the Management of Complicated Appendicitis in Paediatric Age Group – A Multi-Institutional Retrospective Study

Singh

Kunnur²,

Shantala

et al. 2023

African Journal of Paediatric Surgery

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Aim: The aim is to evaluate the outcome of right subumbilical transverse incision approach for the management of complicated appendicitis in paediatric age group. Materials and Methods: This is a retrospective multi-institutional study which was conducted in the Department of Paediatric Surgery, I Q City Medical College and Hospital, Durgapur, West Bengal, India and the Department of Paediatric Surgery, Rajiv Gandhi Super Speciality Hospital/Raichur Institute of Medical Sciences, Raichur, Karnataka, India. In this study, a review of 77 paediatric patients operated for complicated appendicitis using a right subumbilical transverse incision approach was done for a period of 3 years (from December 2017 to December 2020). All patients had proven complicated appendicular pathology like appendicular perforation, appendicular abscess or complicated appendicular lumps on ultrasonography or computed tomography scan, which mandated exploration. Results: There was no mortality. Average operative time was 1 h 48 min (ranging from 58 min to 3 h 12 min). Average length of hospital stay was 9 days (ranging from 5 days to 13 days). There was no incidence of fecal fistula. Seventeen (22%) patients developed superficial surgical site infection which subsided with regular dressings. There was no incidence of wound dehiscence or burst abdomen. Five (6.5%) patients required the incision to be extended beyond the midline to the left side to deal with the pathology and to access the entire peritoneal cavity. Nine (11.6%) patients required loop ileostomies, which was fashioned on the lateral aspect of the transverse incision. Only one patient had a doubtful caecal injury which was repaired and loop ileostomy was done. Six patients (7.7%) had adhesive intestinal obstruction postoperatively, of which three required re-exploration. There was no incidence of incisional hernia or any stoma-related complications. Conclusion: Complicated appendicitis is a condition which lacks standardisation of approach for management, and is inherently associated with complications. However, with a more logical incision and intra-operative approach we can keep the complications to minimum and improve outcomes to great extent in those patients requiring surgical intervention. We have been using the subumbilical transverse incision in all sizes of patients ranging from small children to adolescents with excellent results, and we believe that the same approach can be applied even in adult patients in similar clinical scenarios.

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Section: Introductionmentioning

confidence: 99%

Evaluation of the Outcome of Right Subumbilical Transverse Incision Approach for the Management of Complicated Appendicitis in Paediatric Age Group – A Multi-Institutional Retrospective Study

Singh

Kunnur²,

Shantala

et al. 2023

African Journal of Paediatric Surgery

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Intestinal Obstruction Due to Acute Appendicitis

Krishna¹,

A²

2021

Indian J Surg

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Intestinal obstruction caused by acute perforated appendicitis misdiagnosed as Hirschsprung’s disease in a 31-month-old boy

Nam

2022

Pediatr Emerg Med J

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Symptomatic abdominal distension in young children requires a differential diagnosis, such as overeating, constipation or surgical emergency. If the distension is associated with intestinal obstruction, clinicians should determine the cause, such as adhesion, hernia, tumor or inflammatory lesions. Herein, the author reports a case of intestinal obstruction caused by acute perforated appendicitis. A 31-month-old boy was referred with a 10-day history of abdominal distension and a presumptive diagnosis of Hirschsprung's disease. He had undergone an unsuccessful enema. Initial plain radiography and computed tomography showed severely dilated bowel loops with the colon collapsed. During laparotomy, the perforated appendix was found attached to the retroperitoneum and mesentery, which resulted in ileal stenosis with ischemia. The author resected 10 cm of the ileum, and performed ileocecectomy. Postoperatively, the boy recovered uneventfully, except wound seroma. Due to the low incidence and vague symptoms, it is difficult to diagnose intestinal obstruction caused by appendicitis, particularly in young children. This case may serve as a reminder that acute perforated appendicitis can cause sudden onset of intestinal obstruction in young children without a history of surgery.

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Intestinal Obstruction due to Acute Appendicitis

Cited by 3 publications

References 13 publications

Evaluation of the Outcome of Right Subumbilical Transverse Incision Approach for the Management of Complicated Appendicitis in Paediatric Age Group – A Multi-Institutional Retrospective Study

Evaluation of the Outcome of Right Subumbilical Transverse Incision Approach for the Management of Complicated Appendicitis in Paediatric Age Group – A Multi-Institutional Retrospective Study

Intestinal Obstruction Due to Acute Appendicitis

Intestinal obstruction caused by acute perforated appendicitis misdiagnosed as Hirschsprung’s disease in a 31-month-old boy

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