Not only appendicitis: rare appendix disorders manifesting as surgical emergencies in children

Samuk, Inbal; Dlugy, Elena; Seguier‐Lipszyc, Emmanuelle; Rootman, Mika Shapira; Nica, Adriana Elena; Kravarušić, Dragan

doi:10.1007/s00431-020-03784-4

Cited by 7 publications

(9 citation statements)

References 25 publications

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“…What we describe in this case report is the formation of an ‘appendicular ring’ by which the inflamed appendix wraps around the terminal ileum, resulting in a mechanical distal small bowel obstruction. This has previously been reported in a small subset of patients 5–9 …”

Section: Figsupporting

confidence: 74%

Appendicular ring: an unusual cause of mechanical small bowel obstruction

Karlsen

Mulholland

Mouline

et al. 2021

ANZ Journal of Surgery

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Section: Figsupporting

confidence: 74%

Appendicular ring: an unusual cause of mechanical small bowel obstruction

Karlsen

Mulholland

Mouline

et al. 2021

ANZ Journal of Surgery

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“…In a review of 33 adults with appendiceal torsion, reported during 1918-2018, only one had an associated congenital anomaly "cecal malposition". 11,30,33 In primary torsion is hypothesized that the axial rotation is due to different possible cause: i) to abnormalities of the mesentery, such as a narrow base, as occurred in our case, ii) to the absence of azygotic folds that normally laterally fix the appendix, iii) to cecal malposition, iv) to abnormal peristaltic movements and v) to vigorous physical exercise. Secondary torsion of appendix is rarest.…”

Section: Discussionmentioning

confidence: 74%

Torsion of cecal appendix. Report of the first Italian case and review of the literature

2021

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In pediatric patients appendicitis is the most common cause of abdominal pain and surgery. Torsion of vermiform appendix is a rare cause, clinically indistinguishable from appendicitis with usually an intraoperative diagnosis. The first description of vermiform appendix torsion was made by Payne in 1918. Clinical presentation is similar to acute appendicitis. Preoperative investigations play a minimal role. Etiology of this condition is unclear, but is possible to distinguish a primary and a secondary torsion. We report a case of 5-years-old boy who presented with right lower quadrant abdominal pain. His clinical signs, symptoms and investigations mimicked an acute appendicitis. Intraoperatively we found a 720° appendix torsion on its base with its mesentery rotated in counter-clockwise direction. The appendix was gangrenous in appearance. A video-assisted trans-umbilical appendectomy was performed. We describe clinical presentation and management of this rare condition reviewing the literature.

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“…With cross‐referencing, eight additional eligible articles were identified. In total, 131 articles were included in this systematic review 3,6,12–140 . Figure 1 provides the PRISMA flowchart.…”

Section: Resultsmentioning

confidence: 99%

“…Reported indications were: N = 2 ileocaecal resection due to perforation of the caecum or fistula of the appendix into caecum, N = 1 resection of a part of ascending colon due to local lesion caused by adherent appendix, N = 1 resection terminal ileum due to adherent appendix and cystic lesion, N = 1 Meckel's diverticulum, N = 1 adherent ileal loop, N = 1 old perforation terminal ileum 44,45,69,98,124,131,135 . In one patient a diverticulectomy of a Meckel's diverticulum was performed and in three patients a Ladd's procedure 20,24,104,134 …”

Section: Resultsmentioning

confidence: 99%

Appendicitis and its associated mortality and morbidity in infants up to 3 months of age: A systematic review

The,

Derikx

et al. 2023

Health Science Reports

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Background and AimsAlthough appendicitis is rare in young infants, the reported mortality is high. Primary aim of this systematic review was to provide updated insights in the mortality and morbidity (postoperative complications, Clavien‐Dindo grades I–IV) of appendicitis in infants ≤3 months of age. Secondary aims comprised the evaluation of patient characteristics, diagnostic work‐up, treatment strategies, comorbidity, and factors associated with poor outcome.MethodsThis systematic review was reported according to the PRISMA statement with a search performed in Pubmed, Embase and Web of Science (up to September 5th 2022). Original articles (published in English ≥1980) reporting on infants ≤3 months of age with appendicitis were included. Both patients with abdominal appendicitis and herniated appendicitis (such as Amyand's hernia) were considered. Data were provided descriptively.ResultsIn total, 131 articles were included encompassing 242 cases after identification of 4294 records. Overall, 184 (76%) of the 242 patients had abdominal and 58 (24%) had herniated appendicitis. Two‐hundred (83%) of the patients were newborns (≤28 days) and 42 (17%) were infants between 29 days and ≤3 months of age. Either immediate, or after initial conservative treatment, 236 (98%) patients underwent surgical treatment. Some 168 (69%) patients had perforated appendicitis. Mortality was reported in 20 (8%) patients and morbidity in an additional 18 (8%). All fatal cases had abdominal appendicitis and fatal outcome was relatively more often reported in newborns, term patients, patients with relevant comorbidity, nonperforated appendicitis and those presented from home.ConclusionMortality was reported in 20 (8%) infants ≤3 months of age and additional morbidity in 18 (8%). All patients with fatal outcome had abdominal appendicitis. Several patient characteristics were relatively more often reported in infants with poor outcome and adequate monitoring, early recognition and prompt treatment may favour the outcome.

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Not only appendicitis: rare appendix disorders manifesting as surgical emergencies in children

Cited by 7 publications

References 25 publications

Appendicular ring: an unusual cause of mechanical small bowel obstruction

Appendicular ring: an unusual cause of mechanical small bowel obstruction

Torsion of cecal appendix. Report of the first Italian case and review of the literature

Appendicitis and its associated mortality and morbidity in infants up to 3 months of age: A systematic review

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