- Community-acquired infection to Raoultella ornithinolytica presenting as appendicitis and shock in a healthy individual. [Journal Article]
- JSJ Surg Case Rep 2018; 2018(5):rjy097
- Raoultella ornithinolytica and Raoultella planticola are histamine-producing bacteria that are usually found in fish and water. They are associated with scombroid syndrome that presents with vomiting...
Raoultella ornithinolytica and Raoultella planticola are histamine-producing bacteria that are usually found in fish and water. They are associated with scombroid syndrome that presents with vomiting and flushing. A wide range of infections with these germs is reported, but mainly in fragile hospitalized patients with multiple comorbidities. We report the case of a 54-year-old healthy patient who presented with 24-hours abdominal pain, vomiting, flushing and shock. The abdominal examination showed guarding in the right lower quadrant (RLQ), and the abdominal CT scan images showed a thickened terminal ileum and a distended appendix. The patient underwent a surgical exploration revealing a normal terminal ileum but an inflamed appendicular base. Raoultella ornithinolytica was found in blood cultures and in the liquid retrieved from the RLQ. To the best of our knowledge, this is the first report of a severe life-threatening intra-abdominal presentation due to a community-acquired R. ornithinolytica infection.
- Primary lymphoma of appendix presenting as acute appendicitis: A case report. [Journal Article]
- IJInt J Surg Case Rep 2018 May 07; 48:30-33
- CONCLUSIONS: The patient received laparotomic appendectomy. The definitive histopathological examination revealed the presence of diffuse large cell B-lymphoma of the appendix. The neoplasms of appendix usually manifest clinically with sign and symptoms of acute appendicitis from luminal obstruction (30-50%). Preoperative diagnosis is difficult and often occurs through histopathological examination.Primary appendiceal lymphoma is rare and there are no clear guidelines for therapy. Primary surgical resection followed by post-operative chemotherapy showed high efficacy. The histopathological examination of all appendectomy is essential.
- [Prognostic analysis and clinicopathological features of 20 patients with appendiceal neuroendocrine neoplasms]. [Journal Article]
- ZWZhonghua Wei Chang Wai Ke Za Zhi 2018 May 25; 21(5):564-568
- CONCLUSIONS: Most a-NEN patients have no typical symptoms, and the main complaint at consultation is acute right lower quadrant abdominal pain. Prognosis is poor for patients with age >50 years, MANEC pathology grade and metastasis.
- StatPearls [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- Pseudoappendicitis can describe any condition mimicking appendicitis. Acute right lower quadrant abdominal pain with anorexia and point tenderness (McBurney's sign) are characteristic symptoms of app...
Pseudoappendicitis can describe any condition mimicking appendicitis. Acute right lower quadrant abdominal pain with anorexia and point tenderness (McBurney's sign) are characteristic symptoms of appendicitis. The more specific definition of pseudoappendicitis is associated with Yersinia enterocolitica infections. This bacteria is associated with the infective and inflammatory intestinal condition known as yersiniosis. Most cases of Y. enterocolitica, however, are asymptomatic and self-limiting.
- StatPearls [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- The patient is a 32-year-old male with no significant past medical history presents to the emergency department with abdominal pain. He states the pain began a few days ago in the right lower quadran...
The patient is a 32-year-old male with no significant past medical history presents to the emergency department with abdominal pain. He states the pain began a few days ago in the right lower quadrant of the abdomen, and now feels as though it is spreading to the mid-abdomen.
- A case report on recurrent appendicitis: An often forgotten and atypical cause of recurrent abdominal pain. [Journal Article]
- AMAnn Med Surg (Lond) 2018; 28:16-19
- CONCLUSIONS: Therefore, recurrent appendicitis should be considered as differential diagnosis in patients with recurring right lower quadrant abdominal pain and mild/or no tenderness.
- Hypereosinophilic syndrome preceding a diagnosis of B-cell lymphoma. [Journal Article]
- TTumori 2018 Mar 01; :300891618763211
- CONCLUSIONS: Reviewing the literature indicates only one case of similar presentation with concomitant HES and DLBCL. Eosinophilia is routinely encountered in clinical practice and as such physicians must be aware of the rarer, more malevolent underlying associations of this condition so as to aid early diagnosis and prompt treatment.
- Ingested foreign body mimicking acute appendicitis. [Journal Article]
- IJInt J Surg Case Rep 2018 Apr 09; 46:66-68
- CONCLUSIONS: Discussion includes a literature review of computed tomography negative appendicitis, as well as the frequency of foreign body mimicking appendicitis. This case demonstrates the importance of the clinical exam even in the face of negative highly sensitive imaging modalities.In conclusion, there are several mimics of acute appendicitis and we present an unusual case of a foreign body mimicking this disorder in a young person. Highly sensitive imaging coupled with history and physical examination remains the standard of care for diagnosing appendicitis; however, clinical acumen must be utilized to formulate a broad differential.
- When a cure becomes the pathology: mechanical bowel obstruction due to herbal pharmacobezoar. A case report with review of literature. [Journal Article]
- CJClin J Gastroenterol 2018 Apr 21
- Bezoars are intra-luminal concretions of ingested material which accumulate within the bowel. They are termed pharmacobezoars when the constituent material is drugs. We report a 64-year-old female wi...
Bezoars are intra-luminal concretions of ingested material which accumulate within the bowel. They are termed pharmacobezoars when the constituent material is drugs. We report a 64-year-old female with abdominal pain and obstipation for 3 days. Patient had completed anti-tuberculous combination therapy for suspected abdominal tuberculosis 25 years ago. She exhibited features of shock with a right iliac fossa lump. Abdominal X-ray displayed multiple air-fluid levels with densely cluttered radio-opacities in the right lower quadrant. Laparotomy revealed a palpable mid-ileal intra-luminal lump, adherent to the ascending colon and proximal ileum necessitating resection. Ex vivo examination of resected specimen revealed numerous tablets aggregating proximal to an ileal stricture. The patient post-operatively confirmed the tablets resembled the herbal laxatives she had been consuming. Pharmacobezoars can lead to subacute intestinal obstruction. Numerous drugs have been implicated. Patients with partial gastrectomy and vagotomy are at risk. CT is the pre-eminent diagnostic modality. The treatment options for pharmacobezoars include lavage, endoscopic retrieval, in addition to surgery. Pharmacobezoars need a high index of suspicion for pre-operative diagnosis. A detailed history and correlation with radioimaging can offer important cues. One can prevent pharmacobezoars by abstaining from unwarranted medications and identifying those at risk.
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- Novel Quality Indicators for Radiologists Interpreting Abdominopelvic CT Images: Risk-Adjusted Outcomes Among Emergency Department Patients With Right Lower Quadrant Pain. [Journal Article]
- AAAJR Am J Roentgenol 2018; 210(6):1292-1300
- CONCLUSIONS: Individual radiologists were indistinguishable both within group and between group by emergency and abdominal specialization for the prediction of major patient outcomes after abdominopelvic CT performed for right lower quadrant pain in the ED.