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Traumatic appendicitis: a case report and literature review.

Bouassria A, Ibn Majdoub K, Yazough I, Ousadden A, Mazaz K, Taleb KA - World J Emerg Surg (2013)

Bottom Line: Appendicitis and trauma may exist together, which causes an interesting debate whether trauma has led to appendicitis.We report a case of appendicitis after an abdominal trauma.Our patient developed acute appendicitis following a stab wound in the right iliac fossa.

View Article: PubMed Central - HTML - PubMed

Affiliation: School of medicine and pharmacy of Fez, Sidi Mohammed Ben Abdellah University, BP: 1893; km2,200, route de sidi Hrazem, Fez 30000, Morocco. bouassriaabdesslam@gmail.com.

ABSTRACT
Appendicitis and trauma may exist together, which causes an interesting debate whether trauma has led to appendicitis. We report a case of appendicitis after an abdominal trauma. Our patient developed acute appendicitis following a stab wound in the right iliac fossa. Surgical exploration confirmed the traumatic origin of appendicitis, appendectomy was performed and our patient made an excellent recovery. In non operative management of abdominal trauma, physical examinations and radiological explorations should be repeated in order to diagnose traumatic appendicitis.

No MeSH data available.


Related in: MedlinePlus

Intra operative photo showing the right para colic retroperitoneal hematoma and the appendicitis.
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Figure 2: Intra operative photo showing the right para colic retroperitoneal hematoma and the appendicitis.

Mentions: A 24 year-old man was admitted to the emergency department because of an abdominal injury following a stab wound which occurred on the same day. He said he was assaulted one hour before his admission by a stab wound in the right iliac fossa. His assailant used a sharp instrument (kitchen knife).The physical examination showed a conscious patient hemodynamically stable whose temperature was 37°C, whose pulse rate was 80 beats/min, whose respiratory rate of 20 breaths/min and whose blood pressure was 130/80 mmHg. Abdominal examination was normal out of mild tenderness at the abdominal wound which was located in the right iliac fossa. Laboratory investigations showed that the hemoglobin level was 12.8 g/dl, and the white blood cell count was 9800/mm3. Abdominal ultra sonography (US) was normal. So, a non operative management was decided. The penetrating abdominal wound (2 centimeters in length) was located in the right iliac fossa. It was disinfected and sutured. The day after his hospitalization, he had acute right iliac fossa pain. On examination, he was found to have a blood pressure of 120/80 mmHg, a pulse rate of 80 beats/min and a respiratory rate of 20 breaths/min; he was mildly pyrexial at 37.5°C. Abdominal examination revealed tenderness in the right iliac fossa. Laboratory investigations showed that the hemoglobin level was stable, but the white blood cell count was significant for a leukocyte count of 14,000/mm3 with 80% polymorphonuclear leukocytes. Then, abdominal US showed acute appendicitis (Figure 1). An emergency operation was performed. At laparotomy, a right paracolic retroperitoneal hematoma was detected. The patient had pelvic appendix in position. The appendix was hyperemic and edematous. Hematomas of the caecal wall and of the appendiceal wall were found (Figure 2). Appendectomy was performed. Histopathology confirmed diagnosis of acute appendicitis. Our patient made an excellent recovery, and he was discharged from the hospital in stable condition 2 days later.


Traumatic appendicitis: a case report and literature review.

Bouassria A, Ibn Majdoub K, Yazough I, Ousadden A, Mazaz K, Taleb KA - World J Emerg Surg (2013)

Intra operative photo showing the right para colic retroperitoneal hematoma and the appendicitis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750490&req=5

Figure 2: Intra operative photo showing the right para colic retroperitoneal hematoma and the appendicitis.
Mentions: A 24 year-old man was admitted to the emergency department because of an abdominal injury following a stab wound which occurred on the same day. He said he was assaulted one hour before his admission by a stab wound in the right iliac fossa. His assailant used a sharp instrument (kitchen knife).The physical examination showed a conscious patient hemodynamically stable whose temperature was 37°C, whose pulse rate was 80 beats/min, whose respiratory rate of 20 breaths/min and whose blood pressure was 130/80 mmHg. Abdominal examination was normal out of mild tenderness at the abdominal wound which was located in the right iliac fossa. Laboratory investigations showed that the hemoglobin level was 12.8 g/dl, and the white blood cell count was 9800/mm3. Abdominal ultra sonography (US) was normal. So, a non operative management was decided. The penetrating abdominal wound (2 centimeters in length) was located in the right iliac fossa. It was disinfected and sutured. The day after his hospitalization, he had acute right iliac fossa pain. On examination, he was found to have a blood pressure of 120/80 mmHg, a pulse rate of 80 beats/min and a respiratory rate of 20 breaths/min; he was mildly pyrexial at 37.5°C. Abdominal examination revealed tenderness in the right iliac fossa. Laboratory investigations showed that the hemoglobin level was stable, but the white blood cell count was significant for a leukocyte count of 14,000/mm3 with 80% polymorphonuclear leukocytes. Then, abdominal US showed acute appendicitis (Figure 1). An emergency operation was performed. At laparotomy, a right paracolic retroperitoneal hematoma was detected. The patient had pelvic appendix in position. The appendix was hyperemic and edematous. Hematomas of the caecal wall and of the appendiceal wall were found (Figure 2). Appendectomy was performed. Histopathology confirmed diagnosis of acute appendicitis. Our patient made an excellent recovery, and he was discharged from the hospital in stable condition 2 days later.

Bottom Line: Appendicitis and trauma may exist together, which causes an interesting debate whether trauma has led to appendicitis.We report a case of appendicitis after an abdominal trauma.Our patient developed acute appendicitis following a stab wound in the right iliac fossa.

View Article: PubMed Central - HTML - PubMed

Affiliation: School of medicine and pharmacy of Fez, Sidi Mohammed Ben Abdellah University, BP: 1893; km2,200, route de sidi Hrazem, Fez 30000, Morocco. bouassriaabdesslam@gmail.com.

ABSTRACT
Appendicitis and trauma may exist together, which causes an interesting debate whether trauma has led to appendicitis. We report a case of appendicitis after an abdominal trauma. Our patient developed acute appendicitis following a stab wound in the right iliac fossa. Surgical exploration confirmed the traumatic origin of appendicitis, appendectomy was performed and our patient made an excellent recovery. In non operative management of abdominal trauma, physical examinations and radiological explorations should be repeated in order to diagnose traumatic appendicitis.

No MeSH data available.


Related in: MedlinePlus