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Jaramillo JD, Mosquera BR, Botello YP. Retrocecal Appendicitis Post-blunt Abdominal Trauma: A Case Report. Cureus 2024; 16:e61839. [PMID: 38975489 PMCID: PMC11227443 DOI: 10.7759/cureus.61839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2024] [Indexed: 07/09/2024] Open
Abstract
Appendicitis, characterized by inflammation and obstruction of the appendiceal lumen, is a common surgical emergency often attributed to various factors. We present the case of an 18-year-old female who developed retrocecal appendicitis following blunt abdominal trauma, a rare occurrence with significant diagnostic challenges. Initial symptoms mimicked upper abdominal trauma, evolving to classic signs of appendicitis within hours. Despite a negative pre-trauma history of abdominal pain, clinical evaluation led to a suspicion of appendicitis. Contrast-enhanced CT scan confirmed the thickening of the cecal appendix, prompting urgent surgical intervention. An open appendectomy revealed a congested retrocecal appendix, supporting the diagnosis. Our case underscores the importance of considering trauma as a potential trigger for appendicitis, especially in the absence of typical pre-trauma symptoms. Diagnostic criteria for post-trauma appendicitis are evolving, and we underscore a comprehensive clinical assessment alongside imaging modalities. While surgical management remains standard, newer approaches like endoscopic retrograde appendicitis therapy warrant exploration. Further research is essential to refine diagnostic and therapeutic strategies for this uncommon presentation, ensuring timely intervention and improved patient outcomes.
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Habachi G, Aziza B, Ben-Ammar S, Maherzi O, Houas Y, Kerkeni Y, Sahli S, Jouini R. Acute peritonitis secondary to post-traumatic appendicitis: A case report and literature review. World J Clin Cases 2023; 11:6491-6497. [PMID: 37900251 PMCID: PMC10600999 DOI: 10.12998/wjcc.v11.i27.6491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/30/2023] [Accepted: 08/25/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Blunt abdominal trauma has rarely been reported as a cause of acute appendicitis in the literature. However, the coexistence of the two conditions can cause issues for the patient. We present here a systematic review of cases of traumatic appendicitis as well as our own experience with a 12-year-old male patient. CASE SUMMARY A 12-year-old male was admitted 3 d after abdominal trauma, experiencing peritoneal syndrome. A pelvic formation was discovered during abdominal ultrasound, and surgical exploration revealed a perforated appendix. A literature review was conducted applying the keywords "appendicitis," "abdominal," and "trauma" to the PubMed, Embase, and Medline databases. Our initial search included 529 papers published between 1991 and 2022, of which 33 papers were finally included. They revealed 51 reported cases. The trauma mechanisms included road traffic accidents, falls, assaults, ball accidents, a horse kick, and a colonoscopy. Eight patients underwent surgical exploration with no prior radiological investigation, and twenty-six patients underwent an initial radiological examination. All reports indicated a perforated appendix. CONCLUSION Acute traumatic appendicitis represents a diagnostic quandary that can be misdiagnosed resulting in significant morbidity and potential mortality. A high level of suspicion combined with radiological examination may aid in the diagnosis and treatment of this condition.
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Affiliation(s)
- Ghada Habachi
- Department of Pediatric Surgery A, The Béchir-Hamza Children’s Hospital, Tunis 1029, Tunisia
| | - Bochra Aziza
- Department of Pediatric Surgery A, The Béchir-Hamza Children’s Hospital, Tunis 1029, Tunisia
| | - Sabrine Ben-Ammar
- Department of Pediatric Surgery A, The Béchir-Hamza Children’s Hospital, Tunis 1029, Tunisia
| | - Oussama Maherzi
- Department of Pediatric Surgery A, The Béchir-Hamza Children’s Hospital, Tunis 1029, Tunisia
| | - Yasmine Houas
- Department of Pediatric Surgery A, The Béchir-Hamza Children’s Hospital, Tunis 1029, Tunisia
| | - Yosra Kerkeni
- Department of Pediatric Surgery A, The Béchir-Hamza Children’s Hospital, Tunis 1029, Tunisia
| | - Sondes Sahli
- Department of Pediatric Surgery A, The Béchir-Hamza Children’s Hospital, Tunis 1029, Tunisia
| | - Riadh Jouini
- Department of Pediatric Surgery A, The Béchir-Hamza Children’s Hospital, Tunis 1029, Tunisia
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Naumann DN, Barker T. Traumatic appendicitis is probably not real: an illustrative analysis of coincidental occurrences in nature. Trauma Surg Acute Care Open 2023; 8:e001093. [PMID: 36967864 PMCID: PMC10030918 DOI: 10.1136/tsaco-2023-001093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 03/01/2023] [Indexed: 03/17/2023] Open
Abstract
There have been sporadic case reports describing ‘traumatic appendicitis’ (acute appendicitis occurring following injury) for almost a hundred years. Although this might seem to be an interesting and rare diagnosis for the journal reader, both appendicitis and trauma are very common, and their occurrence together may only give the illusion of causality. Indeed, such a diagnosis may not even exist. We provide an illustration of the statistical phenomenon of coincidental occurrences in nature using a computer simulation of traumatic appendicitis in the UK population. In our simulation, there are enough cases of traumatic appendicitis every 2 years to 3 years to account for the entire global literature on the topic. We suggest that unless there is a credible pathological process reported with demonstrable causality, further case reports of traumatic appendicitis need to have robust justification.
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Affiliation(s)
- David N Naumann
- Department of Emergency General Surgery and Trauma, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK
| | - Tom Barker
- Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK
- Department of Vascular Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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Siller RA, Skubic JJ, Almeda JL, Villarreal JF, Kaplan AE. Candida pericarditis presenting with cardiac tamponade and multiple organ failure after combined damage control thoracotomy and laparotomy with splenectomy in a trauma patient: Case report and review of literature. Trauma Case Rep 2021; 37:100564. [PMID: 34917734 PMCID: PMC8669452 DOI: 10.1016/j.tcr.2021.100564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2021] [Indexed: 12/04/2022] Open
Abstract
Candida pericarditis is a rare condition which has previously been described after cardiothoracic surgery and immunosuppressive states (Geisler et al., 1981; Eng et al., 1981; Kraus et al., 1988; Kaufman et al., 1988; Tang et al., 2009; Glower et al., 1990; Carrel et al., 1991; Rabinovici et al., 1997; Canver et al., 1998; Farjah et al., 2005; Gronemeyer et al., 1982 [1-11]). We describe the case of a 19-year-old male blunt trauma patient, who survived a damage control thoracotomy and laparotomy with splenectomy, who later developed a loculated Candida pericardial effusion, complicated with cardiac tamponade and multiple organ failure, and required antifungals and surgical reintervention with thoracotomy for drainage. A literature search of the reported cases demonstrates that Candida pericarditis is indeed a rare but fatal condition if not identified and treated appropriately. This article discusses the difficulties we encountered while recognizing the disorder in our patient and proposes a guideline to adequately treat the condition in an effective and timely manner. Candida pericarditis poses a special challenge for the physician since its correct diagnosis and management requires a multidisciplinary approach.
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Affiliation(s)
- R A Siller
- University of Texas at Rio Grande Valley - General Surgery Residency at Doctors Hospital at Renaissance, 5321 S, McColl Road, Edinburg, TX 78569, United States of America
| | - J J Skubic
- DHR Health Surgery Institute, Department of Trauma and Critical Care, 1100 E. Dove Ave, Suite 201, McAllen, TX 78504, United States of America
| | - J L Almeda
- DHR Health Transplant Institute, Hepatobiliary, Pancreas and Organ Transplantation Center, 5540 Raphael Drive, Edinburg, TX 78539, United States of America
| | - J F Villarreal
- DHR Health Heart Institute, 224 Lindberg Ave, McAllen, TX 78501, United States of America
| | - A E Kaplan
- Pulmonary Sleep Center of the Rio Grande Valley, 5300 N, McColl Rd, McAllen, TX 78504, United States of America
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Sharma K, Tomar S, Sharma S, Bajpai M. Floating appendix: post-traumatic amputation of the appendix as sequela or complication?: a case report. J Med Case Rep 2021; 15:192. [PMID: 33827681 PMCID: PMC8025496 DOI: 10.1186/s13256-021-02747-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 02/17/2021] [Indexed: 11/18/2022] Open
Abstract
Background Appendicitis following trauma is a well-documented sequela of blunt trauma to the abdomen, while appendiceal transection following trauma is extremely rare. Literature reports have documented appendicitis and appendiceal transection as the presenting pathology in a trauma setting. This is first report of auto-amputation of the appendix as a delayed presentation with peritonitis, which was detected during the second surgery in a child with blunt abdominal trauma. Case presentation A 11-year-old Asian boy presented to our center with a 2-day history of blunt abdominal trauma and chief complaint of severe abdominal pain. On evaluation, a computed tomography scan showed gross pneumoperitoneum. The child underwent emergency laparotomy, where a jejunal perforation was noted, which was repaired. The rest of the bowel and solid organs were healthy. The child was managed in the intensive care unit postoperatively, when he developed a burst abdomen. During the second surgery, pyoperitoneum and free-floating appendix were found in the left paracolic gutter. After peritoneal wash, the bowel was noted to be healthy and the previous jejunal repair was intact. The child was allowed oral intake of food and discharged on postoperative days 4 and 8, respectively. At the 1-year follow-up, he remained asymptomatic. Conclusions This case report is unique as it describes auto-amputation of the appendix as a delayed event in the course of treatment for blunt trauma of the abdomen. Although a remote event, the possibility of amputation of the appendix should be retained as a differential diagnosis and unusual complication in cases of delayed peritonitis.
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Affiliation(s)
- Kanika Sharma
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Shreya Tomar
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Shilpa Sharma
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - Minu Bajpai
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, 110029, India
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Chalh O, El Haddad S, Choayb S, Allali N, Chat L. Traumatic Appendicitis in Children. Glob Pediatr Health 2021; 8:2333794X21992168. [PMID: 33614856 PMCID: PMC7868464 DOI: 10.1177/2333794x21992168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/22/2020] [Accepted: 01/13/2021] [Indexed: 11/15/2022] Open
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Appendicitis Secondary to Trauma following a Camel Kick: Case Report and Review of Literature. Case Rep Surg 2021; 2021:6667873. [PMID: 33505757 PMCID: PMC7808804 DOI: 10.1155/2021/6667873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 12/19/2020] [Accepted: 12/30/2020] [Indexed: 11/18/2022] Open
Abstract
Introduction Independently, trauma and appendicitis are two of the most common conditions in surgical practice. Rarely, both conditions may coexist, which raises the controversy whether it is merely a coincidence or trauma may lead to acute appendicitis. Presentation of Case. We report a case of acute appendicitis after blunt abdominal trauma caused by a camel hoof kick to the abdomen in a young man and discuss the potential underlying pathophysiologic mechanisms with review of the pertinent literature. Conclusions Blunt abdominal trauma caused by a camel kick to the abdomen requires a close observation of the patients. A camel kick may increase intra-abdominal pressure and cause internal organ injury including the appendix. Therefore, acute appendicitis should be considered in differential diagnosis in any patient with abdominal pain resembling appendicitis following blunt abdominal trauma.
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