Chronic appendicitis: the process from pre-diagnosis to pathology.

OBJECTIVE: Chronic appendicitis (CA) is a rare medical condition. CA is characterized by a less severe and almost continuous abdominal pain. It has a clinical picture lasting longer than 1-2 days and extending over weeks, months, even years. The exact etiology of CA is unclear. Certain resources have reported it as the cause of partial obstruction in the lumen of the appendix. PATIENTS AND METHODS: Our study was carried out with the approval of the Clinical Research Ethics Committee. A retrospective analysis was performed between August 2018 and March 2020. RESULTS: It was determined that 207 appendectomies were performed during the retrospective scan period. The data of 182 of these patients could be accessed fully and we could get answers to the criteria we thought. Only 8 of the patients screened were likely to be diagnosed with chronic appendicitis in the preoperative period. CA was found in 1 of the 8 patients (12.5%) who underwent surgery after a preliminary diagnosis of CA. Two patients were reported as malignant (25%), 3 patients (37.5%) as reactive lymphoid hyperplasia, and 1 patient as peri appendicitis (12.5%). Bleeding and congestion were reported in the last patient (12.5%). CONCLUSIONS: The diagnosis of chronic appendicitis is made by pathological examination. It may not always be possible to consider "chronic appendicitis" as a preliminary diagnosis. This should still be kept in mind. In our opinion, it is a bit difficult to make a preliminary diagnosis of chronic appendicitis and make a surgical decision. We believe that controlled and prospective studies can shed more light on chronic appendicitis.

Investigation of the relationship between serum hormones and pilonidal sinus disease: a cross-sectional study.

AIM: The aim of this cross-sectional study was to determine whether pilonidal sinus is influenced by hormones that stimulate body hair growth. Currently, there are insufficient data on the presence of hormonal abnormalities in pilonidal sinus disease. METHOD: Hormone levels (including those of thyroid-stimulating hormone, follicular-stimulating hormone, luteinizing hormone, prolactin, progesterone, oestradiol, testosterone, cortisol and dehydroepiandrosterone) were measured in 39 patients with pilonodal sinus presenting between February 2013 and March 2013. The results were compared with those of 39 volunteers without this disease. RESULTS: There was no statistically significant difference between men with pilonidal sinus disease (P > 0.05). The prolactin levels of women with pilonoidal sinus were significantly higher than those of women in the control group (P < 0.05). CONCLUSION: Raised serum prolactin levels in women may be related to the development of pilonidal sinus disease.

Small bowel obstruction due to anomalous congenital peritoneal bands - case series in adults.

BACKGROUND: Congenital bands cause 3 % of all intestinal obstruction and almost always lead to small bowel obstruction. In adults, obstruction due to bands is even rarer. MATERIALS AND METHODS: A multicenter study in Turkey. From January 2000 to December 2010 inclusive - a period of 10 years - all adult patients admitted to the emergency departments with a clinical diagnosis of acute intestinal obstruction due to congenital peritoneal band were included in the study. Surgery was defined as emergency. Recorded operative findings included the site of obstruction, and the operative procedure to relieve it. In the present study, the findings in adult patients with congenital band reported in the literature together with findings in ten cases operated at four center were retrospectively assessed with respect to their demographic, preoperative, peroperative, and postoperative characteristics. RESULTS: There were 8 males and 2 females aged between 18 and 72 year. There were no history of abdominal or inguinal surgery. Plain abdominal X-rays radiography revealed air- fluid levels in all patients. All the bands were ligated and divided. On histopathological examination, the bands were composed of loose connective tissue containing blood vessels. There were no calcification in the bands. CONCLUSION: an anomalous congenital band could be included in the differential diagnosis of intestinal obstruction. This clinical situation requires early surgical intervention that will be diagnostic and therapeutic (Tab. 1, Fig. 4, Ref. 21).