Chronic Appendicitis, the Lesser-Known Form of Appendiceal Inflammation: A Case Report.

Chronic appendicitis is a rare condition involving appendiceal inflammation as these conditions typically present acutely and are treated with appendectomy. However, in a small minority of patients, appendicitis can have a mild presentation and become recurrent or chronic appendicitis. Due to the acute nature and immediate treatment of patients presenting with typical symptoms of appendicitis, chronic appendicitis has been often overlooked and/or misdiagnosed. We present a case in which a 50-year-old male presented with right lower quadrant (RLQ) pain of one-month duration. Computed tomography (CT) imaging showed evidence of lymph node enlargement near the patient's appendix, raising suspicion of chronic appendicitis. The patient underwent a successful laparoscopic appendectomy.

Peanut-Related Perforated Diverticulitis Before the Age of 60.

We present a case in which a 55-year-old male with a past medical history of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) presented with sharp, worsening right-sided abdominal pain radiating across the entire abdomen after eating peanuts. Computed tomography (CT) imaging showed evidence of acute sigmoid diverticulitis complicated by a walled-off perforation. The patient's past medical history suggested previous recurrent episodes of diverticulitis. Our patient underwent exploratory laparotomy, sigmoid colon resection with low anterior anastomosis and proctocolectomy, and loop ileostomy. During treatment, the sigmoid colon was found to be very indurated and abnormally going all the way down to the peritoneal reflection. Appropriate identification of the patient's condition and timely intervention resulted in a successful outcome.

Persistent Small Bowel Obstruction due to Small Bowel Adenocarcinoma: A Case Report.

Small bowel obstruction (SBO), of both partial and complete types, is a condition predominantly caused by intra-abdominal adhesions and hernias. However, a known but very uncommon cause of SBO is malignancies, which are more complicated than those caused by adhesions and hernias, and associated with poorer prognoses; of these, small bowel adenocarcinoma is an even rarer etiology of SBO. The majority of SBO cases that are treated have resolution of symptoms and do not have recurrence/persistence of the condition; however, reports suggest that approximately one-fifth of SBO cases that are treated will result in recurrence/persistence of SBO requiring repeat admission. Here we report the case of an 89-year-old female with a past medical history of right lower extremity deep venous thrombosis, inferior vena cava filter placement, iron deficiency anemia, diverticular disease, internal hemorrhoids, sick sinus syndrome, emphysema, hypertension, dyslipidemia, and hypothyroidism, who presented with diarrhea and intermittent dark stool. Abdominal computed tomography (CT) while in the emergency department initially showed possible ischemic bowel and SBO. After an exploratory laparotomy with small bowel resection and adhesiolysis, pathological analysis of a resected specimen showed infiltrating small bowel adenocarcinoma. Persistence of symptoms necessitated subsequent abdominal imaging, which demonstrated persistent SBO, which was treated with a second exploratory laparotomy with small bowel resection and end ileostomy.