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1.
J. coloproctol. (Rio J., Impr.) ; 39(3): 279-287, June-Sept. 2019. tab, ilus
Artigo em Inglês | LILACS | ID: biblio-1040330

RESUMO

ABSTRACT Aim: The purpose of this review was to present and discuss the anatomical variations and congenital abnormalities of the vermiform appendix and mesoappendix reported in recent years, and their associations with acute appendicitis and other associated pathologies. Methods: The search was carried out in the following databases: PubMed, Science Direct, and SciELO. Results: Thirty-seven studies were included in this review. Among the abnormalities of the vermiform appendix identified are agenesis and duplicity, and anatomical variations were related to length and positioning. Appendicular duplicity was a more frequent abnormality, mainly Type B2, associated with acute appendicitis, followed by agenesis, Type III. The first case of agenesis associated with acute appendicitis and volvulus-type duplicity of the appendix was identified. The most frequent position was retrocecal in adults and pelvic in children. In the mesoappendix, anatomical variations in its positioning, shape, absence, and length were identified. Conclusion: This review sought to present and discuss the anatomical variations and congenital abnormalities of the vermiform appendix and mesoappendix reported in recent years, and their associations with acute appendicitis and other associated pathologies, contributing to aid in clinical diagnosis and surgical interventions in patients with suspected acute appendicitis.


RESUMO Objetivo: O objetivo desta revisão foi apresentar e discutir as variações anatômicas e anomalias congênitas do apêndice vermiforme e mesoapêndice relatados nos últimos anos e suas associações com apendicite aguda e outras patologias associadas. Métodos: A busca foi realizada nas seguintes bases de dados: Pubmed, Science Direct e Scielo. Resultados: Trinta e sete estudos foram incluídos nesta revisão. Entre as anormalidades do apêndice vermiforme identificada estão agenesia e duplicidade e, variações anatômicas relacionadas ao comprimento e posicionamento. A duplicidade apendicular foi a anormalidade mais incidente, principalmente do Tipo B2, associada à apendicite aguda, seguida de agenesia do Tipo III. O primeiro caso de agenesia associada à apendicite aguda e à duplicidade de apêndice do tipo vólvulo foi identificado. A posição mais frequente foi a retrocecal em adultos e a pélvica em crianças. No mesoapêndice, foram identificadas variações anatômicas em seu posicionamento, formato, ausência e comprimento. Conclusão: Esta revisão procurou apresentar e discutir as variações anatômicas e anomalias congênitas do apêndice vermiforme e mesoapêndice relatados nos últimos anos e suas associações com apendicite aguda e outras patologias associadas contribuindo para o auxílio no diagnóstico clínico e intervenções cirúrgicas em pacientes com suspeita apendicite aguda.


Assuntos
Humanos , Masculino , Feminino , Apêndice/anatomia & histologia , Apêndice/anormalidades , Apendicite , Anormalidades Congênitas , Variação Anatômica
2.
Pan Afr Med J ; 32: 72, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31223363

RESUMO

The appendix is a diverticulum attached to the caecum. It can have variable lengths and locations. Acute inflammation from long appendix is a diagnostic challenge with unusual signs and symptoms. A 35 years old man admitted to the emergency department for an acute abdominal pain with low-grade fever which had been present for 03 days. The abdomen Ultrasound showed minimal effusion in the right iliac fossa. He underwent an appendicectomy which revealed a very long appendix (23 cm in length) with tip reaching the sub hepatic area. The surgeon must kip in mind all anatomical variations of the appendix for making diagnosis and decisison to operate acute appendicitis because the increasing risk of morbidity.


Assuntos
Apendicectomia/métodos , Apendicite/cirurgia , Apêndice/anormalidades , Dor Abdominal/etiologia , Adulto , Apendicite/patologia , Apêndice/patologia , Apêndice/cirurgia , Serviço Hospitalar de Emergência , Febre/etiologia , Humanos , Masculino , Marrocos , Ultrassonografia
3.
Medicine (Baltimore) ; 98(5): e14104, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30702564

RESUMO

RATIONALE: The horseshoe anomaly of the vermiform appendix is extremely rare. Preoperative confirmation of this anomaly is difficult; therefore, routine procedures, such as appendectomy, may become unexpectedly challenging when such anomalies are encountered during the surgical process. PATIENT CONCERNS: A 33-year-old man presented with abdominal pain in the right lower abdomen owing to acute appendicitis confirmed via computed tomography. Immediate laparoscopic appendectomy was decided as the method for treatment. DIAGNOSIS: Horseshoe anomaly was diagnosed as a gross finding during surgery. INTERVENTION: First, the appendiceal base was resected and appendectomy was performed via the retrograde method because the appendiceal tip was curled behind the cecum. However, it was discovered that the appendiceal tip was connected to the lateral part of the ascending colon and showed a horseshoe-shaped anomaly. The second appendiceal base arising from the ascending colon was also ligated, and the appendectomy was completed without any further complications. OUTCOMES: After successful completion of appendectomy, the patient was discharged without any complications 2 days later. LESSONS: An appendiceal anomaly is rarely seen during appendectomy or other forms of abdominal surgery; however, the ability of surgeons to both recognize and categorize an appendiceal anomaly is crucial if detected during surgery. After successfully recognizing the horseshoe anomaly of the appendix, it is important to know that 2 appendiceal base ligations will be required to complete the surgery successfully.


Assuntos
Apendicectomia/métodos , Apendicite/cirurgia , Apêndice/anormalidades , Adulto , Apendicite/diagnóstico por imagem , Apêndice/diagnóstico por imagem , Apêndice/patologia , Colo/patologia , Humanos , Laparoscopia , Masculino , Tomografia Computadorizada por Raios X
4.
Surg Radiol Anat ; 41(1): 141-142, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30361841

RESUMO

Incidental CT findings of a 67 years old female patient that had right piriformis agenesis and migration of appendix vermiformis to the right deep gluteal region is presented. To our knowledge this is the first case that the appendix has such ectopic location. Consideration of such variation would be beneficial to avoid possible complications, especially for surgeons who deal with gluteal region.


Assuntos
Apêndice/anormalidades , Nádegas/diagnóstico por imagem , Músculo Esquelético/anormalidades , Idoso , Apêndice/diagnóstico por imagem , Feminino , Humanos , Achados Incidentais , Músculo Esquelético/diagnóstico por imagem , Tomografia Computadorizada por Raios X
5.
BMJ Case Rep ; 20182018 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-30389731

RESUMO

Congenital colonic stenosis is a rare condition with less than 20 cases reported in the literature since 1966. We report an interesting case of a 7-month-old baby girl who presented with features suggestive of acute intestinal obstruction. On exploration, it was a case of ascending colon stenosis with absence of caecum and appendix. A double barrel ileocolostomy was performed. The histopathology confirmed the diagnosis of colonic stenosis and ruled out the presence of Hirschsprung's disease in the distal colon. The child underwent second stage surgery (stoma closure) after 9 months. In complex cases of congenital colonic stenosis, an early decompressive surgery followed by a delayed second stage closure is recommended in patients with poor general condition.


Assuntos
Apêndice/patologia , Ceco/patologia , Colo/patologia , Obstrução Intestinal/cirurgia , Doença Aguda , Anastomose Cirúrgica/métodos , Apêndice/anormalidades , Ceco/anormalidades , Colo/anormalidades , Colo/cirurgia , Colostomia/métodos , Constrição Patológica/complicações , Diagnóstico Diferencial , Feminino , Humanos , Ileostomia/métodos , Lactente , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/patologia , Doenças Raras , Estomas Cirúrgicos , Resultado do Tratamento
6.
Am J Case Rep ; 19: 1362-1365, 2018 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-30429450

RESUMO

BACKGROUND Bowel obstruction is a mechanical or functional obstruction of the intestines which prevents the normal movement of the products of digestion. Intestinal malrotation is one of the rarest causes of mechanical bowel obstruction. In adults, the incidence rate is 0.2%, and 15% of all patients with confirmed diagnosis remain asymptomatic throughout life. Surgery is generally required when the patient is symptomatic. CASE REPORT A 30-year-old man with multiple admissions for chronic intermittent colicky abdominal pain since childhood, was admitted for symptoms suggestive of proximal small bowel obstruction. Tomographic imaging identified a midgut malrotation and a duodenal obstruction by a non-diseased displaced appendix. Laparoscopic liberation of the duodenum and the terminal ilium was done successfully. CONCLUSIONS Intestinal malrotation is infrequently encountered in the adult population, but it should be kept in mind as a differential diagnosis whenever a case of acute intestinal obstruction in an adult presents without any significant past surgical history.


Assuntos
Apêndice/anormalidades , Duodeno/patologia , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Volvo Intestinal/diagnóstico por imagem , Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Doença Aguda , Adulto , Meios de Contraste , Duodeno/diagnóstico por imagem , Duodeno/cirurgia , Humanos , Obstrução Intestinal/diagnóstico por imagem , Volvo Intestinal/complicações , Volvo Intestinal/cirurgia , Laparoscopia/métodos , Masculino , Doenças Raras , Recidiva , Medição de Risco , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
10.
Surg Radiol Anat ; 40(1): 111-114, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28620778

RESUMO

Appendicitis is the most common surgical abdominal emergency in the developed world. Most of the surprises encountered during an appendectomy are usually due to the various positions of the appendix tip. Anatomical variations are an extremely rare phenomenon, with only a few case reports scattered among volumes of literature on the vermiform appendix. A new variation is described in which the appendix was intracecal and cause for surprise during surgery. A review of literature of rare anatomical variations of the appendix is also presented.


Assuntos
Apêndice/anormalidades , Ceco/anormalidades , Adulto , Variação Anatômica , Humanos , Masculino
11.
World J Surg ; 42(2): 574-581, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28799135

RESUMO

BACKGROUND: Duplex appendix is very rare (incidence 0.004%) but has clinical relevance given the frequency of appendicectomies performed. Failure to recognise duplication can result in failure of treatment and medico-legal consequences. A review of published cases was undertaken to identify factors that may help in managing this rare condition. METHODS: All English and non-English publications were identified in PubMed, Embase and Cochrane databases. Patient demographics, intraoperative findings, anatomical details and histopathology were analysed. RESULTS: A total of 141 cases were identified [male/female ratio 1.4:1, median age 20 years (range foetus to 69 years)]. Duplication of the appendix ranges from branching of the appendix trunk to a fully matured appendix located elsewhere along the colon. Most can be categorised by the Cave-Wallbridge classification. There were 22 Type A, 8 Type B1, 46 Type B2 and 10 Type C cases (Cave-Wallbridge). There were six cases of horseshoe and two cases of triple appendix. Six reports gave anatomical descriptions that could not be classified by Cave-Wallbridge categories and in 11 cases there were no anatomical descriptions. CONCLUSIONS: An anteriorly placed appendix, away from the convergence of the taenia, or a normal appendix in the presence of convincing clinical or radiological signs of appendicitis should instigate a careful examination of the caecal pole and possible exploration of the retrocaecal space for appendiceal duplication. If the patient had previous surgery for congenital abnormalities, Type B1 or Type C duplication should be considered.


Assuntos
Apêndice/anormalidades , Apendicectomia , Apendicite/cirurgia , Anormalidades Congênitas/classificação , Anormalidades Congênitas/diagnóstico , Humanos
13.
Neurocir.-Soc. Luso-Esp. Neurocir ; 28(6): 294-297, nov.-dic. 2017. ilus
Artigo em Inglês | IBECS | ID: ibc-168503

RESUMO

Background: Lumbosacral and coccygeal skin covered appendages are a rare malformation, considered human-tails. Case report: The authors describe the case of a full term newborn girl with lumbar skin appendage and a normal neurologic examination. The magnetic resonance of the spine revealed a dermal sinus continuous with the skin appendage and with extension into to the spinal canal. Due to the infection risk, a surgery was performed on the third day of life, with dermal sinus ligation and appendage removal. At 12 months of follow-up the girl has a normal neurologic examination. Conclusions: With the description of this case the authors aim to emphasize that although rare, lumbar skin appendages can be associated with spinal dysraphism and other lesions, requiring extensive work-up and long-term surveillance (AU)


Antecedentes: Los apéndices humanos lumbosacros y coccígeos recubiertos de piel son malformaciones raras, consideradas colas humanas. Caso clínico: Describimos el caso de una niña recién nacida a término, con un apéndice cutáneo lumbar y con una exploración neurológica normal. La resonancia magnética lumbosacra demostró un seno dérmico contiguo al apéndice cutáneo con extensión al canal vertebral. Dado el riesgo de infección, fue operada al tercer día de vida realizándose ligación del seno dérmico y resección del apéndice cutáneo. Pasados 12 meses la niña continúa presentando un examen neurológico normal. Conclusiones: Con la descripción de este caso los autores pretenden realzar que, aunque raros, los apéndices cutáneos lumbares suelen asociarse a disrafismos espinales. Precisan, por ello, un estudio exhaustivo y seguimiento a largo plazo (AU)


Assuntos
Humanos , Feminino , Recém-Nascido , Disrafismo Espinal/cirurgia , Apêndice/anormalidades , Apêndice/cirurgia , Disrafismo Espinal/diagnóstico por imagem , Espinha Bífida Oculta/diagnóstico por imagem , Espinha Bífida Oculta/cirurgia , Região Lombossacral/anormalidades , Região Lombossacral/cirurgia
14.
Tunis Med ; 95(4): 304-306, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29492937

RESUMO

Duplication of the vermiform appendix is a rare malformation. Few than 100 cases have been reported worldwide. It is usually diagnosed incidentally during emergency appendectomies due to inflammatory processes in the cecal appendix. We report a case of a woman presented with clinical features typical of acute appendicitis and surgical exploration revealed a double appendix. The operating surgeon should be vigilant of these rare anomalies to avoid serious clinical and medico legal consequences.


Assuntos
Apendicectomia , Apendicite/cirurgia , Apêndice/anormalidades , Apêndice/cirurgia , Adulto , Anormalidades Congênitas/diagnóstico , Feminino , Humanos , Achados Incidentais
15.
G Chir ; 37(4): 158-161, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27938532

RESUMO

Foreign body ingestion is not an uncommon problem in clinical practice. While most ingested foreign bodies pass uneventfully through the gastrointestinal tract, sharp foreign bodies such as toothpicks should cause intestinal perforation. We reported the case of a perforation of the appendix caused by a toothpick, which also pierced the liver without hepatic damages, in a male with an intestinal malrotation and subhepatic appendix. The patient was admitted to our hospital for abdominal pain in the right upper quadrant. An abdominal computed tomography scan revealed the anomalous position of the first portion of the large intestine with inflamed appendix. A laparoscopic appendicectomy and the exploration of the abdominal cavity was performed using minimally invasive technique.


Assuntos
Apendicectomia , Apendicite/etiologia , Apêndice/anormalidades , Apêndice/lesões , Anormalidades do Sistema Digestório/complicações , Migração de Corpo Estranho/complicações , Volvo Intestinal/complicações , Laparoscopia , Idoso , Apendicectomia/métodos , Apendicite/diagnóstico , Apendicite/cirurgia , Migração de Corpo Estranho/diagnóstico , Migração de Corpo Estranho/cirurgia , Humanos , Laparoscopia/métodos , Masculino , Tomografia Computadorizada por Raios X , Resultado do Tratamento
16.
J Emerg Med ; 51(5): 589-591, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27623217

RESUMO

BACKGROUND: Appendix invagination is a rare cause of right lower quadrant abdominal pain. Clinical findings are not specific and can mimic a wide range of diseases. CASE REPORT: An 8-year-old girl was admitted with abdominal pain lasting for 2 weeks. Clinical and radiologic findings suggested ileocecal intussusception initially. A failed hydrostatic reduction attempt and subsequent abdominal ultrasound and computed tomography studies showed that the underlying pathology was invagination of the vermiform appendix. The patient was managed conservatively and spontaneous reduction was observed during follow-up. She underwent appendectomy 9 months later due to chronic appendicitis. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Appendix invagination should be kept in mind while evaluating patients with suspected ileocecal intussusception. In distinguishing between these two conditions, a blind-ending invaginating segment is an important clue in favor of appendix intussusception.


Assuntos
Apêndice/anormalidades , Intussuscepção/diagnóstico , Dor Abdominal/etiologia , Apendicite/cirurgia , Apêndice/fisiopatologia , Criança , Feminino , Humanos , Pressão Hidrostática , Intussuscepção/terapia , Tomografia Computadorizada por Raios X/métodos , Ultrassonografia/métodos
17.
Rev. chil. cir ; 68(3): 254-257, jun. 2016. ilus
Artigo em Espanhol | LILACS | ID: lil-787083

RESUMO

Objetivo: Dar a conocer una rara presentación de una patología frecuente. Caso clínico: Presentamos el caso de un paciente de 27 años de edad con clínica de apendicitis aguda con antecedentes de haberse realizado 9 años atrás una apendicectomía, encontrándose un apéndice inflamado, en posición retrocecal, ascendente y subseroso. En la segunda apendicectomía se encontró un nuevo apéndice sano en la unión de las 3 tenias. El estudio histológico posterior confirmó que ambas piezas quirúrgicas eran apéndices, uno inflamado y el otro normal.


Aim: To report a rare presentation of a frequent pathology. Case report: We report a patient of 27 years old with symptoms of acute appendicitis and medical records of an appendectomyy 9 years before where surgical findings were an inflamed appendix retrocecal ascendant and subserosa. In our procedure, we found a new one at the junction of the three tapeworms. Histological examination later confirmed that both surgical specimens were appendices, one swollen and the other normal.


Assuntos
Humanos , Masculino , Adulto , Apendicectomia , Apendicite/cirurgia , Apêndice/anormalidades , Apêndice/cirurgia , Reoperação , Doenças Raras
19.
Z Gastroenterol ; 54(4): 316-8, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27056460

RESUMO

Appendico-ileal knotting is a very rare and widely unknown cause of closed loop bowel obstruction. In most cases it is discovered incidentally during surgery. We report a 59 year old female with a previous history of a total abdominal hysterectomy who presented with features of intestinal obstruction and was thought to suffer from postoperative adhesions. At laparotomy, appendico-ileal knotting was found; after appendectomy, she made a full recovery. Appendico-ileal knotting should be known as a possible differential diagnosis when managing patients with features of intestinal obstruction and symptoms or signs of appendicitis.


Assuntos
Apêndice/anormalidades , Doenças do Íleo/diagnóstico , Doenças do Íleo/etiologia , Obstrução Intestinal/diagnóstico , Anormalidade Torcional/diagnóstico , Diagnóstico Diferencial , Reações Falso-Positivas , Feminino , Humanos , Obstrução Intestinal/etiologia , Pessoa de Meia-Idade , Aderências Teciduais/complicações , Aderências Teciduais/diagnóstico por imagem , Anormalidade Torcional/complicações
20.
Int J Surg Pathol ; 24(1): 66-9, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26272990

RESUMO

Appendiceal pneumatosis is rare, reported either in the context of acute appendicitis or enterocolitis. Here, we report the case of an elderly adult in whom the acute appendicitis was associated with pneumatosis and occurred in the context of a malformed appendix with pathogenic organism remnants. A 72-year-old man presented with abdominal pain 3 weeks after posttraumatic dorsolumbar surgery. The computed tomography scan showed acute appendicitis and 2 diverticula. On microscopy, the appendix showed acute appendicitis along with a Cave-Wallbridge type A duplication. In addition, several optically clear spaces were observed in the entire appendiceal wall consistent with pneumatosis of the appendix. Focally, calcified structures suggesting pathogenic organisms such as Schistosoma were noted as well. In conclusion, we report a case of appendiceal pneumatosis occurring in the context of acute appendicitis in a duplicated appendix, with presence of calcified structures suggestive of pathogenic organisms.


Assuntos
Apendicite/patologia , Apêndice/anormalidades , Pneumatose Cistoide Intestinal/patologia , Esquistossomose/patologia , Idoso , Animais , Apendicite/complicações , Apêndice/patologia , Humanos , Masculino , Pneumatose Cistoide Intestinal/complicações , Schistosoma/isolamento & purificação , Esquistossomose/complicações
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