A clinicopathological study of acute appendicitis in eastern India.

Background: Appendicitis is the most commonly performed emergency abdominal surgery. An accurate and timely diagnosis of acute appendicitis remains a challenge. Objective: This study was performed to determine and correlate between the clinical patterns of acute appendicitis, laboratory and ultrasound findings and pathology found in appendicectomy specimens to help timely diagnosis and reduce negative appendicectomy rate. Methods: This is a cross sectional study, detailed history and clinical examination of the patient was carried out at the time of admission. Operative findings along with any complications as well as histopathological findings were recorded. Patients were followed up for one month for any complications. Results: A total of 125 patients were treated for appendicitis during this period with a male female ratio of 1:1.36. Most common age group was the 2nd decade with mean age being 20 years, while most common symptom was abdominal pain. Ultrasonography showed evidence of acute appendicitis in 85.6% and leucocytosis in 66.4% cases. Although only 5.6% of appendices grossly appeared normal during surgery, histopathology showed 14.4% to be normal. Wound sepsis (24.8%) was the most common post-operative complication. Conclusion: Diagnosis of acute appendicitis in our setting is still based on high index of suspicion following clinical evaluation. Combining this with laboratory findings and ultrasound scan has yielded an acceptable negative appendicectomy rate. We advocate routine use of ultrasound along with clinical evaluation and laboratory tests for the timely diagnosis of acute appendicitis and an early surgical intervention to prevent complications.

Intra-abdominal hypertension and abdominal compartment syndrome: A review of current concept and trends.

Abdominal compartment syndrome (ACS) and intra-abdominal hypertension (IAH) have been a cause of complications in ICU patients, especially those of trauma and acute abdomen. ACS affects almost every system of the body namely the cardiac, respiratory, renal, CNS and the GIT. It has been under-recognized as it primarily affects patients who are already critically ill and the organ dysfunction may be incorrectly attributed to the primary illness. Since ACS can improve with treatment, it is important that the diagnosis be considered in the appropriate patient. We will review here the definition, classification, incidence, etiology, pathophysiology, clinical presentation, diagnosis and management of intraabdominal hypertension and abdominal compartment syndrome. The method employed for literature search included web search of articles in various international and national bibliographic indices. The websites used for the search include Google, PubMed, NIH.gov, Medscape.com, Science direct and Scopus.

Translocation of IUCD into caecum causing acute appendicitis.

Cases of extra uterine translocation of intrauterine contraceptive device (IUCD) to adjacent structures like peritoneal cavity, urinary bladder & sigmoid colon have been reported. Here is a case of translocation of IUCD into the caecum presenting as appendicitis. Appendicitis resulting from IUCD translocation is very rare. As per our knowledge only 19 cases have been reported earlier.