Torsion of appendices epiploicae masquerading as ogilve’s syndrome.

Torsion of appendices ep loicae is an uncommon differential diagnosis of a patient presenting with acute abdominal pain and its presentation as a Ogilvie’s syndrome or colonic ileus is even rare.The diagnosis requires a keen suspicion on the part of the attending surgeon. Preoperative computrized tomography ( CT) may help in the diagnosis but the final diagnosis is established only on the operating table . Adding this pathology to the existing list of the causes of colonic ileus /Ogilvies syndrome may give us a good insight into the understanding of the condition&improvise our management. This is a case report of 60 year old lady who was referred to us with nonspecific abdominal pain , distention of abdomen and vomiting from orthopaedics department , where she was being planned for surgery for intertrochanteric fracture femur. All our investigations were equivocal and suggested a Ogilvie’s syndrome like picture .Atrial of neostigmine therapy was also given after excluding physical obstruction and the patient did not respond and the patient was operated upon and intraoperative finding of torsed epiploic appendage was found as the cause of her symptoms. The patient made a good post operative recovery following surgical excision of torsed epiploic appendages. This case should give us another dimension of thought in the management of such cases and help improvise our management.

Mucocele of the appendix: appendectomy or colectomy?

Mucocele of the appendix is a rare disease. It can be triggered by benign or malignant diseases, which cause the obstruction of the appendix and the consequent accumulation of mucus secretion. The preoperative diagnosis is difficult due to non-specific clinical manifestations of the disease. Imaging tests can suggest the diagnosis. The treatment is always surgical and depends on the integrity and size of the appendix base and on the histological type of the original lesion. The prognosis is good in cases of integrity of the appendix. The perforation of the appendix and subsequent extravasation of its contents into the abdominal cavity may lead to pseudomyxoma peritonei, which has very poor prognosis if not treated properly. (AU)

A mucocele do apêndice cecal é uma doença rara. Pode ser causada por doenças benignas ou malignas que provocam a obstrução da luz do apêndice e, consequente, acúmulo de secreção mucoide. O diagnóstico pré-operatório é difícil devido ao quadro clínico inespecífico da doença. Exames de imagem sugerem o diagnóstico. O tratamento é sempre cirúrgico e é determinado pela integridade do órgão, dimensões da base e tipo histológico da lesão. O prognóstico é bom nos casos com integridade do apêndice cecal. A perfuração do apêndice e o consequente extravasamento do seu conteúdo para a cavidade abdominal pode ocasionar o pseudomixoma peritoneal, cujo prognóstico é bastante desfavorável se não tratado adequadamente. (AU)

Torsion of appendices epiploicae of the colon: a case report.

Torsion of the appendices epiploicae is a rare surgical entity. It has been described very rarely in the literature. A case of a 33-year-old female presented with acute pain abdomen in the right iliac fossa accompanied with vomiting. On per abdomen examination MacBurney's tenderness was elicited. On exploring the abdomen, the appendix was found to be normal. But one of the nearby appendices epiploicae was found to have undergone torsion. It was resected out and so also the appendix.

Apendicitis: hallazgo ecográfico por ecografía transvaginal / Appendicitis: ecographic finding with transvaginal ultrasound

Se presenta el caso de una paciente joven que consultó en la guardia de ginecología por un dolor en la fosa ilíaca derecha. Al interpretarse el cuadro como de origen ginecológico, se le realizó una ecografía ginecológica transvaginal, donde se halló una lesión apendicular, que derivó en una cirugía.

Apendicitis aguda en una paciente con dos apéndices vermiformes / Acute appendicitis in a patient with two vermiform appendix

Comunicar un caso clínico infrecuente en una paciente con apendicitis aguda con dos apéndices vermiformes separadas, y agenesia renal izquierda. Descripción del caso clínico y revisión de la literatura. Departamento de Cirugía del Hospital "Dr. Alfredo Van Grieken". Coro, Estado Falcón. Se procedió a realizar doble apendicetomía, informando el reporte histopatológico doble apendicitis en fase gangrenosa. La presencia de dos apéndices vermiformes separadas es extremadamente infrecuente, puede acompañarse de otras malformaciones del tracto gastrointestinal o urogenital. En el presente reporte, esta rara anormalidad se acompañó de agenesia renal izquierda

Apendicectomía por laparoscopia: técnica quirúrgica: experiencia y resultados en 18 casos / Laparoscopic appendectomy: surgical technique: experience and results in 18 cases

Descripción de técnica y resultados en 18 apendicectomías laparoscópicas. Estudio retrospectivo, descriptivo, documental, secuencial de 18 apendicectomías laparoscópicas en pacientes con diagnóstico de apendicitis aguda, durante febrero de 1998-enero 2000. Analizamos edad, sexo, riesgo cardiovascular, tiempo operatorio, manejo del muñón, complicaciones intraoperatorias, tasa de conversión, característica apendicular, evolución, estancia hospitalaria, complicaciones. mortalidad. Unidad Cirugía Endoscópica, Hospital Clínicas Aragua. Rango de edad 9 y 43 años; media 25,11 años. Femenino 61,11 por ciento (11), masculino 38,88 por ciento (7). Riesgo cardiovascular ASA 1 88,88 por ciento (16), ASA 2 11,11 por ciento (2). Tiempo operatorio promedio 83,33 minutos; rango 50-120 minutos. No hubo complicaciones intraoperatorias inherentes a la técnica. Conversión a cirugía abierta 0 por ciento. Complicaciones locales 11,11 por ciento (2) (absceso portal suprapúbico), sin complicaciones 88,81 por ciento (16). Complicaciones generales 11,11 por ciento (2): ileo posoperatorio prolongado 5,55 por ciento (1), absceso intraabdominal 5,55 por ciento (1), drenado por laparoscopia. Mortalidad 0 por ciento. La apendicectomía laparoscópica es una técnica que ofrece menos complicaciones y recuperación rápida.