RESUMEN
Primary epiploic appendagitis is uncommon and is estimated to induce 1.1–1.3% of all abdominal pain. We report a 42-year-oldmale who appeared in the morning in the emergency department with abdominal pain localized in the right lower abdomen andassociated with anorexia and nausea. Clinical examination, laboratory tests, and abdominal ultrasound revealed deep tendernessat Mc Burney point and a mild elevation of CRP (0.7 mg/dL). In the evening, the symptoms were exacerbated, and a diagnosticlaparoscopy was performed. Intra-operatively, the appendix was normal and a twisted, necrotic epiploic appendage originatingfrom the antimesenteric border of the mid ascending colon was found. Laparoscopic resection of the necrotic epiploic appendageand prophylactic appendectomy was carried out. Histology indicated the diagnosis of the necrotic epiploic appendage.Postoperatively, the patient recovered without complications. Although the preoperative diagnosis of primary epiploic appendagitishas improved due to abdominal ultrasound and mainly CT, there are still cases which are diagnosed during laparoscopy. Thetreatment of choice is conservative management, while the use of antibiotics remains controversial. The relapse and complicationrates are rare. Surgical excision, particularly laparoscopic, should be considered in cases of uncertain diagnosis, persistentsymptoms, or recurrence.
RESUMEN
Objective: To evaluate the correlation between the Manchester Grading Scale and the American Orthopaedic Foot and Ankle Society [AOFAS] score in patients with a hallux valgus deformity
Subjects and Methods: The study sample included 181 feet of 122 patients with hallux valgus and 424 feet of 212 individuals without hallux valgus deformity as the control group. The severity of hallux valgus, utilizing a relative nonmetric scale, the Manchester Grading Scale, and the metric AOFAS score, was determined for all individuals in the hallux valgus and control groups. SPSS version 18 [Chicago, Ill., USA] was used for data analysis
Results: According to the Manchester Grading Scale, the 424 feet of the normal group were classified as 'no deformity'. In the hallux valgus group, 85 feet were classified as 'mild deformity', 67 as 'moderate deformity' and 29 as 'severe deformity'. The AOFAS total score in the control group was 99.14. In the hallux valgus group, patients with mild or moderate deformity had total scores of 86.20 and 68.19, respectively. For those with severe hallux valgus, the total score was 44.69 and the differences were statistically significant [p = 0.000]. Using the Pearson correlation, strong negative correlations were found between the AOFAS score and the hallux valgus angle [HVA; r = -0.899, p = 0.000]. Strong negative correlations were demonstrated between the AOFAS score and the first intermetatarsal angle [IMA] as well [r = -0.748, p = 0.000]
Conclusions: The AOFAS score was negatively associated with the Manchester Grading Scale, HVA and first IMA. As the severity of hallux valgus increased, the AOFAS score seemed to decrease