ABSTRACT
UNLABELLED: Accurate diagnosis of acute appendicitis (AA) is still a problem and is not always easy, even for experienced surgeons. Studies have shown that 20 to 30% of the appendices removedwere normal. Therefore, various scoring systems have been developed to aid in the diagnosis of doubtful cases and reduce the number of unnecessary appendectomies. The aim of this study was to assess the diagnostic value of different scoring systems in acute appendicitis. MATERIAL AND METHODS: The study involved 94 patients who underwent laparotomy due to suspected acute appendicitis. Medical examination at hospital admission was performed by a resident and a general surgery specialist. The probability of AA was evaluated using six different scoring systems: Alvarado, Fenyo, Eskelinen, Ohman, Tzankis, and RIPASA. The resident calculated the results in individual systems. The decision to perform the operation was taken by a specialist surgeon who did not know the results. RESULTS: Normal appendix was removed in 26% of cases. Eskelinen, RIPASA and Alvarado systems showed highest sensitivity (99%, 88% and 85%, respectively). Tzankis and Fenyo systems showed highest specificity (62% and 50%, respectively). CONCLUSIONS: Our study has shown limited value of scoring systems for the diagnosis of acute appendicitis. The systems may improve diagnostic accuracy as they require obtaining a more detailed medical history, and making a more thorough and organized data analysis. However, the scoring systems should be treated only as an aid to diagnosis.
Subject(s)
Appendectomy , Appendicitis/classification , Appendicitis/diagnosis , Severity of Illness Index , Acute Disease , Appendicitis/epidemiology , Appendicitis/surgery , Databases, Factual , Female , Humans , MaleABSTRACT
Volvulus of transverse colon is a rare cause of large bowel obstruction. Diagnosis can be challenging and the effective management remains controversial. We report a case of volvulus of the transverse colon in a 76-year-old woman. The literature regarding diagnosis and treatment of such pathology was also reviewed.
Subject(s)
Colon, Transverse/surgery , Intestinal Obstruction/etiology , Intestinal Obstruction/surgery , Intestinal Volvulus/complications , Intestinal Volvulus/diagnosis , Aged , Fatal Outcome , Female , Humans , Intestinal Volvulus/surgeryABSTRACT
Schwannomas are benign tumors derived from glial cells of peripheral nerve sheaths. They usually occur in association with Von Recklinghausen's disease and most commonly are observed on the head, neck, and upper extremities. Rare morphological variants may be misinterpreted as a malignancy under microscopic examination. The study presented a case of a sporadic "ancient" Schwannoma cell tumor located in the retroperitoneum. Literature data concerning diagnosis and treatment of the above-mentioned pathology was also reviewed.
Subject(s)
Neurilemmoma/diagnosis , Neurilemmoma/surgery , Retroperitoneal Neoplasms/diagnosis , Retroperitoneal Neoplasms/surgery , Colonoscopy , Humans , Laparotomy , Middle Aged , Neurilemmoma/pathology , Retroperitoneal Neoplasms/pathologyABSTRACT
Meckel's diverticulum is the most common congenital abnormality of alimentary tract. The antimesenteric location is one of the cardinal attribiutes of this pathology. We report case which tries to verify this dogma. The literature regarding uncommon location of Meckel's diverticulum was also reviewed.
