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Related Concept Videos

Appendicitis-I: Introduction01:22

Appendicitis-I: Introduction

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The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
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Appendicitis-II: Diagnostic Studies and Management01:29

Appendicitis-II: Diagnostic Studies and Management

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Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
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Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

Aneurysm II: Clinical Manifestations and Diagnostic Studies

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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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Assessment of the Rectum and Anus01:25

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Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
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Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies01:28

Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies

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Peptic ulcer disease (PUD) presents with diverse symptoms depending on the location and severity of the ulcer. Clinical manifestations of peptic ulcer include dull pain and a burning sensation in the mid-epigastric region.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
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Acute Pancreatitis II: Clinical Manifestations and Management01:30

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Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
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Murine Appendectomy Model of Chronic Colitis Associated Colorectal Cancer by Precise Localization of Caecal Patch
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Atypical presentation of appendicitis.

Oliver Beaumont1,2, Robert Miller1, Richard Guy1

  • 1John Radcliffe Hospital, Oxford, UK.

BMJ Case Reports
|November 23, 2016
PubMed
Summary

A rare case of appendicitis presented as a subcutaneous abscess, leading to an enterocutaneous fistula (ECF). Conservative management led to spontaneous ECF resolution, avoiding surgery.

Area of Science:

  • Gastroenterology
  • Surgical Case Report

Background:

  • Appendicitis is a common condition, but rare presentations can challenge clinical diagnosis.
  • Subcutaneous abscess formation is an unusual complication of appendicitis.

Observation:

  • A 64-year-old woman presented with a right iliac fossa mass, initially suspected to be within the abdominal wall.
  • CT scan revealed a perforated appendix with a large subcutaneous abscess.
  • Incision and drainage of the abscess led to the development of an enterocutaneous fistula (ECF).

Findings:

  • The enterocutaneous fistula (ECF) was managed conservatively with nutritional support, wound care, and antibiotics.
  • Despite planning for surgical resection, the ECF resolved spontaneously during a period of postponed surgery.
  • The patient's symptoms and fistula fully resolved without surgical intervention.

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Implications:

  • This case highlights the importance of considering atypical presentations of common diseases like appendicitis.
  • Conservative management can be successful for enterocutaneous fistulas secondary to appendiceal abscess.
  • Spontaneous resolution of ECFs is possible, potentially avoiding major surgery.