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Author Spotlight: Quantifying Pain Experience – An Illustrative Approach Using the Pain Body Diagram
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[A man with abdominal pain and nausea].
Laura M C Vorstermans1,2, Karin Nielsen3, A J N M Bastiaansen3
1Noordwest Ziekenhuisgroep, locatie Alkmaar, afd. Spoedeisende Hulp.
Nederlands Tijdschrift Voor Geneeskunde
|April 5, 2019
Summary
A perforated appendicitis was found in a surgical hernia site in a liver transplant patient. This rare presentation highlights the importance of considering unusual locations for abdominal emergencies.
Area of Science:
- Gastroenterology
- Transplant Surgery
- Abdominal Imaging
Background:
- Orthotopic liver transplantation is a complex procedure with potential long-term complications.
- Hernia cicatricalis, or incisional hernias, can occur at surgical sites.
- Appendicitis is a common surgical emergency, but its presentation can vary.
Observation:
- A 63-year-old male liver transplant recipient presented with flank pain and nausea.
- Physical examination revealed a painful hernia cicatricalis.
- Abdominal CT scan was performed to investigate the symptoms.
Findings:
- The CT scan demonstrated acute perforated appendicitis.
- The appendix was located within the hernia cicatricalis.
- This indicates a rare anatomical complication post-transplantation.
Implications:
- This case underscores the need for high clinical suspicion in transplant patients with atypical abdominal pain.
- Accurate diagnosis requires advanced imaging like CT scans.
- Understanding rare presentations is crucial for timely and appropriate surgical intervention in complex patient populations.
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