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Related Experiment Videos

[Neurogenic appendicitis. A case]

K Aouad1, J E Clotteau, M Prémont

  • 1Hôpital Henry-Dunant, Paris.

Presse Medicale (Paris, France : 1983)
|May 28, 1994
PubMed
Summary
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Neurogenic appendicitis, a condition often presenting with chronic right flank pain, requires surgical removal (appendectomy) even if the appendix appears normal during exploratory surgery. This case highlights the importance of considering this diagnosis when other causes are ruled out.

Area of Science:

  • Gastroenterology
  • Surgical Pathology
  • Diagnostic Imaging

Background:

  • Laparoscopic surgery has refined appendectomy indications, emphasizing exploration for suspected conditions.
  • Neurogenic appendicitis, though rare, presents a diagnostic challenge, often mimicking other abdominal pathologies.

Observation:

  • A 76-year-old woman presented with recurrent right flank pain, nausea, and diarrhea, initially treated with cholecystectomy.
  • Post-discharge, she experienced recurring pain and fever, with imaging ruling out abscess or pancreatitis.
  • Persistent pain localized to McBurney's point led to appendectomy despite a normal-appearing colon.

Findings:

  • Pathological examination confirmed neurogenic appendicitis, characterized by a fibromyxoid nodule with hyperplastic nervous tissue obliterating the appendiceal lumen.

Related Experiment Videos

  • This condition, known since 1924, often presents chronically with a macroscopically normal appendix.
  • Surgical resection is curative for neurogenic appendicitis.

    • Implications:

    • Laparoscopic procedures can identify alternative causes of abdominal pain, but appendectomy remains crucial when neurogenic appendicitis is suspected.
    • This case underscores the necessity of considering neurogenic appendicitis in unexplained chronic abdominal pain, even after negative initial investigations.
    • Accurate pathological examination is vital for diagnosing neurogenic appendicitis and ensuring appropriate patient management.