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Query: UMLS:C0085693 (acute appendicitis)
 3,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The presentation of acute appendicitis in a strangulated femoral hernia is rare. The authors describe what they believe is the first reported case of necrotizing fasciitis as a consequence of a gangrenous appendix in this situation. An 80-year-old woman presented with crepitant cellulitis of her right thigh with fever and leukocytosis, leading to a preoperative diagnosis of necrotizing fasciitis. Intraoperatively, an unsuspected gangrenous appendix was found in an incarcerated femoral hernia. A knowledge of the existence of this rare and serious condition will avoid delay in its recognition and management.
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PMID:Femoral appendicitis: an unusual case. 276 44

The mortality of acute appendicitis increases sixfold if perforation occurs. We have reported a case of perforated appendix complicated by necrotizing fasciitis of the abdominal wall and retroperitoneum. We believe this complication has not been previously described in the English literature.
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PMID:Necrotizing fasciitis: a rare complication of appendicitis. 295 93

A 14-year-old girl presented with symptoms resembling acute appendicitis. Five days after appendectomy and continued fever and severe abdominal pain, blood cultures were found positive for Streptococcus pyogenes. Two days later a diagnosis of group A streptococcal peritonitis with necrotizing retroperitoneal fasciitis was confirmed by retroperitoneal cultures obtained at laparotomy. Although multiple organ systems showed impaired functioning, including hepatic, renal and respiratory changes, she did not meet the criteria for streptococcal toxic shock syndrome. She was treated with a combination of high-dose parenteral penicillin and clindamycin, followed by prolonged treatment with clindamycin orally. Recovery was complicated by persistent hydronephrosis, which was slow to resolve.
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PMID:Necrotizing fasciitis of the retroperitoneum: an unusual presentation of group A Streptococcus infection. 957

Necrotizing fasciitis, although rare, is one of the more serious, life-threatening complications of missed acute appendicitis. Patients who are predisposed to developing necrotizing fasciitis, regardless of the cause, are typically immunocompromised. We present a case of a 49-year-old immunocompetent female whose diagnosis of acute appendicitis was missed and who subsequently developed necrotizing fasciitis of the abdominal wall and flank. She recovered 1 month after admission due to aggressive surgical and medical therapy.
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PMID:Necrotizing fasciitis due to appendicitis. 1053 May 43

Acute appendicitis and its subsequent complications continue to pose a surgical challenge. One such complication, the appendico-cutaneous fistula, represents a very rare form of enterocutaneous fistula. Very few cases have been reported thus far in the literature. The clinical presentation of this case before the final diagnosis was made makes interesting reading. The report describes a unique case that presented with the onset of cellulitis around the right lumbar/loin region, spreading down the right posterior back to the posterior gluteal area, and appearing as necrotizing fasciitis. There were no abdominal signs at all. The patient was then taken to the operating room (OR) for incision and drainage through a right flank incision, which could be extended. At drainage, there was a feculent smell with discharge that immediately raised the possibility of colonic connection with the abscess cavity. Swab sent for culture and sensitivity grew E. coli and Bacteroides. The final diagnosis proved to be a perforated appendix. Therefore, perforated appendix should always be considered in the differential diagnosis of any spreading cellulitis in the right lumbar area or right lower abdominal quadrant in the presence of limited urinary symptoms and little or no abdominal signs.
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PMID:Appendico-cutaneous fistula presenting clinically as right loin necrotizing fasciitis: a case report. 1458 64

The authors report on a neonate who presented with acute appendicitis and who went on to have fatal necrotizing fasciitis. Although recognized in adults, this rare combination of conditions has not been reported previously in the neonate and requires rapid recognition with aggressive medical and surgical intervention.
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PMID:Acute appendicitis with fulminant necrotizing fasciitis in a neonate. 1461 33

Acute appendicitis is one of the most common surgical emergencies. Accurate diagnosis is often hindered due to various presentations that differ from the typical signs of appendicitis, especially the position of the appendix. A delay in treatment increases the likelihood of complications such as perforation, which is associated with an increase in morbidity and mortality rates. We herein present the case of a 76-year-old woman presenting with necrotizing fasciitis of the abdominal wall and right flank regions due to a perforated appendix. Such complication is extremely rare but life-threatening. It may be confused with cellulitis, causing a delay in aggressive treatment. This case represents an unusual complication of a common disease. Also, acute appendicitis or intra-abdominal pathologies should be taken into consideration in determining the cause of necrotizing fasciitis presenting over abdominal, flank, or perineal regions.
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PMID:Necrotizing fasciitis due to acute perforated appendicitis: case report. 1822 75

Infections and their complications requiring surgical intervention are a frequent presentation in African children. Surgical site infection (SSI) is common with rates over 20%, even after clean procedures. The high rates of SSI are due in part to lack of infection control and surveillance policies in most hospitals in Africa. SSI is attended by complications, long hospital stay, and some mortality, but the economic consequences are unestimated. Typhoid fever and typhoid intestinal perforation are major problems with perforation rates of approximately 10%, which is higher in older children. The ideal surgical treatment is arguable, but simple closure and segmental resection are the present effective surgical options. Because of delayed presentation, complications after surgical treatment are high with a mortality approaching 41% in some parts of Africa. Nutrition for these patients remains a challenge. Acute appendicitis, although not as common in African children, often presents rather late with up to 50% of children presenting with perforation and other complications, and mortality is approximately 4% is some settings. Pyomyositis and necrotizing fasciitis are the more common serious soft-tissue infections, but early recognition and prompt treatment should minimize the occasional mortality. Though common in Africa, the exact impact of human immunodeficiency virus infection on the spectrum and severity of surgical infection in African children is not clear, but it may well worsen the course of infection in these patients.
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PMID:Surgical aspects of bacterial infection in African children. 2247 17

Acute appendicitis is one of the most common causes of acute abdominal pain. Accurate diagnosis is often hindered due to various presentations that differ from the typical signs of appendicitis, especially the position of the appendix. A delay in diagnosis or treatment may result in increased risks of complications, such as perforation, which is associated with increased morbidity and mortality rates. Necrotizing fasciitis caused by perforated appendicitis is extremely rare. We herein report a case of 50-year-old man presenting with an appendiceal abscess in local hospital. After ten days of conservative treatment with intravenous antibiotics, the patient complained about pain and swelling of the right lower limb and computed tomography (CT) demonstrated a perforated appendix and gas and fluid collection extending from his retroperitoneal cavity to the subcutaneous layer of his right loin and right lower limb. He was transferred to our hospital and was diagnosed with necrotizing fasciitis caused by perforated appendicitis. Emergency surgery including surgical debridement and appendectomy was performed. However, the patient died of severe sepsis and multiple organ failure two days after the operation. This case represents an unusual complication of a common disease and we should bear in mind that retroperitoneal inflammation and/or abscesses may cause necrotizing fasciitis through lumbar triangles.
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PMID:Necrotizing fasciitis caused by perforated appendicitis: a case report. 2604 63

Garengeot's hernia corresponds to the presence of the appendix within a femoral hernia, associated or not with acute appendicitis. The diagnosis of this uncommon situation is usually done during surgery. Furthermore, the clinical presentation as necrotizing fasciitis is a rare condition. We report a 54 years old obese hypertensive woman with rheumatoid arthritis of 40 years of evolution treated with methotrexate and prednisone. She consulted for pain and erythema in the right inguinal region. Laboratory revealed leukocytosis and an elevated C-reactive Protein. Suspecting a cellulitis, the patient was admitted for antimicrobial therapy. A pelvic magnetic resonance imaging showed a perforated acute appendicitis in an inguinal hernia with extensive pelvic cellulitis associated with signs of fasciitis. At surgery, an extensive groin and pubic fasciitis was evident, with a necrotic and perforated appendix within a femoral hernia. Surgical debridement, open appendectomy, and femoral hernioplasty without mesh were carried out. Vacuum-assisted closure was installed in the coverage defect. Three surgical debridement procedures were required for the closure of the wound. Two weeks after the first surgical procedure, the patient was discharged in good condition. During the follow-up, she evolved with a surgical wound dehiscence, which was managed with wound dressings until closure.
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PMID:[Necrotizing fasciitis caused by a Garengeot's hernia. Case report]. 3014 30


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