MyMedR

Fulltext Mucopyocele in the oral region: an unusual case

Telang , Ajay, Lahari, T., Chacko , James P.

Archives of Orofacial Sciences, 2011;6(2):1-4.

MyJurnal

Mucopyoceles are rare lesions defined as infected mucoceles. They have been reported only in the paranasal sinuses and appendix. Our case is the first to be reported in the oral region. A 58- year-old male presented with complaint of a painless swelling of two years duration in the right buccal sulcus with associated pus discharge. Radiographic examination ruled out pulpal and periodontal foci of infection and histopathology confirmed an underlying mucopyocele in the right buccal mucosa.

Matched MeSH terms: Appendix

Malrotated Subhepatic Caecum with Subhepatic Appendicitis: Diagnosis and Management

Chong HC, Chai FY, Balakrishnan D, Asilah SM, Adila IN, Syibrah KZ

Case Rep Surg, 2016;2016:6067374.

PMID: 27648337

Subhepatically located caecum and appendix is a very rare entity. It occurs due to the anomaly in fetal gut rotation that results in an incomplete rotation and fixation of the intestine. Appendicitis, which is a common surgical emergency, in combination with the abnormal subhepatic location, presents a great challenge in its diagnosis and management. Here, we describe a 42-year-old male with chronic dyspepsia who presented with sepsis and severe pain at his right hypochondriac and epigastric region. The final diagnosis was acute appendicitis of the subhepatic appendix. Our discussion focuses on the diagnostic approach and clinical and surgical management. We hope that our report will increase the awareness among the clinicians and hasten the management of such rare condition to avoid complications.

Matched MeSH terms: Appendix

Diverticular disease of the large bowel in Singapore. An autopsy survey

Lee YS

Dis Colon Rectum, 1986 May;29(5):330-5.

PMID: 3084185

One thousand fourteen consecutive large intestines were removed at autopsy from persons over the age of 14 years and examined for diverticular disease. Diverticulosis was encountered in 194 patients (19 percent). The lesion appeared early in life, after the second decade. Men were affected more frequently than women before the age of 60 years. Chinese men had significantly more diverticular disease than Malayan men (P less than 0.01) and Indian men (P less than 0.02). Chinese men also had significantly more diverticular disease than Chinese women. There was a predominance of right colon involvement, with the disease affecting especially the ascending colon and cecum. This pattern was observed in all three major ethnic groups, and in both the Singapore-born and foreign-born Singaporeans. The cause of right-sided diverticulosis is unknown. It appears that, while adoption of the western diet may influence the prevalence of diverticular disease, the site of predilection is determined more by racial or genetic predisposition. All diverticula examined histologically were false, including 39 (20 percent) solitary diverticula. The distribution of solitary diverticula was similar to that of multiple diverticulosis. It is suggested that solitary and multiple diverticulosis are part of the spectrum of the same disease.

Matched MeSH terms: Appendix/pathology

Isolation of Aggregatibacter aphrophilus from a patient with acute appendicitis

Aye AM, Law CW, Sabet NS, Karunakaran R, Hanifah YA, Jafar FL, et al.

Eur Rev Med Pharmacol Sci, 2011 Jul;15(7):845-7.

PMID: 21780555

Acute appendicitis is a common surgical emergency. The etiology and pathophysiology of appendicitis have been well investigated. Aggregatibacter aphrophilus is a fastidious gram-negative coccobacilli. Detection of this organism in clinical samples and its differentiation from Haemophilus aphrophilus or from Aggregatibacter actinomycetemcomitans in routine microbiology settings could be difficult.

Matched MeSH terms: Appendix/microbiology*; Appendix/surgery

Fulltext Acute appendicitis in pregnancy: a diagnostic and management challenge

Zainur Rashid, Z., Sulaiha, S.A., Azmi, M.N.

International Medical Journal Malaysia, 2014;13(1):77-80.

MyJurnal

Acute appendicitis is the most common extra-uterine surgical emergency encountered during pregnancy, but an accurate diagnosis is still an enigma. Anatomical shifting of the appendix by the enlarging uterus makes the clinical and sonographic diagnosis difficult. Prompt diagnosis and treatment are essential to prevent perforation, which increases the risk of fetal and maternal death. Surgical intervention, either by an open laparotomy or laparoscopy is the most appropriate treatment for appendicitis. This article reviews the epidemiology, clinical diagnosis, investigation, complications and treatment of acute appendicitis in pregnancy.

Matched MeSH terms: Appendix

Fulltext Issues in management of acute appendicitis in pregnancy

Nalliah, Sivalingam, Wijesuriya, Lionel, Venugopal, Subramani

International e-Journal of Science, Medicine & Education, 2011;5(1):2-9.

MyJurnal

Acute appendicitis is an infrequent yet the commonest surgical emergency in pregnancy occurring in about 1:1500 pregnancies. The classical abdominal pain in the right lower quadrant of the abdomen is the only reliable clinical sign. Delay in diagnosis is attributed to presence of symptoms commonly seen in pregnancy like nausea and vomiting and difficulty in localizing abdominal pain due to displacement of the appendix with advancing gestation. Perforated appendix and generalized peritonitis impacts adversely on pregnancy contributing to increases in miscarriage, pre-term delivery, fetal loss and even maternal mortality. Imaging studies like abdominal ultrasonogram, helical computerized tomography and magnetic imaging have been utilized to complement clinical suspicion and decrease ‘negative appendectomies’ but robust data on their routine use is awaited. Although the laparoscopic approach is a useful diagnostic and therapeutic tool in early pregnancy, its use as the primary approach for appendicectomy in pregnancy requires further evaluation as increases in the incidence of fetal loss of 5.6% has been reported compared to 3.1% in open access surgery

Matched MeSH terms: Appendix

Microscopic studies on postmortem vermiform appendix of the adult males of Bangladesh

Bakar SM, Shamim M, Salam A, Sultana SA

Ir J Med Sci, 2016 Feb;185(1):249-57.

PMID: 25894278 DOI: 10.1007/s11845-015-1287-4

BACKGROUND: The anatomy of the vermiform appendix shows variations in its macroscopic dimensions and microscopic features, some of which have potentials of influencing the clinical aspects of the appendix.

AIM: The aim of this study was to find out some microscopic features of appendix and evaluate the correlation between the microscopic features of the appendix and the age of the subjects and to determine whether these findings should influence the clinical implications of appendix.

METHODS: In this cross-sectional observational study, thirty adult males' (age from 18 to 67 years) postmortem appendices and adnexa from Bangladeshi victims of road traffic accidents were sectioned at the base, midzone and tip stained with H+E stain and examined under microscope. Measurements were taken at the base, at the midzone and at the tip of the appendix, and the mean of the three measurements was considered as the overall value.

RESULTS: The overall number of mucosal glands in a section ranged from 42.33 to 130.00 and the number of the germinal centres varied between 2.33 and 10.00. The overall luminal diameter ranged between 1764.58 and 3208.33 µm. The overall luminal diameter in more than 52 % of cases was between 2700.00 and 3299.99 µm with a median value of 2750 µm.

CONCLUSION: The overall number of mucosal glands showed a tendency towards a positive correlation with age. The overall luminal diameter and the overall number of germinal centres showed a tendency towards a negative correlation with the age. However, none of the tendencies of correlation reached statistically any significant level.

Matched MeSH terms: Appendix/pathology*

Rupture of the caecum due to invasive amoebiasis

Rohela M, Lee A, Khairul Anuar A, Zuminee MN, Johari S

JUMMEC, 2000;5:51-52.

This paper describes a case of invasive arnoebiasis in a 72 year old woman. About 1 week prior to admission she had right iliac fossa pain and physical examination suggested perforated appendix or carcinoma of caecum. Laparotomy revealed perforation of caecum. Histopathology of tissue removed showed abundant trophozoites of Entamoeba histolytica. After surgery treatment was instituted and patient had an uneventful recovery. KEYWORDS: Rupture of caecum, amoebiasis

Matched MeSH terms: Appendix

Fulltext Implementing occupational safety and health requirements in construction project

Firdaus Abd Latib, Haziq Zul Asyraf Zahari, Abdul Rahim Abdul Hamid, Kevin Chester Wong How Yee

Journal of Advanced Research in Applied Sciences and Engineering Technology, 2016;5(1):53-63.

MyJurnal

The probability of the construction accident to happen is high due the nature of
Construction work that involves complex activities, methods, machineries, materials
and hazards. The occupational safety and health (OSH) law and regulations are
mandatory for every construction project to uphold. Responsibilities to ensure the
safety and health at the workplace lies with those who create the risk and with those
who work with the risk. The owner or client of the construction project has the upper
hand in determining the standard of OSH implementation in their project through
contract documents. If the contract documents comprehensively spell out OSH
requirements and cover all OSH cost, then the issues of contractor not implementing
OSH measures could be minimized. The objective of this study is to identify
Occupational Safety and Health requirements (OSH) in the contract document of
selected construction projects. To achieve this objective, a total of seven contract
document was collected from several construction companies. The qualitative analysis
was performed to identify the extent of OSH requirements and costs are being
mentioned in the contract documents. The finding shows that most of the contract
document contains very little emphasis on OSH requirements and budgeting. Only one
contract contains, an appendix that spell out about the safe work practices for
construction works. The visible allocated budget for OSH requirements for all seven
contracts is very minute range from 0.21% to 1.99% of contract value. In order to
ensure that occupational safety and health is properly implemented, safety needs must
be included in the budget because implementation it is not free, this can be achieved
by making it a permanent feature in all bills of quantity of the project.

Matched MeSH terms: Appendix

Fulltext A Case of Appendiceal Goblet Cell Carcinoid Tumor: Getting it right under the Microscope

Kang WH, Wahab NA, Kamaruddin NA

J ASEAN Fed Endocr Soc, 2020;35(1):102-104.

PMID: 33442175 DOI: 10.15605/jafes.035.01.16

Goblet cell carcinoid (GCC) is a rare neoplasm of the vermiform appendix and can be mistaken as a typical neuroendocrine tumour (TNET). The natural history of this disease is more aggressive compared to TNETs and requires a more aggressive approach. We report a case of a 37-year-old male who was initially diagnosed with TNET, but subsequently revised as Tang's A GCC. He underwent appendectomy and right hemicolectomy. Aside from a persistently elevated carcinoembyrogenic antigen (CEA) result, his 18F-fluorodeoxyglucose (FDG) PET/CT and a 68-Gallium DOTATATE PET/CT scan showed no FDG or DOTATATE avid lesions.

Matched MeSH terms: Appendix

Fulltext Imaging as an aid to the diagnosis of acute appendicitis

Wijesuriya LI

Malays Fam Physician, 2007;2(3):106-9.

PMID: 25606095 MyJurnal

Acute appendicitis has been known as a disease entity for well over a century but a confident diagnosis before surgery in all patients suspected of the condition is still not possible. Timely diagnosis is essential to minimise morbidity due to possible perforation of the inflamed organ in the event treatment is delayed; so much so that surgeons often preferred to operate at the slightest suspicion of the diagnosis in the past. This resulted in the removal of many normal appendixes. When the diagnosis of appendicitis is clear from the history and clinical examination, then no further investigation is necessary and prompt surgical treatment is appropriate. Where there is doubt about the diagnosis however it is advisable to resort to imaging studies such as abdominal ultrasound or computed tomography to clear such suspicions before subjecting the patient to an appendicectomy. These studies would also help avoid delays in surgery in deserving patients.

Matched MeSH terms: Appendix

Diverticula of the vermiform appendix: a report of nine cases

Chong KC

Postgrad Med J, 1976 Aug;52(610):504-10.

PMID: 824633

The incidence, clinical features and pathology of nine cases of diverticula of the appendix in Malaysians are reported. The findings are discussed and compared with those previously reported. The pathogenesis of the lesion in eight cases is unknown. The rare association of lumenal obstruction by a carcinoid tumour and diverticulum formation in the appendix is seen in one case.

Matched MeSH terms: Appendix/pathology*

Fulltext Intraspecific macroscopic digestive anatomy of ring-tailed lemurs (Lemur catta), including a comparison of frozen and formalin-stored specimens

Clauss M, Trümpler J, Ackermans NL, Kitchener AC, Hantke G, Stagegaard J, et al.

Primates, 2021 Mar;62(2):431-441.

PMID: 33180215 DOI: 10.1007/s10329-020-00873-8

Digestive tract measurements are often considered species specific, but little information exists on the degree to which they change during ontogeny within a species. Additionally, access to anatomical material from nondomestic species is often limited, with fixed tissues possibly representing the only available source, though the degree to which this material is representative in terms of dimensions and weight is debatable. In the present study, the macroscopic anatomy of the digestive tract (length of intestinal sections, and tissue weights of stomach and intestines) of 58 Lemur catta [ranging in age from 1 month (neonates) to 25 years], which had been stored frozen (n = 27) or fixed in formalin (n = 31), was quantified. Particular attention was paid to the caecum and the possible presence of an appendix. The intraspecific allometric scaling of body mass (BM)0.46[0.40;0.51] for total intestine length and BM0.48[0.41;0.54] for small intestine length was higher than the expected geometric scaling of BM0.33, and similar to that reported in the literature for interspecific scaling. This difference in scaling is usually explained by the hypothesis that, to maintain optimal absorption, the diameter of the intestinal tube cannot increase geometrically. Therefore, geometric volume gain of increasing body mass is accommodated for by more-than-geometric length scaling. According to the literature, not all L. catta have an appendix. No appendix was found in the specimens in the present study. The proportions of length measurements did not change markedly during ontogeny, indicating that the proportions of the foetus are representative of those of the adult animal. By contrast, width and tissue-mass scaling of the caecum indicated disproportionate growth of this organ during ontogeny that was not reflected in its length. Compared to overall intraspecific variation, the method of storage (frozen vs. formalin) had no relevant impact on length or weight measurements.

Matched MeSH terms: Appendix

Fulltext Endometriosis of the appendix presenting as acute appendicitis

Khoo JJ, Ismail MS, Tiu CC

Singapore Med J, 2004 Sep;45(9):435-6.

PMID: 15334288

While endometriosis is fairly common, endometriosis of the appendix is a very rare occurrence. Correct pre-operative diagnosis is uncommon and definitive diagnosis is established by histology of the appendix. We present a case of endometriosis of the appendix that manifested as acute appendicitis in a 40-year-old woman.

Matched MeSH terms: Appendicitis/diagnosis*; Appendix*

"Anterior appendix": a boon for clinicians and radiologists

Nayak SB, Soumya KV

Surg Radiol Anat, 2019 Jun 18.

PMID: 31214757 DOI: 10.1007/s00276-019-02268-x

Vermiform appendix is considered as a vestigial organ, and it has minimal or no role to play in the digestion and absorption of food. It is an enigma to the clinicians due to its variable positions and symptoms caused by its inflammation. In the available literature, there are many reports on various positions, size and disease of appendix. However, there is no report on an anteriorly located appendicular attachment to the caecum. During dissection classes for medical undergraduates, an appendix with its base attached to the anterior wall of the caecum was noted. The entire appendix was attached to the ileum through a mesoappendix and was readily visible when the anterior abdominal wall was reflected. This position could be a boon to the clinicians and radiologists during diagnosis and surgery of the appendix.

Matched MeSH terms: Appendix

Fulltext A Cross-Sectional Study of Neutrophil-to-Lymphocyte Ratio in Diagnosing Acute Appendicitis in Hospital Melaka

Ahmad KA, Ideris N, Aziz SHSA

Malays J Med Sci, 2019 Nov;26(6):55-66.

PMID: 31908587 DOI: 10.21315/mjms2019.26.6.6

Background: Acute appendicitis is one of the most common surgical emergencies. However, its proper diagnosis is complicated. This study aims to evaluate the ability of the neutrophil-to-lymphocyte ratio (NLR) to diagnose acute appendicitis in pre-operative state.

Methods: Histopathological examination of appendicectomies conducted between 2016 and 2017 in Melaka Hospital, Malaysia were traced and categorised into three groups: i) G1 (normal appendix), ii) G2 (acute appendicitis) and iii) G3 (perforated appendicitis). The reports were randomised and a total of 338 samples were collected. NLR values were compared between the three different groups and analysed.

Results: The median values of NLR for G1, G2 and G3 were 2.37, 5.25 and 9.27, respectively. We found a statistically significant difference in NLR between G1 and G2 (P < 0.001), and G2 and G3 (P < 0.001). The diagnostic values of NLR for acute appendicitis and perforated appendicitis were 3.11 (sensitivity: 75.23%, specificity: 68.70%) and 6.17 (sensitivity: 76.32%, specificity: 58.72%), respectively. There was a substantial correlation between NLR and disease severity, and a moderate correlation between NLR and duration of admission.

Conclusion: NLR, with a sensitivity of 75.23% and specificity of 68.70%, is a useful and reliable adjunct in diagnosing acute appendicitis. Hence, it will help in reducing the rate of negative appendicectomies.

Matched MeSH terms: Appendix

Appendiceal intussusception presenting as a caecal mass

Alhamar M, Ahsan B, Hogan K, Raoufi M

Malays J Pathol, 2020 Dec;42(3):483-486.

PMID: 33361733

INTRODUCTION: The differential diagnosis of caecal mass is broad and the inclusion of appendiceal pathologies is an important element.

CASE REPORT: We report a 37-year-old woman with recurrent right iliac fossa pain. Computed tomography scan revealed a caecal mass suggesting complete inversion or intussusception of the appendix, which was confirmed by pathologic microscopic examination. This case report discusses appendiceal intussusception with emphasis on diagnosis and treatment options.

DISCUSSION: Appendiceal intussusception is a rare entity and the complete type typically presents as a polypoid lesion located at the appendiceal orifice in the caecum. It is imperative to include this entity in the differential diagnosis of caecal mass, especially during colonoscopy, as the removal of this polypoid lesion can result in a devastating caecal perforation or haemorrhage.

Matched MeSH terms: Appendix/pathology*

Intussusception of the appendix

SALE TA

Med J Malaya, 1956 Jun;10(4):305-10.

PMID: 13399531

Matched MeSH terms: Appendix*

Torsion of the vermiform appendix

STIRK DI

Med J Malaya, 1958 Mar;12(3):555-8.

PMID: 13565028

Matched MeSH terms: Appendix*

An improved exposure in appendicectomy