MyMedR

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*

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

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 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

Fulltext Simultaneous omental infarction and acute appendicitis in a child

Koay HT, Mahmoud HE

Med J Malaysia, 2015 Feb;70(1):42-4.

PMID: 26032530

It is crucial to realize that both omental infarction and acute appendicitis can occur simultaneously in the children as both diseases are managed differently. Omental infarction itself is rare in the pediatric group, and its association with acute appendicitis is even rarer. Both diseases usually present with right sided abdominal pain. Ultrasound is the choice of imaging modality in the investigation of abdominal pain in the children. It should not be content if omental infarction is detected, whilst the normal appendix is not seen. We reported a case of simultaneous omental infarction and acute appendicitis in a child who presented with 3 days history of right sided abdominal pain. It was diagnosed preoperatively by ultrasound. Prompt surgical intervention was proceeded and the child made uneventful recovery.

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

An unexpected gangrenous duplication of ileum

Chiar CI, Elango T, Sivaneswaran L, Umasangar R, Mohan N

Med J Malaysia, 2017 02;72(1):83-84.

PMID: 28255153 MyJurnal

Alimentary tract duplication is a rare congenital anomaly which may involve any part of the alimentary tract extending from stomach to rectum. Clinical presentation may mimic an inflamed appendix as described in this case. A 9-year-old boy with a clinical diagnosis of perforated appendix was noted to have a normal appendix intra-operatively. On further search for an underlying pathology, a gangrenous ileal duplication was discovered. En-bloc resection with primary bowel anastomosis was done. Histopathology report revealed a gangrenous small bowel duplication. We discuss the preoperative diagnostic dilemma and management options in approaching this rare entity.

Matched MeSH terms: Appendix

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

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

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: pathology of 1,000 cases

Thanaletchimy N

Med J Malaysia, 1986 Dec;41(4):336-42.

PMID: 3670157

A retrospective study of the pathology seen in 1,000 consecutive appendicectomy specimens with a pre-operative diagnosis of acute appendicitis, was made in an attempt to find common factors which might throw light on the aetiology of the disease. Acute inflammation was seen in 775 cases. In 225 cases where no inflammation was seen, 168 appendices were associated with other pathology, i.e., lymphoid hyperplasia, fibrosis and tumour. In 57 cases the appendix was not inflamed. Acute inflammation was seen more in males and in patients aged below 30 years, while normal appendices were more commonly seen in females of reproductive age.

Matched MeSH terms: Appendix/parasitology; Appendix/pathology*

Incidence of Retrocaecal Acute Appendicitis at the Hospital Sultanah Nora Ismail (HSNI) Batu Pahat

Nur Bazlaah B, Khairuzi S, Nabiha F, Mohd Nadzri M, Nur Bazilah B, Hirdayu AB, et al.

Med J Malaysia, 2021 03;76(2):223-228.

PMID: 33742632

BACKGROUND: A surgical audit study among Batu Pahat population was conducted in determining the commonest position of appendix in post appendectomy.

METHODOLOGY: This is a retrospective study. A total of 204 cases of patients underwent an appendectomy admitted to the surgical ward from January 2017 until January 2018 at Hospital Sultanah Nora Ismail (HSNI) were audited retrospectively.

RESULTS: This findings showed different figures of ascendancy in gender among patients who underwent an appendectomy with females 58.8% and males 41.2%. The perforation rate was 40.7% and delay in diagnosis was found to be 19.1%. The perforated appendix had a significantly higher incidence in males with a correlation of p-value 0.04. Retrocaecal appendix (RA) remained the commonest position for patients who underwent an appendectomy with 26.9%. RA is associated with an increased incidence of perforation (p-value 0.01).

CONCLUSION: The position of appendix in our patients who underwent an appendectomy is parallel to the reports available globally in that it is retrocaecal followed by retroileal as the commonest position among residence of Batu Pahat.

Matched MeSH terms: Appendix

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

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 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

Displaying publications 1 - 20 of 28 in total