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Details
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Written by Randy Gay - Johnston Community College
Abstract
Acute appendicitis is a common cause of abdominal pain that often results in immediate surgical removal of the appendix. Due to the complications that may occur from appendicitis, such as rupture and subsequent infection, a careful evaluation of the appendix is warranted to confirm its diagnosis. The use of sonographic imaging has been recognized as an effective approach for determining acute appendicitis. This particular case involves a patient that presented to the emergency room with clinical features associated with acute appendicitis, and with the use of sonography, was able to confirm the suspected diagnosis.
Acute appendicitis is one of the most common causes of emergency abdominal surgeries in the United States.1 Its occurrence is more prevalent between the ages of 10-20 years old
1, but no specific age group is exempt.
1 Acute appendicitis is often the result of some type of blockage within the lumen of the appendix such as an appendicolith (calcified concretion) or more specifically, a fecalith (calcified fecal matter).
2 Additionally, appendicitis can also be caused by a parasitic infection.
2 In all cases, inflammation of the wall of the appendix occurs as a result of bacterial invasion. As the infection proliferates within the appendix, the risk of perforation increases. Should perforation occur, the bacterial infection can no longer be contained and could therefore spread into the abdominal peritoneum (a membranous lining of the abdominal organs); a condition known as peritonitis.
3
Clinical findings associated with cases of acute appendicitis include abdominal pain (epigastric and right lower quadrant), rebound tenderness, nausea and vomiting, fever, and possibly an elevated white blood cell count (leukocytosis).
2 Unfortunately, because these findings are somewhat non-specific and imprecise, acute appendicitis can often disguise itself as something else and can be difficult to diagnose clinically without the assistance of accurate diagnostic imaging.
4 The use of sonography can provide physicians with a quick and non-invasive method to detect appendicitis.
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