Longest Appendix Removed
- PDF / 315,546 Bytes
- 2 Pages / 595.276 x 790.866 pts Page_size
- 107 Downloads / 229 Views
CASE REPORT
Longest Appendix Removed V. Yelke 1 & A. Vaidya 1 & Shardul Khade 1
&
S. Kapilesh 1
Received: 12 August 2020 / Accepted: 26 August 2020 # Association of Surgeons of India 2020
Abstract Acute appendicitis is one of the most common surgical emergencies worldwide. Diagnosis of appendicitis can be puzzling at times and requires a high index of suspicion. The length of an appendix can vary between 2 and 20 cm with an average adult length of about 9 cm. In our case study, a 42-year-old man presented in the surgical outpatient department with complaint of pain in the abdomen for the past 7 days and nausea in the last 2 days. Intra-operatively, the blind-ended muscular tip of the appendix was identified in the pelvic region and was traced by gentle blunt dissection to the base of the caecum. The length of the appendix measured post-operatively was found to be 23 cm. Appendicitis is one of the most routinely performed operations in the world. The length of the appendix is found to be highly variable which is responsible for its myriad of different presentations intraoperatively. The focal point of any appendectomy is either finding the caecum and then tracing it to the appendix or in our case, tracing the tip of the appendix and then tracing it to its base at the caecum. Keywords Appendix . Acute appendicitis . Length of appendix
Introduction Acute appendicitis is one of the most common surgical emergencies worldwide. Diagnosis of appendicitis can be puzzling at times and requires a high index of suspicion. The length of an appendix can vary between 2 and 20 cm with an average adult length of about 9 cm.
Case Report A 42-year-old man patient presented in the surgical outpatient department with complaint of pain in the abdomen for the past 7 days and nausea in the last 2 days. The pain was insidious in onset and present in the periumbilical region and right iliac fossa region. The patient gave a previous history of two similar episodes for which he was prescribed antibiotics after which his symptoms subsided. On examination, the patient’s blood pressure was 130/70 mm HG, pulse was 110/min, and tenderness was present over the right iliac fossa. There was no * Shardul Khade [email protected] 1
Department of General Surgery, Shri Vasantrao Naik Government Medical College, Yavatmal, India
history of fever, any urinary complaints, altered bowel habits, loss of appetite, etc. Rebound tenderness was present. Guarding was present over the right iliac fossa while the rest of the abdomen was non-tender and soft. The patient’s blood investigation showed his white blood cell counts to be 10,600 mm3 and neutrophils to be 69.4% (normal range = 40–75%). The rest of the blood investigations were normal. A chest X-ray was done and was found to be normal. Abdomen ultrasound was done and was suggestive of a perforated appendix with a maximum diameter of 6.2 mm. There was surrounding fat inflammation with mild collection draining into the pelvis with multiple air foci within. Thus, a decision was taken to perform an emergen
Data Loading...
