Endometriosis is a condition characterized by the presence of endometrial tissue outside the uterine cavity. This tissue, found in the inner lining of the uterus, develops in other pelvic organs, such as the ovaries, ...Endometriosis is a condition characterized by the presence of endometrial tissue outside the uterine cavity. This tissue, found in the inner lining of the uterus, develops in other pelvic organs, such as the ovaries, fallopian tubes, peritoneum, and bowel. In cases of deep endometriosis, the appendix may be affected, and consequently, appendectomy becomes a perioperative possibility. From February 2018 to February 2023, the surgical team performed 133 laparoscopic procedures. The number of appendectomies by the time of the surgical procedure was 19.5% (26 cases), with 50% of these (13 cases) confirming the histological presence of appendiceal endometriosis (AE), no increasing of postoperative complications was noticed. This report is important to reinforce multidisciplinary training, review postoperative complications, and provide training in advanced pelvic surgery. Furthermore, it aims to emphasize that appendectomy performed during the surgical act is a safe and viable procedure that does not increase complication rates.展开更多
It is a globally rare condition that can present in a variety of clinical syndromes or can occur as an incidental surgical finding. It poses the double problem of its possible malignancy and the risk of gelatinous dis...It is a globally rare condition that can present in a variety of clinical syndromes or can occur as an incidental surgical finding. It poses the double problem of its possible malignancy and the risk of gelatinous disease of the peritoneum in the event of perforation. We report a case treated in the “A” Surgery Department of the Point-G University Hospital Center (CHU) in Mali in 2022. It was a 62-year-old woman, a housewife who presented to the department. “A” surgery at the Point G University Hospital Center for pain in the iliac fossa. As a medical history, she was hypertensive on atenolol and a known diabetic on diet and metformin-based treatment, as well as symptomatic sickle cell disease (AS) and an undocumented history of peptic ulcer disease. The biological assessments revealed hyperleukocyte with granulocyte predominance. C-reactive protein was positive at 32 mg/l. Ultrasound revealed a 27 mm cystic dilation of the appendicitis in favor of appendicular mucocele. We proceeded with the appendix. The surgical specimen containing gelatinous fluid was removed and histological examination was in favor of a mucinous adenocarcinoma of the appendix.展开更多
Aims and Objective: To develop a better operation for hypospadias patients with poor and bad quality urethral plate and damaged urethral plate as in hypospadias cripples. Materials and Methods: I operated 21 cases of ...Aims and Objective: To develop a better operation for hypospadias patients with poor and bad quality urethral plate and damaged urethral plate as in hypospadias cripples. Materials and Methods: I operated 21 cases of hypospadias with Appendicular mucosal tube implant with Dartos wrap operation from 17/04/2017 to 03/03/2019, in Jawale Institute of pediatric Surgery, and that group was labeled as group A. 27 cases of hypospadias were operated in same time span with conventional techniques such as extended Snodgrass operation and Byar’s two-stage operation (group B), kept as control. 7 patients (33.33%) were cases of hypospadias cripples with multiple surgeries done in the past. 4 patients (9.52%) patients had congenital short urethra. Remaining 10 patients (50%) were fresh cases with no operation done in past but with bad and fibrotic urethral plate. The longest follow up was 3 years and the shortest of 1 year. Technique of Operation: Appendicectomy performed by open technique and the serosa of Appendix cut longitudinally and stripped off the mucosal tube. The proximal hypospadias opening sutured with the appendicular mucosal tube with 6 sutures of 5-0 Vicryl. Dartos fascia is raised from the scrotum wrapped over the tube and 8 - 10 interrupted stitches taken with 5-0 Vicryl. Glanuloplasty performed over it. Suprapubic diversion did and kept for 3 weeks postoperatively. Results: In group A, 3 patients developed fistula and only 1 (4.76%) required repair at the end of 6 weeks. 2 (9.52%) patients developed grade 3 infection and settled with conservative treatment. UFR was normal at the end of 12 weeks (12.85 Ml/sec. In group B, 11 patients developed fistula and 9 (33.33%) required repaired. 9 (33.33%) patients developed strictures and all of them required multiple urethral dilatation under GA. 7 (25.92%) patients developed meatal stenosis.UFR was badly reduced with average of 5.78 ML/Sec. Conclusion: The operation proves to be a much better option compared to the conventional for group A patients. We need a series with longer follow up and larger number of patients.展开更多
Objectives: To determine hospital frequency and to write the diagnostic and therapeutic aspects of appendicular abscess in adults in the General Surgery Department of teaching Hospital Gabriel Touré from 2005 to ...Objectives: To determine hospital frequency and to write the diagnostic and therapeutic aspects of appendicular abscess in adults in the General Surgery Department of teaching Hospital Gabriel Touré from 2005 to 2017. Material and Methods: This was a retrospective study conducted from January 1, 2005 to December 31, 2017 in the General Surgery De-partment of Gabriel Touré University Hospital in all patients with appen-dicular abscess. Results: In 13 years, 1420 cases of acute appendicitis have been reported, including 105 cases of appendicular abscess (7.4%). Mean age of the patients was 32 years with extremes of 16 years and 70 years. Abdominal pain and fever were present in all patients. Pain sat in the right iliac fossa in 73.3% and was epigastric in 11.4%. In almost all cases abdominal defense was present (97.1%). There was generalized abdominal contracture in 2.8% of cases. Average duration of evolution was 27 days with extremes of 1 day and 60 days. Ultrasonography was performed in 42.6% of cases and found peri-appendicular effusion in 29 cases (27.6%). 90 incisions were made by incision of Mac Burney, 8 by median umbilical, 7 by midline above and below umbilical. The amount of fluid aspirated was greater than 100 cc in 47 patients. We performed an appendectomy with appendicular stump burying followed by washing plus drainage of the abdominal cavity in 65 patients. Morbidity rate was 14.3%. No deaths were recorded. Average duration of hospitalization was 6.5 days with extremes of 2 days and 26 days.展开更多
<strong>Introduction:</strong> Appendicular abscess is a progressive complication of acute appendicitis in which the spread of infection is contained by the greater omentum and the slender loops resulting ...<strong>Introduction:</strong> Appendicular abscess is a progressive complication of acute appendicitis in which the spread of infection is contained by the greater omentum and the slender loops resulting in the formation of a true septate abscess of the large peritoneal cavity. <strong>Materials and Methods:</strong> This was a retrospective study from January 2010 to December 2019 carried out at the Bocar Sidi Sall University Hospital in Kati (CHU BSS in Kati) in general surgery. It concerned all patients operated on for appendicular abscess in the department. <strong>Results:</strong> 75 cases of appendicular abscess were collected, which represented 5.76% of surgical emergencies and 25% of acute appendicitis. The average age of the patients was 29 years. The male sex represented 67% of our patients with a sex ratio of 2. The average consultation time was 5 days. Abdominal pain was noted in all patients. It was localized in the right iliac fossa in 80% (n = 60) and diffuse in 2.7% of cases (n = 2). It was accompanied by nausea and vomiting in 93% of cases (n = 70), urinary disorders in 20% (n = 15), fever in 94% (n = 71), cessation of materials and gas in 1.33% (n = 1). Abdominal ultrasound was performed in 86% (n = 65). It made it possible to suggest a peri-appendicular effusion. Biological examination revealed a neutrophilic hyperleukocytosis greater than 20,000/mm3 in 47 patients, or 63%. All the patients were operated on by laparotomy (Marc Burney or midline subumbilical) under general anesthesia. The length of hospitalization was 6 days. We have not recorded any deaths. Morbidity was 8% (n = 6) represented by parietal suppuration. The postoperative course was straightforward in 92% of cases (n = 69). <strong>Conclusion:</strong> Appendicular abscess is a frequent medico-surgical emergency, the prognosis of which depends greatly on early diagnosis and adequate and immediate management.展开更多
<strong>Introduction:</strong> Appendicular peritonitis is a complication of acute appendicitis characterized by the spread of the infectious process in the peritoneal cavity thus achieving wide spread or ...<strong>Introduction:</strong> Appendicular peritonitis is a complication of acute appendicitis characterized by the spread of the infectious process in the peritoneal cavity thus achieving wide spread or localized purulent peritonitis;it’s a medico-surgical emergency. Our objectives are to determine the frequency, describe the clinical, therapeutic and prognostic aspects of peritonitis by appendicular perforations. <strong>Patients-Method:</strong> This was a 24-month retro, prospective, descriptive study from January 1, 2018 to December 31, 2019;conducted in the Bougouni Reference Health Center Surgery Unit. All patients of appendicular peritonitis at the Bougouni Reference Health Centre were included. <strong>Results:</strong> During the study period, 68 cases of generalized acute peritonitis including 30 appendicular peritonitis cases were collected. Appendicular peritonitis accounted for 44.1% of surgical procedures. Males accounted for 71.0% with a sex ratio of 1.2 at risk of men, the average age was 26.07 years. Abdominal pain and vomiting were the reasons for consultation in 86.7% and 76.7% of cases. Physical examination was used in most cases to make the diagnosis. X-ray of the abdomen without preparation, and abdominal ultrasound were performed systematically. Surgical treatment consisted of an appendectomy with peritoneal toilet followed by drainage. The average length of hospitalization was 8.8 days with extremes of 1 - 44 days. Hospital mortality was 3.3%;morbidity and high mortality were related to delayed consultation. <strong>Conclusion:</strong> Appendicular generalized acute peritonitis is a medical-surgical emergency with a high mortality rate associated with delayed management.展开更多
Introduction: Appendicitis is the most common surgical emergency in childhood. It’s a common surgical disease that can be presented with a wide variety of atypical clinical features. Clinical Case: We report a case o...Introduction: Appendicitis is the most common surgical emergency in childhood. It’s a common surgical disease that can be presented with a wide variety of atypical clinical features. Clinical Case: We report a case of a 7-year-old female patient admitted for abdominal pain dating back 20 days, radiological exploration suggested a right ovarian teratoma, while laparoscopic exploration has objective an appendicular abscess. Conclusion: This case has allowed us to clarify an atypical case of complicated appendicitis, and also to show the contribution of laparoscopy.展开更多
Low-grade appendiceal mucinous neoplasm (LAMN) is rare, and patients are often asymptomatic or have nonspecific symptoms. Appendicectomy should be performed with care and limited handling of the appendix, with extract...Low-grade appendiceal mucinous neoplasm (LAMN) is rare, and patients are often asymptomatic or have nonspecific symptoms. Appendicectomy should be performed with care and limited handling of the appendix, with extraction of the specimen through an extraction bag to prevent perforation and spillage of mucin, which can result in the development of pseudomyxoma peritonei (PMP). This case report aims to shed light on the approach to appendicular mucocele in contemporary medicine. The reported case shows a presentation of mucocele in a young female patient with symptoms compatible with appendicitis. This case report serves as an example of how to diagnose, manage, and follow-up on appendicular mucocele treatment for colleagues who may encounter similar conditions.展开更多
<span style="font-family:Verdana;">The appendicular peritonitis is complications of acute appendicitis which are characterized by the diffusion of the infectious process to the peritoneal cavity thus c...<span style="font-family:Verdana;">The appendicular peritonitis is complications of acute appendicitis which are characterized by the diffusion of the infectious process to the peritoneal cavity thus carr</span><span style="font-family:Verdana;">ying out a generalized or located purulent peritonitis. It can appear from the start or follow the stage of appendicular abscess.</span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Our objectives were to determine the frequency, to describe the clinic and para clinic aspects, to identify the principal germs and their sensitivities to antibiotics</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> and</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> to describe the operative continuations.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">Our prospective and descriptive study focused on patients treated for appendicular peritonitis, from January 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> to December 31</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> 2016, in the General Surgery Department of the Hospital of Sikasso.</span></span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">During the period of our study, 31 cases of appendicular peritonitis were collected, which</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">represented 4.36% of surgical interventions, 19.25% of urgent surgeries.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">The male sex accounted for 71.0% with a sex-ratio of 2.44 at the risk of males, the average age was of 20 years</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">± 12.99, the abdominal pain + vomiting was the reason for consultation in 54.8% of cases. The physical examination allowed in most </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">cases to make the diagnosis. In doubtful cases some additional examinations have been requested (abdomen without preparation, abdominal ultrasound).</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">The surgical treatment consisted of an appendectomy with peritoneal lavage followed by drainage.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">The average length of hospital stay was 8.8 days with extremes of 1</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">44 days. Hospital mortality was 9.7%. Delay in consultation and age were factors of morbidity and high mortality.</span></span></span>展开更多
Postoperative prognosis is generally poor even with adjuvant chemotherapy in dogs with an appendicular osteosarcoma. The purpose of this report was to present the long-term disease-free survival time in a dog with app...Postoperative prognosis is generally poor even with adjuvant chemotherapy in dogs with an appendicular osteosarcoma. The purpose of this report was to present the long-term disease-free survival time in a dog with appendicular osteosarcoma receiving amputation,adjuvant chemotherapy and adoptive immunotherapy. A 12-year-old spayed Golden retriever was referred to our hospital with a suspicion of osteosarcoma in right distal radius. The patient underwent the computed tomography (CT) and incisional biopsy on the next day after the first presentation. The CT revealed the osteolysis in the right distal radius and no metastases in the lungs and lymph nodes. The histopathologic diagnosis was made as an osteosarcoma. On the 13th day after,the patient underwent right forelimb amputation. Six doses of carboplatin (250 mg / m2) were postoperatively administered every 3 weeks. The intravenous infusion of lymphokine-activated killer (LAK) cells suspension was performed every 3 ~ 4 weeks after the adjuvant chemotherapy. At the time of our writing this abstract (on the 880thday after the first presentation),no recurrences and metastases were observed after the 32 transfers of LAK cells. In canine appendicular osteosarcoma,some reports have described that postoperative median survival times were 235 ~ 540 d with adjuvant chemotherapy. In our report,the disease free interval and survival time were prolonged compared with the previous reports. We strongly believed that early diagnosis and surgical intervention and adoptive immunotherapy had a great impact on the improvement of survival time in canine appendicular osteosarcoma.展开更多
BACKGROUND Chronic hyperglycemia can damage the microcirculation,which impairs the function of various organs and tissues and predisposes individuals to chronic complications.Sarcopenia(SP)is the age-related decline i...BACKGROUND Chronic hyperglycemia can damage the microcirculation,which impairs the function of various organs and tissues and predisposes individuals to chronic complications.Sarcopenia(SP)is the age-related decline in muscle mass and function that contributes to the sequelae of type 2 diabetes.In particular,diabetic patients are at higher risk of SP because of insulin resistance,chronic inflam-mation,and decreased physical activity.METHODS A retrospective analysis was conducted on 196 middle-aged and elderly male T2DM inpatients in the First Affiliated Hospital of Chongqing Medical University between June 2021 and June 2023,with 60 concurrent healthy individuals as the control group.Differences in general information,blood biochemistry,glyco-sylated hemoglobin,muscle strength,and detection rate of SP were compared between groups.The BMD,appendicular skeletal muscle(ASM),and fat mass,as well as grip strength and gait speed,were determined for each patient,and the ASM index(ASMI)was counted.The quantitative data were subjected to cor-relation and logistic regression analyses to identify risk factors for SP.RESULTS Fifty-one of the 196 middle-aged and elderly male T2DM patients were diagnosed with SP,which accounted for 26.02%.The middle-aged and elderly T2DM patients with SP exhibited a longer diabetes mellitus(DM)course and a lower body mass index(BMI)and 25(OH)D3 compared with the non-SP patients.The T2DM+SP patients exhibited lower BMI,ASM,ASMI,left-and right-hand grip strength,gait speed,and muscle and fat mass of the upper and lower limbs compared with the diabetic non-SP patients.The femoral neck,total hip,and lumbar spine L1-4 BMD were markedly lower in T2DM+SP patients compared with those in the non-SP diabetics.Long-term DM course,low BMI,and low BMD of the femoral neck,lumbar spine L1-4,and total hip were identified as risk factors for the development of SP.CONCLUSION T2DM patients are at risk for SP;however,measures can be taken to prevent the related risk factors.展开更多
文摘Endometriosis is a condition characterized by the presence of endometrial tissue outside the uterine cavity. This tissue, found in the inner lining of the uterus, develops in other pelvic organs, such as the ovaries, fallopian tubes, peritoneum, and bowel. In cases of deep endometriosis, the appendix may be affected, and consequently, appendectomy becomes a perioperative possibility. From February 2018 to February 2023, the surgical team performed 133 laparoscopic procedures. The number of appendectomies by the time of the surgical procedure was 19.5% (26 cases), with 50% of these (13 cases) confirming the histological presence of appendiceal endometriosis (AE), no increasing of postoperative complications was noticed. This report is important to reinforce multidisciplinary training, review postoperative complications, and provide training in advanced pelvic surgery. Furthermore, it aims to emphasize that appendectomy performed during the surgical act is a safe and viable procedure that does not increase complication rates.
文摘It is a globally rare condition that can present in a variety of clinical syndromes or can occur as an incidental surgical finding. It poses the double problem of its possible malignancy and the risk of gelatinous disease of the peritoneum in the event of perforation. We report a case treated in the “A” Surgery Department of the Point-G University Hospital Center (CHU) in Mali in 2022. It was a 62-year-old woman, a housewife who presented to the department. “A” surgery at the Point G University Hospital Center for pain in the iliac fossa. As a medical history, she was hypertensive on atenolol and a known diabetic on diet and metformin-based treatment, as well as symptomatic sickle cell disease (AS) and an undocumented history of peptic ulcer disease. The biological assessments revealed hyperleukocyte with granulocyte predominance. C-reactive protein was positive at 32 mg/l. Ultrasound revealed a 27 mm cystic dilation of the appendicitis in favor of appendicular mucocele. We proceeded with the appendix. The surgical specimen containing gelatinous fluid was removed and histological examination was in favor of a mucinous adenocarcinoma of the appendix.
文摘Aims and Objective: To develop a better operation for hypospadias patients with poor and bad quality urethral plate and damaged urethral plate as in hypospadias cripples. Materials and Methods: I operated 21 cases of hypospadias with Appendicular mucosal tube implant with Dartos wrap operation from 17/04/2017 to 03/03/2019, in Jawale Institute of pediatric Surgery, and that group was labeled as group A. 27 cases of hypospadias were operated in same time span with conventional techniques such as extended Snodgrass operation and Byar’s two-stage operation (group B), kept as control. 7 patients (33.33%) were cases of hypospadias cripples with multiple surgeries done in the past. 4 patients (9.52%) patients had congenital short urethra. Remaining 10 patients (50%) were fresh cases with no operation done in past but with bad and fibrotic urethral plate. The longest follow up was 3 years and the shortest of 1 year. Technique of Operation: Appendicectomy performed by open technique and the serosa of Appendix cut longitudinally and stripped off the mucosal tube. The proximal hypospadias opening sutured with the appendicular mucosal tube with 6 sutures of 5-0 Vicryl. Dartos fascia is raised from the scrotum wrapped over the tube and 8 - 10 interrupted stitches taken with 5-0 Vicryl. Glanuloplasty performed over it. Suprapubic diversion did and kept for 3 weeks postoperatively. Results: In group A, 3 patients developed fistula and only 1 (4.76%) required repair at the end of 6 weeks. 2 (9.52%) patients developed grade 3 infection and settled with conservative treatment. UFR was normal at the end of 12 weeks (12.85 Ml/sec. In group B, 11 patients developed fistula and 9 (33.33%) required repaired. 9 (33.33%) patients developed strictures and all of them required multiple urethral dilatation under GA. 7 (25.92%) patients developed meatal stenosis.UFR was badly reduced with average of 5.78 ML/Sec. Conclusion: The operation proves to be a much better option compared to the conventional for group A patients. We need a series with longer follow up and larger number of patients.
文摘Objectives: To determine hospital frequency and to write the diagnostic and therapeutic aspects of appendicular abscess in adults in the General Surgery Department of teaching Hospital Gabriel Touré from 2005 to 2017. Material and Methods: This was a retrospective study conducted from January 1, 2005 to December 31, 2017 in the General Surgery De-partment of Gabriel Touré University Hospital in all patients with appen-dicular abscess. Results: In 13 years, 1420 cases of acute appendicitis have been reported, including 105 cases of appendicular abscess (7.4%). Mean age of the patients was 32 years with extremes of 16 years and 70 years. Abdominal pain and fever were present in all patients. Pain sat in the right iliac fossa in 73.3% and was epigastric in 11.4%. In almost all cases abdominal defense was present (97.1%). There was generalized abdominal contracture in 2.8% of cases. Average duration of evolution was 27 days with extremes of 1 day and 60 days. Ultrasonography was performed in 42.6% of cases and found peri-appendicular effusion in 29 cases (27.6%). 90 incisions were made by incision of Mac Burney, 8 by median umbilical, 7 by midline above and below umbilical. The amount of fluid aspirated was greater than 100 cc in 47 patients. We performed an appendectomy with appendicular stump burying followed by washing plus drainage of the abdominal cavity in 65 patients. Morbidity rate was 14.3%. No deaths were recorded. Average duration of hospitalization was 6.5 days with extremes of 2 days and 26 days.
文摘<strong>Introduction:</strong> Appendicular abscess is a progressive complication of acute appendicitis in which the spread of infection is contained by the greater omentum and the slender loops resulting in the formation of a true septate abscess of the large peritoneal cavity. <strong>Materials and Methods:</strong> This was a retrospective study from January 2010 to December 2019 carried out at the Bocar Sidi Sall University Hospital in Kati (CHU BSS in Kati) in general surgery. It concerned all patients operated on for appendicular abscess in the department. <strong>Results:</strong> 75 cases of appendicular abscess were collected, which represented 5.76% of surgical emergencies and 25% of acute appendicitis. The average age of the patients was 29 years. The male sex represented 67% of our patients with a sex ratio of 2. The average consultation time was 5 days. Abdominal pain was noted in all patients. It was localized in the right iliac fossa in 80% (n = 60) and diffuse in 2.7% of cases (n = 2). It was accompanied by nausea and vomiting in 93% of cases (n = 70), urinary disorders in 20% (n = 15), fever in 94% (n = 71), cessation of materials and gas in 1.33% (n = 1). Abdominal ultrasound was performed in 86% (n = 65). It made it possible to suggest a peri-appendicular effusion. Biological examination revealed a neutrophilic hyperleukocytosis greater than 20,000/mm3 in 47 patients, or 63%. All the patients were operated on by laparotomy (Marc Burney or midline subumbilical) under general anesthesia. The length of hospitalization was 6 days. We have not recorded any deaths. Morbidity was 8% (n = 6) represented by parietal suppuration. The postoperative course was straightforward in 92% of cases (n = 69). <strong>Conclusion:</strong> Appendicular abscess is a frequent medico-surgical emergency, the prognosis of which depends greatly on early diagnosis and adequate and immediate management.
文摘<strong>Introduction:</strong> Appendicular peritonitis is a complication of acute appendicitis characterized by the spread of the infectious process in the peritoneal cavity thus achieving wide spread or localized purulent peritonitis;it’s a medico-surgical emergency. Our objectives are to determine the frequency, describe the clinical, therapeutic and prognostic aspects of peritonitis by appendicular perforations. <strong>Patients-Method:</strong> This was a 24-month retro, prospective, descriptive study from January 1, 2018 to December 31, 2019;conducted in the Bougouni Reference Health Center Surgery Unit. All patients of appendicular peritonitis at the Bougouni Reference Health Centre were included. <strong>Results:</strong> During the study period, 68 cases of generalized acute peritonitis including 30 appendicular peritonitis cases were collected. Appendicular peritonitis accounted for 44.1% of surgical procedures. Males accounted for 71.0% with a sex ratio of 1.2 at risk of men, the average age was 26.07 years. Abdominal pain and vomiting were the reasons for consultation in 86.7% and 76.7% of cases. Physical examination was used in most cases to make the diagnosis. X-ray of the abdomen without preparation, and abdominal ultrasound were performed systematically. Surgical treatment consisted of an appendectomy with peritoneal toilet followed by drainage. The average length of hospitalization was 8.8 days with extremes of 1 - 44 days. Hospital mortality was 3.3%;morbidity and high mortality were related to delayed consultation. <strong>Conclusion:</strong> Appendicular generalized acute peritonitis is a medical-surgical emergency with a high mortality rate associated with delayed management.
文摘Introduction: Appendicitis is the most common surgical emergency in childhood. It’s a common surgical disease that can be presented with a wide variety of atypical clinical features. Clinical Case: We report a case of a 7-year-old female patient admitted for abdominal pain dating back 20 days, radiological exploration suggested a right ovarian teratoma, while laparoscopic exploration has objective an appendicular abscess. Conclusion: This case has allowed us to clarify an atypical case of complicated appendicitis, and also to show the contribution of laparoscopy.
文摘Low-grade appendiceal mucinous neoplasm (LAMN) is rare, and patients are often asymptomatic or have nonspecific symptoms. Appendicectomy should be performed with care and limited handling of the appendix, with extraction of the specimen through an extraction bag to prevent perforation and spillage of mucin, which can result in the development of pseudomyxoma peritonei (PMP). This case report aims to shed light on the approach to appendicular mucocele in contemporary medicine. The reported case shows a presentation of mucocele in a young female patient with symptoms compatible with appendicitis. This case report serves as an example of how to diagnose, manage, and follow-up on appendicular mucocele treatment for colleagues who may encounter similar conditions.
文摘<span style="font-family:Verdana;">The appendicular peritonitis is complications of acute appendicitis which are characterized by the diffusion of the infectious process to the peritoneal cavity thus carr</span><span style="font-family:Verdana;">ying out a generalized or located purulent peritonitis. It can appear from the start or follow the stage of appendicular abscess.</span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Our objectives were to determine the frequency, to describe the clinic and para clinic aspects, to identify the principal germs and their sensitivities to antibiotics</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> and</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> to describe the operative continuations.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">Our prospective and descriptive study focused on patients treated for appendicular peritonitis, from January 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> to December 31</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> 2016, in the General Surgery Department of the Hospital of Sikasso.</span></span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">During the period of our study, 31 cases of appendicular peritonitis were collected, which</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">represented 4.36% of surgical interventions, 19.25% of urgent surgeries.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">The male sex accounted for 71.0% with a sex-ratio of 2.44 at the risk of males, the average age was of 20 years</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">± 12.99, the abdominal pain + vomiting was the reason for consultation in 54.8% of cases. The physical examination allowed in most </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">cases to make the diagnosis. In doubtful cases some additional examinations have been requested (abdomen without preparation, abdominal ultrasound).</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">The surgical treatment consisted of an appendectomy with peritoneal lavage followed by drainage.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">The average length of hospital stay was 8.8 days with extremes of 1</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">44 days. Hospital mortality was 9.7%. Delay in consultation and age were factors of morbidity and high mortality.</span></span></span>
文摘Postoperative prognosis is generally poor even with adjuvant chemotherapy in dogs with an appendicular osteosarcoma. The purpose of this report was to present the long-term disease-free survival time in a dog with appendicular osteosarcoma receiving amputation,adjuvant chemotherapy and adoptive immunotherapy. A 12-year-old spayed Golden retriever was referred to our hospital with a suspicion of osteosarcoma in right distal radius. The patient underwent the computed tomography (CT) and incisional biopsy on the next day after the first presentation. The CT revealed the osteolysis in the right distal radius and no metastases in the lungs and lymph nodes. The histopathologic diagnosis was made as an osteosarcoma. On the 13th day after,the patient underwent right forelimb amputation. Six doses of carboplatin (250 mg / m2) were postoperatively administered every 3 weeks. The intravenous infusion of lymphokine-activated killer (LAK) cells suspension was performed every 3 ~ 4 weeks after the adjuvant chemotherapy. At the time of our writing this abstract (on the 880thday after the first presentation),no recurrences and metastases were observed after the 32 transfers of LAK cells. In canine appendicular osteosarcoma,some reports have described that postoperative median survival times were 235 ~ 540 d with adjuvant chemotherapy. In our report,the disease free interval and survival time were prolonged compared with the previous reports. We strongly believed that early diagnosis and surgical intervention and adoptive immunotherapy had a great impact on the improvement of survival time in canine appendicular osteosarcoma.
基金Supported by Chongqing Postgraduate Scientific Research Innovation Project,No.CYB22200.
文摘BACKGROUND Chronic hyperglycemia can damage the microcirculation,which impairs the function of various organs and tissues and predisposes individuals to chronic complications.Sarcopenia(SP)is the age-related decline in muscle mass and function that contributes to the sequelae of type 2 diabetes.In particular,diabetic patients are at higher risk of SP because of insulin resistance,chronic inflam-mation,and decreased physical activity.METHODS A retrospective analysis was conducted on 196 middle-aged and elderly male T2DM inpatients in the First Affiliated Hospital of Chongqing Medical University between June 2021 and June 2023,with 60 concurrent healthy individuals as the control group.Differences in general information,blood biochemistry,glyco-sylated hemoglobin,muscle strength,and detection rate of SP were compared between groups.The BMD,appendicular skeletal muscle(ASM),and fat mass,as well as grip strength and gait speed,were determined for each patient,and the ASM index(ASMI)was counted.The quantitative data were subjected to cor-relation and logistic regression analyses to identify risk factors for SP.RESULTS Fifty-one of the 196 middle-aged and elderly male T2DM patients were diagnosed with SP,which accounted for 26.02%.The middle-aged and elderly T2DM patients with SP exhibited a longer diabetes mellitus(DM)course and a lower body mass index(BMI)and 25(OH)D3 compared with the non-SP patients.The T2DM+SP patients exhibited lower BMI,ASM,ASMI,left-and right-hand grip strength,gait speed,and muscle and fat mass of the upper and lower limbs compared with the diabetic non-SP patients.The femoral neck,total hip,and lumbar spine L1-4 BMD were markedly lower in T2DM+SP patients compared with those in the non-SP diabetics.Long-term DM course,low BMI,and low BMD of the femoral neck,lumbar spine L1-4,and total hip were identified as risk factors for the development of SP.CONCLUSION T2DM patients are at risk for SP;however,measures can be taken to prevent the related risk factors.
