Makale Arama

Amyand Hernia is described as the presence of normal or inflamed appendix vermiformis in inguinal hernia sac. It was first described by C. Amyand in 1735 and occurs in approximately 1% in inguinal hernia. In this article, we presented two patients with amyand hernia that operated incarcerated inguinal hernia with the acute appendicitis detected.

Purpose: In this study, contrubitions of computed tomography (CT) and magnetic resonance imaging (MRI) were researched in the diagnosis of benign paranasal sinüs (PNS) lesions. Materials and methods: According to the clinical findings, between January 2001 – February 2004, 30 cases have been studied who were thought to have benign lesions belonging to nasal cavity, PNS or neighboring structures. CT and MRI studies are made to the all case. Inner structure characteristics, locations and radiological apperarances coursing pathological diagnosis of lesions in CT and MRI have been assessed. Results: The histopathological diagnoses of lesions were mucocele (8), odontogenic cysts (4), fibrous dysplasia (3), inverted papilloma (2), hemangioma (2), menengioma (2), schwannoma, osteoma, osteochondroma, paget disease, ameloblastom, giant cell tumor, central giant cell granuloma. Whwn assessed according to pathological results, sensitivity of CT and MRI were found to be 86.6% and 83.3% respectively. In 3 cases showing radiological malign feature (1 giant cell tumor, 2 inverted papillomas) the correct diagnosis was made histopathologically. Canclusion: CT is an effective method to show bone expansion and destructions, tumors originated from bone and intratumoral calcifications. MRI offers better the inner structures of cystic lesions, intratumoral hemorhages and differentiation of tumor from inflammation. Therefore, CT and MRI should be used jointly in the evaluation of the PNS lesions.

Background: Acute appendicitis is the mostcommon surgical problem in pregnancy after obstetric reasons. Pregnant patients operated with diagnosis of acute appendicitis were reviewed retrospectively in this study. Patients and Methods: 24 pregnant patients operated with diagnosis of acute appendicitis in Ankara Numune Training and Research Hospital between January and December 2003 were included in this study. Results: 19 out of 24 patients (%79.2) were pathologically diagnosed as acute appendicitis. Out of other 5 patients, 2 patients had ovarian cystrupture, 1 had ovarian cyst torsion and 2 had negative laparatomies. Distribution of patients was 2, 16 and 6 patients respectively, for 1st, 2nd and 3rd trimester. 2 patients had pretermlabour and 1 fetus resulted with exitus. Preoperative ultrasonography showed similarity to peroperative findings in 12 of 24 patients. Discussion: Diagnosis of acute appendicitis in pregnancy is quite difficult and physical examination and patient history are still most important diagnostic tools. Perforation risk in pregnant patients higher than normal population.

Torsion of appendix epididymis is a rare entity and the possibilitıj of this condition should be considered in differantial diagnosis of acute scrotal pain and swelling. A few torsions of appendix epididymis have been reported with the most of torsions of appendix testis when the literature is reviewed.

A rare cause of acute abdomen; appendiceal neuroma. Case report

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ABSTRACT

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    Acute abdomen refers to nontraumatic pathologies of abdominal origin which are characterized by sudden-onset abdominal pain. In most cases the cause of pain is a pathological condition requiring urgent surgical intervention. Acute appendicitis is the most common indication for surgical intervention in patients presenting to emergency department with acute abdomen. Obstruction of appendiceal lumen has been widely accepted as the precipitating factor in the pathophysiology of acute appendicitis. It usually develops as a result of food or feces particles entering into and obstructing appendiceal lumen, leading to inflammation and swelling of regional lymph nodes. Luminal obstruction results in overproduction of bacteria, excessive mucus secretion, and increased intraluminal pressure. Some studies in recent years have suggested a neural component in the pathophysiology of this condition. Such cases may present with various diagnoses such as obliterated appendix, fibrous obliteration, appendiceal neuroma, and neurogenic appendicitis. In this paper we present a case operated with the initial diagnosis of appendicitis and histopathologically diagnosed with appendiceal neuroma, a rare cause of acute abdomen.

Our case was pre-diagnosed with appendicitis but during the surgery it was seen that the patient had cecal diverticulum perforation. Further, as the dissection continued appendicitis with retrocecal subserous localization was identified. The goal of our study is to underline the possibility that appendicitis in a rare localization can be overlooked in patients diagnosed with simultaneous cecal diverticulum complications. Although cecal diverticulum is a rare lesion, there are some difficulties regarding its diagnosis and treatment since its symptoms are similar to acute appendicitis when there is a complication. It can hardly be differentiated from acute appendicitis through physical examination and radiological imagining methods are mostly insufficient. Therefore, patients are generally diagnosed intraoperatively. Acute appendicitis is one of the most frequent causes of acute abdomen. Appendectomy, too, is the most frequently performed surgery among intraabdominal emergency surgical procedures. A good anamnesis and a careful and sufficient physical examination are very significant in the diagnosis of acute appendicitis. Alongside these, various laboratory and imaging techniques can be utilized. Although the appendix can be seen in different localizations, the retrocecal site is one of the rare localizations among all. In patients presenting to the emergency departments with complaints of right lower quadrant pain, many diseases, led by appendicitis, based on the patient’s age and sex should be taken into consideration. The possibility that these diseases may co-exist should always be remembered and, therefore, intra-operational exploration should be performed thoroughly.

19 patients suspected of the diagnosis of acute appendicitis were examined with ulirasonography (US). Definitive diagnosis was not reported in one case. in 2 patients, postoperative °Yarkın torsion was reported. in 17 patients, the US diagnosis was provided with cilinical findings. The US diagnosis (%89) was correct. Appendix is seen in target configuration and greater !han normal in patients not having preappendicülar abscess. Target configuration is not seen in patients occurence periappendicüler abscess.

Amyand hernia is described presence of appendices vermiformis in inguinal hernia sac. The incidence of Amyand hernia is approximately 1% of all hernias. There are many treatment procedures of Amyand’s hernia. Since Amyand hernia is extremely rare and there are many controversial surgical managements, we wanted to share our case. We have encountered a Amyand hernia case during right inguinal hernia repair surgery. Treatment method and outcome were evaluated. Twentyone-year-old male patient was suffering from right groin pain and swelling for almost one year. He was operated with the diagnosis of right inguinal hernia, electively. Intraoperative exploration revealed Amyand hernia, appendectomy and hernia repair were performed using polypropylene patch with same incision. The patient’s postoperative course remained without complication and after 3 days he was discharged. Amyand hernia which especially difficult to diagnose preoperatively, particularly in terms of therapeutic approach, the debate continues, is extremely rare entity. There is no current consensus about appendectomy and using patch. We think that; regardless of the appendix is inflamed or noninflamed, appendectomy should be done. If the appendix is inflamed or perforated, prosthetic materials shouldn’t be used and while repairing hernia, anatomic repair or biological materials resistant to infection should be used.

In this article, two patients with appendiceal mucocele is represented, liath patients were diagnosed as acute abdomen and operated on. Peroperative diagnosis was confirmed histopathologically. Appendiceal rnucocele is a morphological definition and the diagnosis should be supported histopathologically