Traumatic appendicitis: a case report and literature review

Traumatic appendicitis with mass formation, a rare case report

This case report delves into an atypical presentation of postblunt abdominal trauma in an adult male, characterized by acute appendicitis complicated by the formation of an appendicular inflammatory mass. The patient's clinical evolution, diagnostic intricacies, and the multidisciplinary approach employed for successful management. By documenting this rare complication, our report contributes to expanding knowledge base on unusual consequences of abdominal trauma, aiming to enhance awareness and facilitate informed decision-making in clinical practice.

Acute peritonitis secondary to post-traumatic appendicitis: A case report and literature review

BACKGROUND

Blunt abdominal trauma has rarely been reported as a cause of acute appendicitis in the literature. However, the coexistence of the two conditions can cause issues for the patient. We present here a systematic review of cases of traumatic appendicitis as well as our own experience with a 12-year-old male patient.

CASE SUMMARY

A 12-year-old male was admitted 3 d after abdominal trauma, experiencing peritoneal syndrome. A pelvic formation was discovered during abdominal ultrasound, and surgical exploration revealed a perforated appendix. A literature review was conducted applying the keywords "appendicitis," "abdominal," and "trauma" to the PubMed, Embase, and Medline databases. Our initial search included 529 papers published between 1991 and 2022, of which 33 papers were finally included. They revealed 51 reported cases. The trauma mechanisms included road traffic accidents, falls, assaults, ball accidents, a horse kick, and a colonoscopy. Eight patients underwent surgical exploration with no prior radiological investigation, and twenty-six patients underwent an initial radiological examination. All reports indicated a perforated appendix.

CONCLUSION

Acute traumatic appendicitis represents a diagnostic quandary that can be misdiagnosed resulting in significant morbidity and potential mortality. A high level of suspicion combined with radiological examination may aid in the diagnosis and treatment of this condition.

Traumatic appendicitis is probably not real: an illustrative analysis of coincidental occurrences in nature

There have been sporadic case reports describing ‘traumatic appendicitis’ (acute appendicitis occurring following injury) for almost a hundred years. Although this might seem to be an interesting and rare diagnosis for the journal reader, both appendicitis and trauma are very common, and their occurrence together may only give the illusion of causality. Indeed, such a diagnosis may not even exist. We provide an illustration of the statistical phenomenon of coincidental occurrences in nature using a computer simulation of traumatic appendicitis in the UK population. In our simulation, there are enough cases of traumatic appendicitis every 2 years to 3 years to account for the entire global literature on the topic. We suggest that unless there is a credible pathological process reported with demonstrable causality, further case reports of traumatic appendicitis need to have robust justification.

Appendiceal transection associated with seat belt restraint

The seat belt is designed for safety in a motor vehicle and should be worn to prevent severe injuries. But, the seat belt itself can be an injury factor in combination with deceleration forces applied to fixation points of mobile viscera. Here, we present a 23-year-man with traumatic transection of the appendix, highly mobile viscera, following seat belt injury.

Treatment Modalities and Antimicrobial Stewardship Initiatives in the Management of Intra-Abdominal Infections

Antimicrobial stewardship programs (ASPs) focus on improving the utilization of broad spectrum antibiotics to decrease the incidence of multidrug-resistant Gram positive and Gram negative pathogens. Hospital admission for both medical and surgical intra-abdominal infections (IAIs) commonly results in the empiric use of broad spectrum antibiotics such as fluoroquinolones, beta-lactam beta-lactamase inhibitors, and carbapenems that can select for resistant organisms. This review will discuss the management of uncomplicated and complicated IAIs as well as highlight stewardship initiatives focusing on the proper use of broad spectrum antibiotics.