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Ma Q, Du JJ. Appendiceal bleeding caused by vascular malformation: A case report. World J Clin Cases 2024; 12:2457-2462. [PMID: 38765744 PMCID: PMC11099410 DOI: 10.12998/wjcc.v12.i14.2457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 03/09/2024] [Accepted: 04/03/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Acute lower gastrointestinal bleeding (LGIB) is a common occurrence in clinical practice. However, appendiceal bleeding is an extremely rare condition that can easily be overlooked and misdiagnosed. The preoperative detection of appendiceal bleeding often poses challenges due to the lack of related guidelines and consensus, resulting in controversial treatment approaches. CASE SUMMARY We presented a case of a 33-year-old female who complained of hematochezia that had lasted for 1 d. Colonoscopy revealed continuous bleeding in the appendiceal orifice. A laparoscopic appendectomy was performed immediately, and a pulsating blood vessel was observed in the mesangium of the appendix, accordingly, active bleeding into the appendicular lumen was considered. Pathological examination revealed numerous hyperplastic vessels in the appendiceal mucosa and dilated capillary vessels. CONCLUSION The preoperative detection of appendiceal bleeding is often challenging, colonoscopy is extremely important, bowel preparation is not routinely recommended for patients with acute LGIB or only low-dose bowel preparation is recommended. Laparoscopic appendectomy is the most appropriate treatment for appendiceal bleeding.
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Affiliation(s)
- Qin Ma
- Department of General Surgery, Fuling Hospital Affiliated to Chongqing University, Chongqing 408000, China
| | - Jin-Jie Du
- Department of Geriatrics, Fuling Hospital Affiliated to Chongqing University, Chongqing 408000, China
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2
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Ma Q, Du J. WITHDRAWN: Appendiceal bleeding caused by vascular malformation: A case report and literature review. Int J Surg Case Rep 2023:108903. [PMID: 38008682 DOI: 10.1016/j.ijscr.2023.108903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/27/2023] [Accepted: 09/30/2023] [Indexed: 11/28/2023] Open
Abstract
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/policies/article-withdrawal.
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Affiliation(s)
- Qin Ma
- Department of General Surgery, Fuling Hospital Affiliated to Chongqing University, China
| | - Jinjie Du
- Department of General Surgery, Fuling Hospital Affiliated to Chongqing University, China.
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Zhou SY, Guo MD, Ye XH. Appendiceal bleeding: A case report. World J Clin Cases 2022; 10:6314-6318. [PMID: 35949834 PMCID: PMC9254187 DOI: 10.12998/wjcc.v10.i18.6314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/27/2022] [Accepted: 04/24/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Acute lower gastrointestinal bleeding is common in clinical practice, and the colon is responsible for the majority of cases. However, appendiceal bleeding is an extremely rare cause. Appendiceal bleeding due to vascular diseases, such as angiodysplasia and Dieulafoy’s lesion, may result in massive lower gastrointestinal bleeding. Appendectomy is a reliable and effective option for treatment.
CASE SUMMARY A 32-year-old male presented to our hospital with hematochezia that had lasted for 6 h, with approximately 600-800 mL bloody stools and loss of consciousness for a few seconds. Persistent bleeding from the orifice of the appendix was observed by colonoscopy. Following the new diagnosis of appendiceal bleeding, the patient was treated by an emergency laparoscopic appendectomy. Finally, the patient was pathologically diagnosed with appendiceal Dieulafoy’s lesion. The patient was uneventfully discharged, and follow-up 2 wk later showed no evidence of rebleeding.
CONCLUSION Although appendiceal bleeding is a rare cause of acute lower gastrointestinal bleeding, clinicians should consider it during differential diagnosis.
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Affiliation(s)
- Sheng-Yue Zhou
- Department of Gastroenterology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, Zhejiang Province, China
| | - Mao-Dong Guo
- Department of Gastroenterology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, Zhejiang Province, China
| | - Xiao-Hua Ye
- Department of Gastroenterology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, Zhejiang Province, China
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Ahn SR, Lee JH. Acute Eosinophilic Appendicitis: A Rare Cause of Lower Gastrointestinal Hemorrhage. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2021; 78:134-137. [PMID: 34446636 DOI: 10.4166/kjg.2021.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 04/26/2021] [Accepted: 05/03/2021] [Indexed: 11/03/2022]
Abstract
Acute eosinophilic appendicitis (AEA) is defined as eosinophilic infiltration of the muscular layer of the appendix instead of neutrophils. The symptoms of this disease are similar to those of acute suppurative appendicitis. On the other hand, it can present as a lower gastrointestinal hemorrhage. This paper reports a case of an elderly man with an appendiceal hemorrhage due to AEA. The diagnosis was made by colonoscopy during an evaluation of hematochezia. The patient underwent a laparoscopic partial cecectomy. The histology findings revealed ulceration and marked eosinophilic infiltration of the muscularis propria of the appendix with accompanying edema. Although appendiceal hemorrhage due to AEA is extremely rare, clinicians should consider it in a differential diagnosis.
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Affiliation(s)
- So Ra Ahn
- Department of Surgery and Digestive Disease Research Institute, Wonkwang University School of Medicine, Iksan, Korea
| | - Joo Hyun Lee
- Department of Surgery and Digestive Disease Research Institute, Wonkwang University School of Medicine, Iksan, Korea
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Soga K. A complete hemostasis of an appendiceal bleeding in a dialysis patient by an endoscopic traction method using endoscopic clips. INTERNATIONAL JOURNAL OF GASTROINTESTINAL INTERVENTION 2021. [DOI: 10.18528/ijgii200045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Koichi Soga
- Department of Gastroenterology, Omihachiman Community Medical Center, Omihachiman, Japan
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Maeda Y, Saito S, Ohuchi M, Tamaoki Y, Nasu J, Baba H. Appendiceal bleeding in an elderly male: a case report and a review of the literature. Surg Case Rep 2021; 7:147. [PMID: 34160703 PMCID: PMC8222427 DOI: 10.1186/s40792-021-01234-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/09/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The prevalence of acute lower gastrointestinal bleeding has been increased including colonic diverticulitis and angioplasty. However, appendiceal bleeding is extremely rare. CASE PRESENTATION We present a case of lower gastrointestinal bleeding from the appendix in an elderly male who presented with melena. Appendiceal bleeding was diagnosed using lower gastrointestinal endoscopy, and laparoscopic appendectomy was performed. The patient did not have melena postoperatively, and was discharged 6 days after the surgery. CONCLUSION It is important to distinguish appendiceal bleeding from lower gastrointestinal bleeding and to treat it as soon as possible with less invasiveness.
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Affiliation(s)
- Yuto Maeda
- grid.274841.c0000 0001 0660 6749Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556 Japan
- grid.415530.60000 0004 0407 1623Department of Surgery, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, Minami-ku, Kumamoto, 862-0965 Japan
| | - Seiya Saito
- grid.415530.60000 0004 0407 1623Department of Surgery, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, Minami-ku, Kumamoto, 862-0965 Japan
| | - Mayuko Ohuchi
- grid.415530.60000 0004 0407 1623Department of Surgery, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, Minami-ku, Kumamoto, 862-0965 Japan
| | - Yuka Tamaoki
- grid.415530.60000 0004 0407 1623Department of Surgery, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, Minami-ku, Kumamoto, 862-0965 Japan
| | - Jiro Nasu
- grid.415530.60000 0004 0407 1623Department of Surgery, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, Minami-ku, Kumamoto, 862-0965 Japan
| | - Hideo Baba
- grid.274841.c0000 0001 0660 6749Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556 Japan
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Smith EJ, Coventry C, Taylor J, De'ath H, Haque A. A case of endovascular management to gain control of a lower gastrointestinal haemorrhage caused by appendiceal artery bleeding. J Surg Case Rep 2021; 2021:rjab204. [PMID: 34123349 PMCID: PMC8192113 DOI: 10.1093/jscr/rjab204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 04/28/2021] [Indexed: 12/24/2022] Open
Abstract
Bleeding from the appendix is a rare cause of lower gastrointestinal haemorrhage. Previous publications have noted diagnosis via colonoscopy or computed tomography angiogram and treatment via surgical or endoscopy. We report a case of large volume per rectal bleeding from the appendix, with diagnosis and treatment via angiography and coil insertion, which is the first of its kind reported in the literature.
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Affiliation(s)
- Eleanor J Smith
- Surgical Department, Harris Suite, University Hospital Lewisham, London SE13 6LH, UK
| | | | | | | | - Ali Haque
- Frimley Park Hospital, Camberley GU16 7UJ, UK
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Karatas M, Simsek C, Gunay S, Zengel B, Okut G, Yıldırım AM, Vardar E, Uslu A. Acute lower gastrointestinal bleeding due to low-grade mucinous neoplasm of appendix. Acta Chir Belg 2020; 122:357-360. [PMID: 33274692 DOI: 10.1080/00015458.2020.1860397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Lower gastrointestinal tract (GIT) bleeding originating from the appendix is rare and may be difficult to diagnose. PATIENTS AND METHODS In this case report, we present an 88-year-old male patient who was admitted with hematochezia due to appendiceal bleeding. A colonoscopy revealed bleeding in the appendix orifice so an appendectomy was performed, and bleeding did not recur in the postoperative period. RESULTS The results of the microscopic examination showed low-grade mucinous neoplasm (LGMN) of the appendix. CONCLUSION It should be kept in mind that bleeding may originate from the appendix in patients presenting with GIT bleeding. Our patient is the first to present with an acute lower GIT bleed who was diagnosed as having LGMN in the appendectomy specimen.
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Affiliation(s)
- Murat Karatas
- Department of General Surgery, Izmir Bozyaka Education and Research Hospital, The University of Health Sciences, Izmir, Turkey
| | - Cenk Simsek
- Department of General Surgery, Izmir Bozyaka Education and Research Hospital, The University of Health Sciences, Izmir, Turkey
| | - Süleyman Gunay
- Department of Gastroenterology, Izmir Ataturk Education and Research Hospital, Katip Celebi University, Izmir, Turkey
| | - Baha Zengel
- Department of General Surgery, Izmir Bozyaka Education and Research Hospital, The University of Health Sciences, Izmir, Turkey
| | - Gokalp Okut
- Department of General Surgery, Izmir Bozyaka Education and Research Hospital, The University of Health Sciences, Izmir, Turkey
| | - Ali Murat Yıldırım
- Department of General Surgery, Izmir Bozyaka Education and Research Hospital, The University of Health Sciences, Izmir, Turkey
| | - Enver Vardar
- Department of Pathology, Izmir Bozyaka Education and Research Hospital, The University of Health Sciences, Izmir, Turkey
| | - Adam Uslu
- Department of General Surgery, Izmir Bozyaka Education and Research Hospital, The University of Health Sciences, Izmir, Turkey
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Kim DH, Lee JH, Kim D, Hwang S, Kang K, Koo JS. [Acute Suppurative Appendicitis Diagnosed by Acute Lower Gastrointestinal Hemorrhage]. THE KOREAN JOURNAL OF GASTROENTEROLOGY = TAEHAN SOHWAGI HAKHOE CHI 2019; 73:45-49. [PMID: 30690958 DOI: 10.4166/kjg.2019.73.1.45] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 06/21/2015] [Accepted: 06/24/2018] [Indexed: 11/03/2022]
Abstract
A 49-year-old man visited the emergency room of Korea University Ansan Hospital with hematochezia starting the day before the visit. Recently, he was on anti-platelet medication due to hypertension. The patient had no definite symptoms other than hematochezia. Digital rectal exam was positive and laboratory tests showed severe anemia. Sigmoidoscopy was initiated and almost no fecal material was observed in the intestinal tract, allowing insertion into the cecum. Active bleeding from the appendiceal opening was noted. On abdominal CT, contrast enhancement was observed at the tip of the appendix. Under suspicion of acute appendicitis, we consulted with a surgeon. The patient underwent appendectomy with partial cecal resection. Pathologic examination revealed a diagnosis of appendix bleeding due to acute suppurative appendicitis. The patient had no further bleeding after surgery and was discharged in a stable state. Careful observation by the endoscopist is necessary for accurate diagnosis of lower gastrointestinal hemorrhage. Appendiceal hemorrhage is very rarely reported, but it has various pathophysiologies. CT scan is useful when appendiceal hemorrhage is confirmed by endoscopic findings. Surgical treatment was needed in almost all cases reported worldwide. If bleeding from the appendix is confirmed, surgical treatment should be considered for both therapeutic and diagnostic purposes.
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Affiliation(s)
- Dae-Ha Kim
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Ju Han Lee
- Department of Pathology, Korea University Ansan Hospital, Ansan, Korea
| | - Dongwoo Kim
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Suhyun Hwang
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Kyuho Kang
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Ja Seol Koo
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
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