Document Detail


Systematic review of blunt abdominal trauma as a cause of acute appendicitis.
MedLine Citation:
PMID:  20513274     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Acute appendicitis commonly presents as an acute abdomen. Cases of acute appendicitis caused by blunt abdominal trauma are rare. We present a systematic review of appendicitis following blunt abdominal trauma. The aim of this review was to collate and report the clinical presentations and experience of such cases.
SUBJECTS AND METHODS: A literature review was performed using PubMed, Embase and Medline and the keywords 'appendicitis', 'abdominal' and 'trauma'.
RESULTS: The initial search returned 381 papers, of which 17 articles were included. We found 28 cases of acute appendicitis secondary to blunt abdominal trauma reported in the literature between 1991 and 2009. Mechanisms of injury included road-traffic accidents, falls, assaults and accidents. Presenting symptoms invariably included abdominal pain, but also nausea, vomiting and anorexia. Only 12 patients had computed tomography scans and 10 patients had ultrasonography. All reported treatment was surgical and positive for appendicitis.
CONCLUSIONS: Although rare, the diagnosis of acute appendicitis must be considered following direct abdominal trauma especially if the patient complains of abdominal right lower quadrant pain, nausea and anorexia. Haemodynamically stable patients who present shortly after blunt abdominal trauma with right lower quadrant pain and tenderness should undergo urgent imaging with a plan to proceed to appendicectomy if the imaging suggested an inflammatory process within the right iliac fossa.
Authors:
Zaher Toumi; Anthony Chan; Matthew B Hadfield; Neil R Hulton
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Publication Detail:
Type:  Case Reports; Journal Article; Review     Date:  2010-05-28
Journal Detail:
Title:  Annals of the Royal College of Surgeons of England     Volume:  92     ISSN:  1478-7083     ISO Abbreviation:  Ann R Coll Surg Engl     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-07     Completed Date:  2010-10-13     Revised Date:  2011-11-14    
Medline Journal Info:
Nlm Unique ID:  7506860     Medline TA:  Ann R Coll Surg Engl     Country:  England    
Other Details:
Languages:  eng     Pagination:  477-82     Citation Subset:  IM    
Affiliation:
Department of Vascular Surgery, Royal Oldham Hospital, Oldham, UK. zahertoumi@btinternet.com
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MeSH Terms
Descriptor/Qualifier:
Abdominal Injuries / complications*
Acute Disease
Appendicitis / diagnosis,  etiology*,  radiography
Child
Female
Humans
Male
Tomography, X-Ray Computed
Wounds, Nonpenetrating / complications*

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