Appendix to Chapter 24 Sources of Pollutants in Urban Areas
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Intussusception of the appendix occurs when part of the appendix passes the part next to it or the whole appendix to the cecum. It is classified as primary or secondary, or can be classified to partial or complete. Most cases are secondary and partial. Patients usually presents with right lower abdominal pain and most cases are diagnosed during surgery. A 27-year-old female presented with right iliac fossa pain and nausea for 2 days. Abdominal examination showed tenderness, guarding, and rebound tenderness at the right iliac fossa. The WBC count was 11,000 c/mm and the urinalysis was normal. At surgery, there was intussusception of the vermiform appendix in its middle part with palpable mass attached to its wall. Appendicectomy was performed successfully. The result of the histopathology was consistent with mucinous cystadenoma of the appendix with no evidence of malignancy. Surgery is the main form of treatment as most of the cases are diagnosed during surgery, the operation type may include appendicectomy or more extensive surgery is required such as right hemicolectomy depending on the cause. Surgery can be performed laparoscopically. Trials of colonoscopic reduction are not recommended.
Vermiform
Iliac fossa
Mucinous cystadenoma
Hemicolectomy
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Lumen (anatomy)
Mucocele
Carcinoid tumour
Carcinoid tumors
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Mucocoele of the appendix is the term used to describe an appendix dilated with mucous collections due to benign or malignant causes. Primary tumors of the appendix are rare. Many a time, a mucocoele of the appendix is reported through histopathological study of the appendix removed in a scenario of acute appendicitis. 25% of the patients with mucocoele of appendix are asymptomatic, however patients may present with acute appendicitis or other obstructive symptoms. Here we report an unusual presentation of mucocoele of appendix who presented with chronic pain and mass in the right lower abdomen.
Mucinous cystadenoma
Cystadenoma
Mucocele
Presentation (obstetrics)
Vermiform
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Vermiform
Iliac fossa
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Within the framework of reflections on the extent of surgical operations in case of carcinoid of the appendix the author evaluates the size of the tumour, site of the tumour on the appendix and the presence of metastases in the appropriate lymph nodes or in remote organs. The author presents two case-histories. In the first one he demonstrates difficulties associated with evaluation of metastases of the mesenterial lymph nodes in case of mesenterial lymphadenitis concurrent with unrecognised carcinoid of the appendix. From the second case-history it is apparent that in advanced appendicitis with marked inflammatory changes of the appendix also colliquation of part of the tumour may occur and even microscopis examination does not provide information on the size of the tumour.
Carcinoid tumour
Carcinoid tumors
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Adenocarcinoid (mucinous carcinoid or goblet cell carcinoid) is an unusual tumour of the appendix with histologic and prognostic features between those of carcinoid and adenocarcinoma. Most patients with adenocarcinoid tumours of the appendix present with symptoms consistent with those of acute appendicitis. We describe a 31 year-old male who presented with such symptoms. Ultrasonography demonstrated an acutely inflamed appendix with a hypoechoic area in the midportion of the appendix, suspicious of a tumour. This rare type of tumour is briefly presented.
Vermiform
Carcinoid tumour
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: Appendix 1 Appendix 2 Appendix 3 Appendix 4 Appendix 5 Appendix 6 Appendix 7 Appendix 8 Appendix 9 Appendix 10 Appendix 11 Appendix 12 Appendix 13 Appendix 14 Appendix 15 Appendix 16 Appendix 17 Appendix 18
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Goblet cell carcinoid (GCC) of the perforated appendix is rare, and its pathological features and prognosis remain poorly described. A 71-year-old woman was admitted to our hospital for right lower abdominal pain, vomiting, and high-grade fever. She was diagnosed with acute appendicitis and underwent emergency laparoscopic appendectomy. Intraoperative examination revealed an enlarged and perforated appendix. Histopathological examination revealed GCC of the appendix with subserosal invasion. She underwent laparoscopic ileocecal resection with lymph node dissection (D3) following appendectomy. Histopathological findings showed no residual tumor or lymph node metastases. To the best of our knowledge, this report is a valuable addition to the GCC literature, describing a case of GCC of the appendix presenting as perforated appendix.
Histopathological examination
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