Delayed Awareness of the History of Barium Examination: Perforated Barium Appendicitis
| Autor: | Susumu Saigusa, Masaki Ohi, Satoshi Oki, Takashi Ichikawa, Minako Kobayashi, Yasuhiro Inoue, Chikao Miki |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: | |
| Zdroj: | Case Reports in Gastrointestinal Medicine, Vol 2017 (2017) |
| Druh dokumentu: | article |
| ISSN: | 2090-6528 2090-6536 |
| DOI: | 10.1155/2017/6316175 |
| Popis: | A 41-year-old man presented to our hospital with lower abdominal pain and a high-grade fever. Physical examination revealed rebound tenderness and guarding in the lower abdomen. Abdominal X-ray examination showed a radiopaque object in the right lower quadrant of the abdomen. Abdominal computed tomography (CT) demonstrated that the object had a strong artifact with over 10,000 Hounsfield units, as well as ascites around the terminal ileum. We diagnosed acute peritonitis with a suspicion of the perforation due to unknown foreign body and performed an emergency laparotomy. Operative findings showed a contained perforation of a phlegmonous appendicitis, and appendectomy was performed. The resected specimen demonstrated that the appendix contained a fecalith, and histopathological examination showed the crystal structure of barium sulfate in the lumen of the appendix. Unfortunately, we did not obtain the history of screening for gastric cancer using a barium examination one month prior to our appendectomy. Our experience demonstrates the importance of establishing a history of barium examinations of the gastrointestinal tract in a patient with a radiopaque object in the right lower quadrant of the abdomen for early diagnosis of barium appendicitis. Additionally, early diagnosis of barium appendicitis may affect the selection of surgical procedures. |
| Databáze: | Directory of Open Access Journals |
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