Year: 2018
Type: article
Study design: Case Report
Abstract: A 24-year female patient presented to our hospital with complaints of pain in right lower abdomen (off/on), associated with vomiting for 3 days and moderate-to-high fever for 2 days.On initial workup, patient's leukocyte count was 15,000/mm 3 .Other routine biochemical and haematological tests were normal.On abdomen examination, there was rebound tenderness on right side of iliac fossa with rebound localised to Mc Burney's point.No past history of similar complaint.USG whole abdomen was suggestive of acute appendicitis.X-ray chest was normal.Working diagnosis of acute appendicitis was made and patient was taken for emergency appendectomy.On exploration through the gridiron incision the appendix wall was found to be thickened, enlarged, inflamed with adhesions in the periappendicular tissues and a tubercle was found only over appendix.Base was healthy, no free fluid. 1 No palpable pathology was detected in the ileocaecal region and mesentery.Appendix along with lymph node was sent for histopathological examination.Gross examination revealed appendix to be about 8 cm in length.On microscopic examination underlying stroma shows ill-formed granulomas comprising of epithelioid cells with peripheral rim of lymphocytes and plasma cells.Also seen are giant cells of Langhan's type with multiple nuclei arranged in a horse shoe arrangement and eosinophilic cytoplasm.Periappendicular region did not show any tubercular lesion.Postoperative period was uneventful and AFB for sputum was negative and X-ray spine and both hip joints were normal that ruled out primary focus.
Authors: Anjani Kumar Tripathi, Osman Musa, Mamta Dwivedi, Namrata Mishra
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W2905123734