Faculty of Medicine

Permanent URI for this communityhttps://repository.ukim.mk/handle/20.500.12188/14

Browse

Settings

Language: search.filters.language.EnglishSubject: search.filters.subject.acute appendicitis

Search Results

Now showing 1 - 5 of 5
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    Amyand's hernia with gangrenous perforated appendicitis and diffuse peritonitis-case report
    (Oxford University Press (OUP), 2025-11)
    Gelevski, Radomir
    ;
    ;
    ;
    ;
    Manevska, Vesna Jovanovska
    Amyand's hernia, the presence of the vermiform appendix within an inguinal hernia sac, is a rare clinical entity (0.2%-1.7% of inguinal hernias). Acute appendicitis within the sac is rarer still, occurring in only 0.1% of cases. We describe a male patient presenting with an incarcerated right inguinal hernia, who developed diffuse peritonitis after manual reduction. Laparotomy revealed gangrenous perforated appendicitis with purulent peritonitis. Appendectomy, partial omentectomy, and peritoneal lavage were performed. The patient recovered uneventfully. Amyand's hernia complicated by perforated appendicitis is an exceptional surgical emergency. Early recognition and prompt surgical management are crucial for favorable outcomes.
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    INCIDENTAL HEMATOPERITONEUM IN LAPAROSCOPIC APPENDECTOMY IN PREGNANT PATIENT
    (Македонско лекарско друштво = Macedonian medical association/De Gruyter, 2025-04)
    ;
    Shurlani, Arben
    ;
    ;
    Ismaili, Bashkim
    ;
    Acute appendicitis is the most common non obstetric emergency in pregnant women and often associated with a late diagnosis and complications such as perforation and fetal loss. We present a case of a 25-year-old primigravida, with epigastric pain radiating to the lower right quadrant that appeared 12 hours before admission, nausea, vomiting, white tongue and foetor ex ore. The laboratory values: WBC 18.000, RBC 4.12, HCT 36.2, CRP 22. Ultrasound examination: fetal biometry corresponded to 7 gestational weeks, positive cardiac activity, a small amount of peritoneal fluid was present in the right paracolic, ileocecal region and in Douglas's space, thickening of the wall of appendix vermiformis, surrounding inflammation of fatty tissue. The patient was observed in the next 6 hours, pain persisted in the lower right quadrant with propagation to the left quadrant. An indication for laparoscopic intervention for acute appendicitis has been made. The patient was placed in the supine position with the first camera and extraction port supraumbilically (10 mm) and the second port (5 mm) suprapubically. On laparoscopic exploration, 200 ml of bloody content was found in the pelvis and the vermiform appendix with reactive changes in the middle part towards the apex. An infundibular paraovarian cyst with a diameter of 20 mm was present on the right fallopian tube. The right ovary was ruptured with bleeding on one side. A third port (5 mm) was placed left pararectally. Aspirated pelvic blood was sent in the laboratory for beta HCG determination and partial resection of the right ovary and appendectomy were performed. After lavage, a Redon drain was placed in the pelvis through the suprapubic port. Postoperative course was normal and the drain was removed on the second postoperative day. Gynecological ultrasound was performed on the third postoperative day, the findings were normal and patient was discharged home.
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    LAPAROSCOPIC AND OPEN APPENDECTOMY IN PEDIATRIC PATIENTS –OPERATIVE AND POSTOPERATIVE EXPERIENCE
    (2022-09)
    ;
    Rozeta Sokolova
    ;
    ;
    Risto Simeonov
    Objective: Acute appendicitis is very frequently encountered in children. Despite many scientific controversies in supporting classical or laparoscopic appendectomy, there is still no official consensus on this issue. This study aimed to present our experience from the comparison of operative and postoperative effects of laparoscopic and open appendectomy in pediatric patients with acute appendicitis. Materials and methods: The analytical cross-sectional study was conducted at the University Clinic for Pediatric Surgery, Ss. Cyril and Methodius University in Skopje, the Republic of N.Macedonia during the period 2015/2022. The study sample covered 184 hospitalized pediatric patients aged 4-14 years treated with laparoscopic (LA) or open appendectomy (OA). The data of interest included demographic characteristics, and selective operative and postoperative parameters. Results: The average age of the children in LA vs. OA group was 9.63±2.70 with min/max of 4/14 vs. 9.16±2.91 with min/max 2/14 respectively. Postoperative complications were detected in 1 (0.90%) of LA patients and 3 (4.11%) of OA patients with no significant association. Analgesics’ treatment received 57 (51.35%) of the children from LA group and all of the children from OA group. Conversion from LA to OA happen only in 1 (0.54%) child. The evaluation of parents/guardians related to the satisfaction from the cosmetic appearance of the scar the significantly higher level of satisfaction from the scare after LA compared to OA intervention. Conclusions: Laparoscopic appendectomy was found to be feasible and comparable to open approach in terms of operative time and offers advantages over the latter in terms of postoperative pain, length of hospital stay and earlier return of bowel function to normal. It is a safe approach in all types of appendicitis, with an overall better complication profile than OA.
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    CORRELATION OF SCORING SYSTEMS WITH HISTOPATHOLOGICAL FINDINGS AND THEIR IMPORTANCE IN REDUCING THE PERCENTAGE OF UNNECESSARY APPENDECTOMIES
    (Македонско лекарско друштво = Macedonian medical association, 2019)
    ;
    ;
    ;
    ;
    Markov, Petar
    Introduction. Acute appendicitis (AA) is one of the most common emergency surgical conditions, where emergency laparotomy is necessary. However, perforation rates and negative laparotomies during this procedure have not been reduced. The purpose of this paper was to evaluate the importance of the scoring systems in the differenttial diagnosis for setting an indication for appendectomy. Method. Prospective comparisons of the values of 4 scoring systems were performed among 60 patients: Alvarado, Appendicitis Inflammatory Response (AIR), Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) and Tzanakis. Values for the scores were determined in all patients treated with lower right quadrant (LRQ) abdominal pain, under a differential diagnosis of AA. After the appendectomy (open surgery or laparoscopic), a correlation was obtained between the histopathologic findings (HP) and the corresponding latent values. Results. In the study 63.33% of the patients were male. Distribution of patients according to the values of the three different systems (Alvarado, RIPASA and Tzanakis) showed that the largest number of patients had values higher than 8 and AIR values of 7- 8. In the study, 95% of the operated patients were positive for appendicitis compared to the histopathological finding. 80% of the surgeries included on-time appendectomy, 15% delayed diagnosis, and 5% were found to be with an unnecessary appendectomy. According to the HP findings of those with positive findings, 77.2% of the cases had appropriate preoperative ultrasonographic (US) diagnosis. A statistically significant association of the scores with HP findings (promptly phlegmonous, promptly gangrenous, late perforated and unnecessary) was found only for the Alvarado, AIR, Tzanakis, and no statistically significant association was found for the RIPASA score. Conclusion. Scoring systems are useful diagnostic tools for appendectomy indication. Using one or a combination of two or more scoring systems reduces the percentage of unnecessary appendectomies.
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    Acute appendicitis during the COVID-19 pandemic versus before pandemic period in Republic of North Macedonia
    (2022-10-13)
    ;
    ;
    Background: The Coronavirus Disease 2019 (COVID-19) pandemic has impacted the outcomes of acute appendicitis. Aim: The aim of the study was to compare the characteristics of acute appendicitis (AA) in children before and during the COVID-19 pandemic. Methods: A cross sectional study was conducted at the University Clinic for pediatric surgery in Skopje, Republic of North Macedonia, between January 2019 and September 2020. We elaborated children aged ≤14 years diagnosed with AA and treated at our clinic before / during COVID-19 period. The time from the first symptoms to hospitalization, incidence of complications, type of intervention, duration of hospital stay, and postoperative use of antibiotics were compared between the two groups. Results: A total of 328 children with appendectomies were included in the study – 197 (60,1%) before (Group 1) and 131 (39,9%) during COVID 19 pandemic (Group 2). No significant differences was found between the groups related to gender (p=0,341) and age (p=0,475). The time from the first symptoms to hospitalization (p=0,031), complications (p=0,044) and use of antibiotic treatment (p=0,028) were significantly associated with Group 2. No association between the groups and AA type of intervention was found (p=0,191). Conclusion: Even with lower incidence, appendectomies in children during Covid 19 pandemic had increased rate of complications, prolonged hospitalization, and higher antibiotic use. Reason for these findings is important to be investigating, as pandemic conditions should be taken into account in children health interventions.