Kikuchi-Fujimoto Disease (KFD) is a self-limiting necrotizing lymphadenitis that usually presents with fever and cervical lymphadenopathy. Recognition of this condition is crucial, because it can be mistaken for tuberculosis, lymphoma and connective tissue disorders. When present at an unusual location the diagnosis can be challenging. We present an unusual case of Kikuchi-Fujimoto disease involving mesenteric lymph node masquerading as acute appendicitis along with its differential diagnosis. A 30-year-old female presented with complaints of acute abdominal pain, vomiting and fever. Physical examination revealed rebound tenderness in the right iliac fossa. The abdominal sonography was suspicious of acute appendicitis. The patient underwent appendectomy with excision of an enlarged mesenteric lymph node. On histopathology mesenteric node showed features of KFD which was confirmed on immunohistochemistry. Appendix was unremarkable. Although rare KFD should be added to the differential diagnosis of acute appendicitis in patients with enlarged mesenteric lymph nodes, Awareness of this disorder helps to prevent misdiagnosis and inappropriate treatment.
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http://dx.doi.org/10.7860/JCDR/2017/27733.10142 | DOI Listing |
Sisli Etfal Hastan Tip Bul
December 2024
Department of General Surgery, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.
Pheochromocytoma is a rare tumor originating from the adrenal gland, characterized by the secretion of catecholamines. Due to the risk of hypertensive crises associated with catecholamine release, surgical procedures in pheochromocytoma patients are risky. In this case report, laparoscopic appendectomy for acute appendicitis in a patient who has pheochromocytoma will be presented.
View Article and Find Full Text PDFCureus
December 2024
Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, USA.
Background: Acute appendicitis is one of the most common causes of an acute abdomen among pediatric patients. The diagnosis of appendicitis is challenging due to the nonspecific presentation. Diagnosis is based on historical, physical, and serologic information as well as right lower quadrant ultrasound (RLQ US).
View Article and Find Full Text PDFAcad Emerg Med
January 2025
Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas, USA.
Objectives: We applied three electronic triggers to study frequency and contributory factors of missed opportunities for improving diagnosis (MOIDs) in pediatric emergency departments (EDs): return visits within 10 days resulting in admission (Trigger 1), care escalation within 24 h of ED presentation (Trigger 2), and death within 24 h of ED visit (Trigger 3).
Methods: We created an electronic query and reporting template for the triggers and applied them to electronic health record systems of five pediatric EDs for visits from 2019. Clinician reviewers manually screened identified charts and initially categorized them as "unlikely for MOIDs" or "unable to rule out MOIDs" without a detailed chart review.
Hosp Pediatr
January 2025
Department of Pediatrics, Children's Hospital at Montefiore, Bronx, New York.
Background/objectives: Limited data exist on the role neighborhood-level social determinants of health (SDOH) play in health care utilization in pediatric patients with common, nonelective surgical conditions. We aimed to test the hypothesis that lower neighborhood-level SDOH are associated with increased health care utilization in pediatric acute uncomplicated appendicitis (AUA) before and during the COVID-19 pandemic.
Methods: This retrospective cohort study included patients aged younger than 19 years, hospitalized through emergency departments, and diagnosed with AUA.
Pediatr Surg Int
January 2025
Department of Paediatric Surgery, Children's Health Ireland at Crumlin, Dublin, Ireland.
Background: Appendicectomy is a common procedure in children. Regional anaesthesia helps reduce requirements for opioids and hospital stay and enhances recovery. Laparoscopic-assisted Transversus Abdominus Plane block (L-TAP) was shown to be efficient and potentially superior to port site infiltration (PSI); however, this was not previously studied in paediatric appendicitis.
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