Acute appendicitis and situs viscerum inversus: radiological and surgical approach—a systematic review
Abstract Introduction Acute appendicitis is one of the most frequent intra-abdominal diseases requiring emergency surgical consult and treatment. The diagnosis of this condition is based on clinical features and radiologic findings. One-third of patients with acute appendicitis present unusual sympt...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-02-01
|
| Series: | European Journal of Medical Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40001-023-01059-w |
| _version_ | 1797865173974777856 |
|---|---|
| author | Giuseppe Di Buono Salvatore Buscemi Massimo Galia Elisa Maienza Giuseppe Amato Giulia Bonventre Roberta Vella Marta Saverino Emanuele Grassedonio Giorgio Romano Antonino Agrusa |
| author_facet | Giuseppe Di Buono Salvatore Buscemi Massimo Galia Elisa Maienza Giuseppe Amato Giulia Bonventre Roberta Vella Marta Saverino Emanuele Grassedonio Giorgio Romano Antonino Agrusa |
| author_sort | Giuseppe Di Buono |
| collection | DOAJ |
| description | Abstract Introduction Acute appendicitis is one of the most frequent intra-abdominal diseases requiring emergency surgical consult and treatment. The diagnosis of this condition is based on clinical features and radiologic findings. One-third of patients with acute appendicitis present unusual symptoms. There are several circumstances that may cause misdiagnosis and unclear prognostic prediction. Among these, situs viscerum inversus totalis and midgut malrotation can be challenging scenarios, leading to a delay in treatment, especially when these conditions are unknown. We decided to carry on a systematic review of published cases of acute appendicitis in the context of anatomical anomalies. Methods We used the MESH terms “appendicitis” AND “situs inversus” AND/OR “gut malrotation” to search for titles and abstracts. Inclusion criteria were patients with clinical and/or radiological diagnosis of acute appendicitis, with conservative or surgical management and with preoperative/intraoperative findings of situs viscerum inversus or gut malrotation. Additionally, previous reviews were examined. Exclusion criteria of the studies were insufficient patient clinical and demographic data. Results We included in this review 70 articles concerning 73 cases of acute appendicitis with anatomical anomaly. Patients were aged from 8 to 86 years (median: 27.0 years). 50 were male and 23 were female. 46 patients (63%) had situs viscerum inversus, 24 (33%) had midgut malrotation, 2 (2.7%) had Kartagener’s syndrome, one of them (1.4%) had an undetermined anomaly In 61 patients the anatomical anomaly was unknown previously (83.6%), while 16,4% already were aware of their condition. Conclusion Acute appendicitis can occur in association of rare anatomical anomalies and in these cases diagnosis can be challenging. Situs viscerum inversus and midgut malrotation should always be considered in the differential diagnosis of a patient with left lower quadrant pain, especially in younger population. Besides clinical features, it is fundamental to implement the diagnostic progress with radiological examination. Laparoscopic approach is useful to identify and treat acute surgical emergency and it is also a diagnostic tool and can be tailored in order to offer the best exposition of the operatory field for each single case. |
| first_indexed | 2024-04-09T23:04:52Z |
| format | Article |
| id | doaj.art-1e62a211cfd04c37acdfa67da6c46ddf |
| institution | Directory Open Access Journal |
| issn | 2047-783X |
| language | English |
| last_indexed | 2024-04-09T23:04:52Z |
| publishDate | 2023-02-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj.art-1e62a211cfd04c37acdfa67da6c46ddf2023-03-22T10:46:01ZengBMCEuropean Journal of Medical Research2047-783X2023-02-0128111110.1186/s40001-023-01059-wAcute appendicitis and situs viscerum inversus: radiological and surgical approach—a systematic reviewGiuseppe Di Buono0Salvatore Buscemi1Massimo Galia2Elisa Maienza3Giuseppe Amato4Giulia Bonventre5Roberta Vella6Marta Saverino7Emanuele Grassedonio8Giorgio Romano9Antonino Agrusa10Department of Surgical, Oncological and Oral Sciences, University of PalermoDepartment of Surgical, Oncological and Oral Sciences, University of PalermoDepartment of Radiology, University of PalermoDepartment of Surgical, Oncological and Oral Sciences, University of PalermoDepartment of Surgical, Oncological and Oral Sciences, University of PalermoDepartment of Surgical, Oncological and Oral Sciences, University of PalermoDepartment of Surgical, Oncological and Oral Sciences, University of PalermoDepartment of Surgical, Oncological and Oral Sciences, University of PalermoDepartment of Radiology, University of PalermoDepartment of Surgical, Oncological and Oral Sciences, University of PalermoDepartment of Surgical, Oncological and Oral Sciences, University of PalermoAbstract Introduction Acute appendicitis is one of the most frequent intra-abdominal diseases requiring emergency surgical consult and treatment. The diagnosis of this condition is based on clinical features and radiologic findings. One-third of patients with acute appendicitis present unusual symptoms. There are several circumstances that may cause misdiagnosis and unclear prognostic prediction. Among these, situs viscerum inversus totalis and midgut malrotation can be challenging scenarios, leading to a delay in treatment, especially when these conditions are unknown. We decided to carry on a systematic review of published cases of acute appendicitis in the context of anatomical anomalies. Methods We used the MESH terms “appendicitis” AND “situs inversus” AND/OR “gut malrotation” to search for titles and abstracts. Inclusion criteria were patients with clinical and/or radiological diagnosis of acute appendicitis, with conservative or surgical management and with preoperative/intraoperative findings of situs viscerum inversus or gut malrotation. Additionally, previous reviews were examined. Exclusion criteria of the studies were insufficient patient clinical and demographic data. Results We included in this review 70 articles concerning 73 cases of acute appendicitis with anatomical anomaly. Patients were aged from 8 to 86 years (median: 27.0 years). 50 were male and 23 were female. 46 patients (63%) had situs viscerum inversus, 24 (33%) had midgut malrotation, 2 (2.7%) had Kartagener’s syndrome, one of them (1.4%) had an undetermined anomaly In 61 patients the anatomical anomaly was unknown previously (83.6%), while 16,4% already were aware of their condition. Conclusion Acute appendicitis can occur in association of rare anatomical anomalies and in these cases diagnosis can be challenging. Situs viscerum inversus and midgut malrotation should always be considered in the differential diagnosis of a patient with left lower quadrant pain, especially in younger population. Besides clinical features, it is fundamental to implement the diagnostic progress with radiological examination. Laparoscopic approach is useful to identify and treat acute surgical emergency and it is also a diagnostic tool and can be tailored in order to offer the best exposition of the operatory field for each single case.https://doi.org/10.1186/s40001-023-01059-wAcute appendicitisSitus viscerum inversusMidgut malrotationKartagener syndromeLaparoscopic appendectomy |
| spellingShingle | Giuseppe Di Buono Salvatore Buscemi Massimo Galia Elisa Maienza Giuseppe Amato Giulia Bonventre Roberta Vella Marta Saverino Emanuele Grassedonio Giorgio Romano Antonino Agrusa Acute appendicitis and situs viscerum inversus: radiological and surgical approach—a systematic review European Journal of Medical Research Acute appendicitis Situs viscerum inversus Midgut malrotation Kartagener syndrome Laparoscopic appendectomy |
| title | Acute appendicitis and situs viscerum inversus: radiological and surgical approach—a systematic review |
| title_full | Acute appendicitis and situs viscerum inversus: radiological and surgical approach—a systematic review |
| title_fullStr | Acute appendicitis and situs viscerum inversus: radiological and surgical approach—a systematic review |
| title_full_unstemmed | Acute appendicitis and situs viscerum inversus: radiological and surgical approach—a systematic review |
| title_short | Acute appendicitis and situs viscerum inversus: radiological and surgical approach—a systematic review |
| title_sort | acute appendicitis and situs viscerum inversus radiological and surgical approach a systematic review |
| topic | Acute appendicitis Situs viscerum inversus Midgut malrotation Kartagener syndrome Laparoscopic appendectomy |
| url | https://doi.org/10.1186/s40001-023-01059-w |
| work_keys_str_mv | AT giuseppedibuono acuteappendicitisandsitusvisceruminversusradiologicalandsurgicalapproachasystematicreview AT salvatorebuscemi acuteappendicitisandsitusvisceruminversusradiologicalandsurgicalapproachasystematicreview AT massimogalia acuteappendicitisandsitusvisceruminversusradiologicalandsurgicalapproachasystematicreview AT elisamaienza acuteappendicitisandsitusvisceruminversusradiologicalandsurgicalapproachasystematicreview AT giuseppeamato acuteappendicitisandsitusvisceruminversusradiologicalandsurgicalapproachasystematicreview AT giuliabonventre acuteappendicitisandsitusvisceruminversusradiologicalandsurgicalapproachasystematicreview AT robertavella acuteappendicitisandsitusvisceruminversusradiologicalandsurgicalapproachasystematicreview AT martasaverino acuteappendicitisandsitusvisceruminversusradiologicalandsurgicalapproachasystematicreview AT emanuelegrassedonio acuteappendicitisandsitusvisceruminversusradiologicalandsurgicalapproachasystematicreview AT giorgioromano acuteappendicitisandsitusvisceruminversusradiologicalandsurgicalapproachasystematicreview AT antoninoagrusa acuteappendicitisandsitusvisceruminversusradiologicalandsurgicalapproachasystematicreview |