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Introduction. Amyand’s hernia is a condition in which the cecal appendix is contained within the inguinal hernia sac, its diagnosis and management continue to be a challenge as it is a rare pathology. Case report. A 10-month-old male infant with a history of extreme prematurity presented a right Amyand’s hernia and a normal appendix. The appendix was returned to the cavity and the hernia was repaired. Result. After one year of follow-up, the patient had no complications. Conclusions. Has been reported that the risk of incarceration in full-term children is 12% and in premature babies it is 39%, therefore, surgical repair of an inguinal hernia is always necessary. There is no standard treatment for Amyand hernia in children, therefore the CiX classification could be considered for management. A treatment proposal is presented in the pediatric population, where three types were included, considering the evolutionary stage of the cecal appendix and that almost all inguinal hernias in children are due to persistence of the vaginal process; therefore, surgical treatment only includes herniotomy. By not using prosthetic material, handling is facilitated and the risk of infection is reduced. [ABSTRACT FROM AUTHOR]

Resumen: El mucocele apendicular es una entidad patológica rara, pero potencialmente peligrosa, se presenta en diferentes formas clínicas. Presentamos el caso de un paciente de 47 años, sin antecedentes particulares, que consulta por dolor crónico en fosa ilíaca derecha y cuya tomografía computarizada abdomino-pélvica muestra una masa quística del apéndice que evoca un mucocele apendicular. El paciente se sometió a una apendicectomía. El análisis histológico de este confirmó el diagnóstico de mucocele apendicular sin células malignas. El seguimiento postoperatorio fue sencillo. Abstract: Appendiceal mucocele is a rare pathological entity, but potentially dangerous, it presents in different clinical forms. We present the case of a 47-year-old patient, with no particular history, who consulted for chronic pain in the right iliac fossa and whose abdominal-pelvic computed tomography showed a cystic mass in the appendix that evokes an appendiceal mucocele. The patient underwent an appendectomy. Histological analysis of this confirmed the diagnosis of appendiceal mucocele without malignant cells. Postoperative follow-up was easy.

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Introduction: Mucinous neoplasms of the cecal appendix are infrequent. These lesions can be an incidental finding in emergency appendectomies, since their preoperative diagnosis is difficult due to the lack of specificity of their symptoms. Objective: To present a case of low-grade mucinous neoplasia of the cecal appendix. Case Report: A 73-year-old male patient presented with acute abdominal pain, vital signs and laboratory tests within normal limits, and ultrasonography showing a cecal appendix measuring 76 x 67 x 107 mm. Radical appendectomy was performed, which included resection of the mesoappendix from the appendicular artery, the antimesenteric border of the ligament of Tréves and the free appendicular base, which included the cecum (cecectomy). In the histopathological examination it was observed that the cecal appendix belonged to 10 x 8 x 5 cm with tumor lesion in the base and part of the body; the cut showed outflow of viscous, mucoid, yellowish material, cystic areas of less than 1 cm, congestive vessels, presence of mucous glands with cells showing scarce atypia and an expansive invasion affecting the muscular and mucosal layer with focal loss and slight fibrosis of the submucosa. Low grade cecal appendiceal mucinous neoplasia of the appendix was diagnosed, with resolution and satisfactory evolution of the patient. Conclusions: Mucinous neoplasms of the cecal appendix may be an incidental finding. They have non-specific symptoms, are largely treated by resection and histopathological study is necessary for their diagnosis.

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El tumor apendicular es raro, normalmente se descubre durante una apendicectomía. Este es el caso de un varón de 21 años que ingresa por dolor abdominal, acompañado de vómitos, alza térmica y pérdida de peso. En paraclínicos hematocrito: 30,7%, hemoglobina: 10,1g/dl. Evaluado por Cirugía General, intervienen por cuadro de apendicitis aguda; los hallazgos quirúrgicos son lesiones granulomatosas, apéndice congestivo con tumoración. Se toma biopsia que revela neoplasia epitelial maligna consistente con adenocarcinoma

Relato de caso de 18 de Outubro de 1948, que passamos a relatar. L. P. C., 37 anos, preto, casado, registrado no S. N. de Câncer sob o número 12.390. Internado na data acima referida, com o diagnóstico de: “Brida. cicatricial post-operâtória (apendicectomia), com sindrome de sub-oclusão intermitente”. O doente nos foi encaminhado pelo seu médico clinico Dr. Granadeiro Neto, nosso particular amigo e cujo diagnóstico foi perfeitamente aceito por todos nós do Serviço.

Introduction: Primary lymphoma of the appendix occurs in 0.015% of all malignant neoplasms of the appendix. The most frequent clinical manifestation is acute appendicitis, and pathological analysis is very important. Case report: Primary lymphoma of the cecal appendix, a 38-year-old man was admitted with acute appendicitis. Macroscopic histopathological study shows diffusely thickened white appendage wall. Microscopically: high-grade Burkitt lymphoma, ACL, CD20, CD10 positive, KI 67 positive 95%, CD3, BCL2, EBV negative. Postoperative: thoracic abdominal tomography showed a tumor in the right iliac fossa without lesions or adenopathies in the abdomen and thorax. The patient was treated with two courses of chemotherapy and a control abdominal CT was performed at 6 months, which showed the initial tumor. At 6 months the patient is stable and controlled. Conclusion: The value of the histopathological study in cecal appendages is emphasized in the presence of primary cecal lymphomas. [ABSTRACT FROM AUTHOR]

Introducción. El dolor abdominal agudo es una causa frecuente de consulta en los servicios de urgencias. Su incidencia es alrededor del 5%, de los cuales el 10%-25% de los pacientes requieren tratamiento quirúrgico. Las neoplasias apendiculares primarias son infrecuentes, actualmente representan 1% de las neoplasias malignas de origen gastrointestinal. Existe un predominio en mujeres y se debe sospechar en pacientes con factores de riesgo. El objetivo es entender la importancia del diagnóstico oportuno en el abordaje del paciente con dolor abdominal agudo. Presentación del caso. Mujer con cuadro clínico de 5 días de dolor abdominal, con hallazgo en tomografía de abdomen de marcada dilatación quística del apéndice cecal con calcificaciones lineales y nodulares en la pared y su interior. Intraoperariamente, se realizó hemicolectomía derecha con resultado histológico de neoplasia mucinosa del apéndice (adenoma serrado) con pérdida de la muscularis mucosae, catalogándolo como adenocarcinoma de bajo grado. Discusión. Los tumores apendiculares representan el 1% de las neoplasias malignas de origen gastrointestinal, son un hallazgo incidental (0.7-1.4%) en los procedimientos de apendicectomía. El diagnóstico es histopatológico y el pronóstico se relaciona con la clasificación. Es importante conocer, identificar y sospechar esta patología dada su infrecuencia, con lo cual se puede mejorar el pronóstico en los pacientes. Conclusión. Los tumores apendiculares son infrecuentes, los cuales deben ser incluidos en el grupo de patologías causantes de dolor abdominal agudo. Introduction. Acute abdominal pain is a frequent cause of consultation to emergency services. Its incidence is about 5%, of which 10%-25% of patients require surgical treatment. Primary appendiceal neoplasms are infrequent. They currently represent 1% of malignant neoplasms of gastrointestinal origin. They are predominant in women and must be suspected in patients with risk factors. The objective is to understand the importance of timely diagnosis in approaching patients with acute abdominal pain. Case report. A woman with clinical condition of 5 days of abdominal pain. Marked cystic dilation of the cecal appendix with linear and nodular calcifications on its wall and interior found in a tomography of the abdomen. Intraoperatively, a right hemicolectomy was performed with a histological result of mucinous neoplasm of the appendix (serrated adenoma) with loss of the muscularis mucosae, classifying it as a low grade adenocarcinoma. Discussion. Appendiceal tumors represent 1% of malignant neoplasms of gastrointestinal origin, with an incidental finding (0.7-1.4%) in appendectomy procedures. The diagnosis is histopathological, and prognosis is related to its classification. It is important to know, identify and suspect this pathology due to its infrequency, which can improve the patient’s prognosis. Conclusion. Appendiceal tumors are infrequent and should be included in the group of pathologies that cause acute abdominal pain. Introdução. A dor abdominal aguda é causa frequente de consulta nos serviços de emergência. Sua incidência é em torno de 5%, dos quais entre 10% e 25% dos pacientes necessitam de tratamento cirúrgico. As neoplasias primárias de apêndice são raras, representando atualmente 1% das neoplasias malignas de origem gastrointestinal. Há predominância em mulheres e deve-se suspeitar em pacientes com fatores de risco. O objetivo é compreender a importância do diagnóstico oportuno na abordagem de pacientes com dor abdominal aguda. Relato de caso. Mulher com quadro clínico de dor abdominal por 5 dias, com achado tomográfico de abdome de dilatação cística acentuada do apêndice cecal com calcificações lineares e nodulares na parede e seu interior. No intraoperatório foi realizada hemicolectomia direita com resultado histológico de neoplasia mucinosa de apêndice (adenoma serrilhado) com perda da muscularis mucosae, classificando-a como adenocarcinoma de baixo grau. Discussão. Os tumores apendiculares representam 1% das neoplasias malignas de origem gastrointestinal, sendo um achado incidental (0.7-1.4%) em procedimentos de apendicectomia. O diagnóstico é histopatológico e o prognóstico está relacionado à classificação. É importante conhecer, identificar e suspeitar desta patologia dada a sua infrequência, o que pode melhorar o prognóstico dos pacientes. Conclusão. Os tumores apendiculares são pouco frequentes e devem ser incluídos no grupo de patologias que causam dor abdominal aguda.

In this paper I reflect on the odds and ends of research – that is to say, the fragments of notes, the miscellanea of drafts, the offcuts of applications, the keepsakes of fieldwork; in short, the archival remains of unfinished research. Through a discussion of failure, loss, the incomplete, and the abandoned, the paper poses questions about the threshold of endings. At what point does something fall by the wayside, never to be returned to? More pragmatically, what might we do with our "loss libraries"? And how might we pick up or return to those concepts, field-sites, or collaborators that we once shared, however temporarily, a trajectory with? [ABSTRACT FROM AUTHOR]

Introduction: Abdominal pain is one of the most frequent reasons for consultation in the emergency services, its adequate diagnostic approach determines the treatment to be chosen by the doctor in charge of the case; This in turn can opt for medical or surgical management, all this if the underlying cause of the symptoms presented by the patient is considered. Clinical case: This article presents the case of a male patient in the fifth decade of life, with a surgical history of appendectomy, which he consults due to a clinical picture of intense abdominal pain located in the right iliac fossa. In the physical examination, the presence of signs of peritoneal irritation was striking, for which serological studies were requested, which were found to be within normal parameters, in addition to a computed tomography of the abdomen that revealed trabeculation of pericecal fat. The patient persisted with symptoms, so he was taken for open abdominal cavity exploration, with an intraoperative finding of acute appendagitis. Conclusion: Despite being an infrequent cause of acute surgical abdomen, acute appendagitis should always be a diagnosis to be considered by emergency physicians and surgeons. The availability of imaging studies that allow an adequate characterization of the clinical picture is going to be essential for the management of patients, especially if the whole variety of entities that occur in the abdominal cavity are taken into account. [ABSTRACT FROM AUTHOR]

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Mucoceles of the appendix are rare, predominate in women and usually present as a palpable mass in the right lower quadrant. Most patients are asymptomatic. The mucocele is defined as a cystic dilatation of the appendicular lumen caused by mucin accumulation. We present the case of a male patient in his seventh decade with clinical symptoms of acute abdomen with suspicion of acute appendicitis, laparoscopic hemicolectomy surgery was performed after finding findings of tumor dependent on ascending colon (blind region), indurated 80 × 100 mm approximately, performing right hemicolectomy plus ileocolonic lateroterminal anastomosis with adequate postoperative evolution. [ABSTRACT FROM AUTHOR]

Introducción. El apéndice cecal invertido, inversión apendicular o intususcepción apendicular, corresponde a una condición anatómica descrita en 1859. La primera operación de invaginación apendicular se realizó en 1890, y desde entonces se han descrito diferentes técnicas quirúrgicas y endoscópicas para el tratamiento de esta alteración. Casos clínicos. Se presentan dos casos de pacientes a quienes se les indicó colonoscopia como parte de estudio de dolor abdominal y diarrea y se identificó una intususcepción apendicular completa y apendicitis y una inversión del muñón apendicular. Resultados. Mediante la colonoscopia se hizo el diagnóstico de apendicitis aguda en una de las pacientes, quien presentaba inversión apendicular completa tipo 5, que fue tratada con manejo farmacológico y seguimiento clínico. En la otra paciente hubo un hallazgo incidental de inversión del muñón apendicular tipo 3. Conclusiones. Durante la realización de estudios colonoscópicos, se debe tener en cuenta el diagnóstico de intususcepción apendicular o apéndice invertido, para evitar intervenciones erróneas, como polipectomías, que generen riesgo potencial en los pacientes.

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Copyright of Gaceta Médica de Caracas is the property of Academia Nacional de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction. Acute abdominal pain is a frequent cause of consultation to emergency services. Its incidence is about 5%, of which 10%-25% of patients require surgical treatment. Primary appendiceal neoplasms are infrequent. They currently represent 1% of malignant neoplasms of gastrointestinal origin. They are predominant in women and must be suspected in patients with risk factors. The objective is to understand the importance of timely diagnosis in approaching patients with acute abdominal pain. Case report. A woman with clinical condition of 5 days of abdominal pain. Marked cystic dilation of the cecal appendix with linear and nodular calcifications on its wall and interior found in a tomography of the abdomen. Intraoperatively, a right hemicolectomy was performed with a histological result of mucinous neoplasm of the appendix (serrated adenoma) with loss of the muscularis mucosae, classifying it as a low grade adenocarcinoma. Discussion. Appendiceal tumors represent 1% of malignant neoplasms of gastrointestinal origin, with an incidental finding (0.7-1.4%) in appendectomy procedures. The diagnosis is histopathological, and prognosis is related to its classification. It is important to know, identify and suspect this pathology due to its infrequency, which can improve the patient's prognosis. Conclusion. Appendiceal tumors are infrequent and should be included in the group of pathologies that cause acute abdominal pain. [ABSTRACT FROM AUTHOR]

Introducción: se describe el caso de una paciente con una metástasis apendicular como primera manifestación encontrada de un colangiocarcinoma. Síntomas principales: expresado con dolor abdominal, ictericia, hiporexia y coluria. Métodos y resultados: se documentó un plastrón apendicular histológicamente compatible con adenocarcinoma apendicular metastásico, estrechez del conducto hepático común, con alta sospecha de colangiocarcinoma, corroborado luego con la realización de una colangiopancreatografía retrógrada endoscópica. Conclusiones: los tumores apendiculares metastásicos son una presentación infrecuente y poco estudiada, donde los secundarios a neoplasia de vía biliar se han reportados de forma muy escasa en la literatura.

Introduction: We describe the case of a patient with appendiceal metastasis as the first manifestation of a cholangiocarcinoma. Main symptoms: Abdominal pain, jaundice, hyporexia, and choluria. Methods and results: We documented an appendiceal plastron histologically compatible with metastatic appendiceal adenocarcinoma, common hepatic duct stricture, and a suspected cholangiocarcinoma, later corroborated by endoscopic retrograde cholangiopancreatography. Conclusions: Metastatic appendiceal tumors are an infrequent and poorly studied manifestation, whereas those secondary to bile duct neoplasia have rarely been reported in the literature. [ABSTRACT FROM AUTHOR]

Introducción: El mucocele es una dilatación apendicular por secreción mucosa secundaria a la obstrucción de la luz, su incidencia estimada es de 0,2-0,3 % de todas las apendicectomías realizadas y el 8-10 % de todos los tumores apendiculares. Objetivo: Presentar un caso inusual de cirugía de urgencia, con dolor abdominal en fosa ilíaca derecha, sugestivo de apendicitis aguda operado en el servicio de urgencia. Caso clínico: Paciente femenina de 32 años de edad, que consulta por dolor abdominal en fosa ilíaca derecha asociado a náuseas, con dolor a la palpación en dicha zona, defensa muscular y dolor a la descompresión brusca del abdomen, fue intervenida quirúrgicamente con el diagnóstico presuntivo apendicitis aguda. Se encuentra durante videolaparoscopia al apéndice cecal aumentado de tamaño, sin compromiso de su base, por lo cual se decide realizar laparotomía y apendicectomía convencional. La paciente fue egresada a las 48 horas de operada con evolución favorable y pendiente de resultado anatomopatológico, el cual informó mucocele apendicular. Conclusiones: El mucocele apendicular es una entidad poco frecuente, que predomina en el sexo femenino y edades entre 50 y 60 años. El tratamiento de elección es el quirúrgico.

Presentado en sesión de 5 de agosto de 1953

Presentado en sesión de 12 de noviembre de 1952

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Se revisaron 399 casos con diagnóstico de apendicitis aguda tratados en el Centro Médico de los Andes durante un período de 4.1 años; se analizaron mediante un programa de computador; se establece la distribución por edades, siendo más frecuente entre la segunda y tercera décadas de la vida. Para el diagnóstico, se relieva nuevamente la utilidad del cuadro hemático con presencia de leucocitosis. Se estudia el valor relativo de las imágenes diagnósticas. Se comprueba la importancia del uso de antibióticos profilácticos demostrada por la baja incidencia de infección de la herida quirúrgica. Se analizan los cultivos obtenidos y se establece el tipo de flora predominante. El porcentaje de apéndices sanos es del 6.9% de acuerdo con la literatura médica mundial.

Introducción: la causa de dolor abdominal mayormente relacionada a cirugía es la apendicitis; su diagnóstico se ve afectado por las variaciones anatómicas del apéndice vermiforme, debido a que es el órgano abdominal con mayores variaciones en cuanto a su posición y relación con otros órganos. Objetivo: determinar las características del apéndice cecal normal en tomografías computarizadas, incluidas la longitud, el diámetro, el grosor de la pared, y la ubicación de la base y de la punta apendicular. Métodos: se estudiaron tomografías computarizadas abdominales con imágenes del protocolo de exploración UroCT para identificar la localización de la base y la punta, y medir longitud, ancho y diámetro del apéndice cecal. La ubicación de la punta se categorizó como anterior o posterior y se subdividió en: pélvica, retrocecal/retrocólica, postileal, paracólica, subcecal, subhepática o línea media. La localización de la base apendicular se definió en tres planos en relación con la válvula ileocecal: antero-posterior, medial-lateral o superior-inferior. Resultados: fueron incluidas tomografías abdominales de 83 pacientes en las que se determinaron las características generales del apéndice cecal: se observó una longitud media de 78 mm (DE = 23,41) y diámetro medio de 6,55 mm (DE= 1,77). Las bases tuvieron con mayor frecuencia una localización inferior posterior, lateral y medial a la válvula ileocecal, las puntas estuvieron más frecuentemente localizadas en la cavidad pélvica, seguidas de localizaciones retrocecal y paracecal. Conclusión: la localización de la base del apéndice se correlaciona con lo descrito en estudios previos. No existe correlación entre la ubicación de la punta y la longitud del apéndice, esto significa que, incluso si el apéndice es largo, no se asocia con una ubicación de la punta más alejada de la válvula ileocecal.

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Presentado en sesión de 12 de setiebre de 1962

Presentado en sesión de 7 de abril de 1943

Los carcinoides son tumores neuroendocrinos de baja incidencia en la población general. Los tumores carcinoides apendiculares pueden presentarse de manera asintomática, los cuales se descubren en las biopsias de las piezas operatorias de apendicectomías. En otros casos la manifestación habitual de estos tumores es el proceso inflamatorio agudo del apéndice cecal, razón por la cual el diagnóstico definitivo se conoce solo con el informe histopatológico. Se presenta el caso de tumor carcinoide del cuerpo apendicular diagnosticado en una adolescente de 15 años intervenida quirúrgicamente por sospecha de apendicitis aguda. El interés por presentar el caso radica en su aparición poco frecuente en la adolescencia así como su localización en cuerpo o tercio medio del órgano.

Aim. Our objective was to demonstrate the impact of appendix removal on the obstetric outcome of the next pregnancy. Materials and method. A questionnaire for the survey of the impact of appendix removal on the obstetric outcome of subsequent pregnancy was applied in 52 and 79 women, who were the study and the control cases, respectively. Prepregnancy complaints, such as pelvic or abdominal discomfort and back pain, were recorded together with the pregnancy outcome, delivery findings and the maternal risk factors for adverse gestational outcome. Results. The rate of pelvic complaints was 67.3% (35/52) and 32.9% (26/79) in patients who were appendectomized or not, respectively. The gestational week at delivery and birth weight were lower in the patients who were appendectomized (p=0.240; p=0.003). The patients with an interval less than two years between appendix removal and pregnancy had lower birth weight and gestational week at delivery compared to the remainders (p=0.003; p=0.068). Moreover, patients who experienced pelvic complaints had lower birth weight and gestational week at delivery compared to the ones who did not experience pelvic complaint, despite the lack of statistical significance (p=0.238; p=0.238). Additionally, further analysis regarding the autoimmune diseases revealed that the rates of autoimmune diseases were 2.5% (2/79) and 32.6% (17/52) in patients without a history of appendectomy and in those with appendix removal, respectively. Conclusions. The long-term complications of appendix removal, such as adhesions and peritoneal irritations, must be considered, especially in the antenatal care of the next pregnancies. Appendectomized pregnancies should be evaluated for the presence of immune system problems. [ABSTRACT FROM AUTHOR]

La hernia de Amyand constituye un raro tipo de herniación inguinal en la que su contenido es el apéndice vermiforme, siendo infrecuente encontrarnos con un apéndice inflamado en el interior del saco herniario, y excepcional realizar su diagnóstico preoperatorio, siendo pocos los casos descritos en la literatura. Dada la rareza del cuadro y la escasa bibliografía médica existente, resulta complicado unificar criterios sobre el manejo óptimo de esta patología. A pesar de esto, consideramos que la mejor opción es la reducción del apéndice al interior de la cavidad abdominal sin exéresis de este en los casos en los que no exista cuadro de apendicitis concomitante, junto con una reparación del defecto herniario según las técnicas habituales. Presentamos un caso de paciente de sexo masculino de 40 años de edad, sin patología de base, con diagnostico intraoperatorio de hernia de amyand, cuya resolución quirrugica fue reducción del apéndice a cavidad adbominal y correcion del defecto herniario con malla protésica.

Los tumores del apéndice cecal constituyen un grupo heterogéneo de neoplasias con evolución y pronóstico variables; representan una pequeña parte de todas las neoplasias gastrointestinales y de las apendicetomías. Se presenta el caso de un hombre blanco, de 55 años de edad, que ingresó en el Servicio de Cirugía por presentar un cuadro abdominal agudo, interpretado como una apendicitis aguda. Al realizar apendicectomía se obtuvo como resultado un tumor carcinoide tipo clásico (insular) del apéndice cecal, sin que se sospechara de este diagnóstico con anterioridad. Se decidió presentar este caso, debido a la poca frecuencia de su aparición. Se concluye que es importante en estos casos el estudio histopatológico, ya que, incluso en el transoperatorio, es muy difícil sospechar esta entidad, lo que conlleva al diagnóstico tardío y a un peor pronóstico.

Los casos de apendicitis aguda debida a cuerpos extraños es una condición muy rara, con una prevalencia de 0,0005 %, en la cual se observa un papel crucial de la obstrucción de la luz apendicular en el inicio de sintoma- tología. La mayoría de los cuerpos extraños que se ingieren son expulsados sin complicaciones y sin necesidad de intervención quirúrgica, observándose perforaciones en menos del 1 %. Se presenta el caso de un hombre de 25 años de edad con un cuadro clínico de apendicitis aguda que necesitaba de intervención quirúrgica, en la que se halló un cuerpo extraño (gancho ‘nodriza’), con perforación proximal apendicular y peritonitis localizada. Fecha de recibido: 12/04/2018 - Fecha aceptación: 29/06/2018

Objective: To evaluate the correlation of morphological criteria of the cecal appendix using computed tomography (CT) and the possible risk of developing acute appendicitis. Materials and Methods: Cases were defined as patients with surgically confirmed acute appendicitis who had undergone CT at least twice: at diagnosis and at least one month prior. Controls were defined as emergency patients with abdominal pain who had undergone abdominal CT that excluded acute appendicitis and had also undergone CT at least one month before. Results: 100 cases and 100 controls were selected for inclusion in the final analysis. Comparisons between the cases and controls revealed the following: mean transverse diameter of 0.6 cm (range, 0.4-1.0 cm) versus 0.6 cm (range, 0.6-0.8 cm; p = 0.37); mean length of 6.6 cm (range, 3.5-9.7 cm) versus 6.6 cm (range, 4.5-8.3 cm; p = 0.87); mean angle of 100° (range, 23-178°) versus 86° (range, 43-160°; p = 0.01); vertical descending orientation in 56% versus 45% (p = 0.2); absence of gas in 69% versus 77% (p = 0.34); and presence of an appendicolith in 17% versus 8% (p = 0.08). Conclusion: Hypothetical risk factors for obstruction of the vermiform appendix detected on CT were not associated with acute appendicitis. That suggests that factors other than those related to mechanical obstruction are implicated in the pathogenesis of acute appendicitis. [ABSTRACT FROM AUTHOR]

The appendicular tumors have a low incidence ranging between 0.2% and 0.5% of all gastrointestinal malignancies. The appendicular neuroma is a benign tumor that is characterized to be a secondary fusocelular reparative process to ulcer and inflammation of the mucosa and pathogenetically similar to neural repairs observed in other parts of the digestive system. A male patient of 21 years old with an appendicular neuroma who was operated on and evolved without complications.

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A patient of 49 years old of white skin is presented with a history of presenting a mass at the level of the umbilical region that spontaneously reduced by adopting the supine decubitus position; in recent weeks, this mass was irreducible and was accompanied by abdominal discomfort. Days before admission the abdominal pain became more intense and radiated the hypogastrium and both iliac fossa and was accompanied by vomiting, so he went to the guard department and was taken to the surgical room with the diagnosis of jammed umbilical hernia. In the surgery an output of content turbid was detected by the hernial orifice, cavity was explored and agrossly enlarged toward its tip with Appendiceal inflammatory reaction is found; the pathology report informed cecal appendix mucocele.

El cáncer de apéndice es una entidad patológica poco común, donde la mayoría de diagnósticos se derivan de un hallazgo incidental post apendectomías. Debido a ser poco conocida, el tratamiento prevalece controversial. Desde el año 2000 se ha visto un aumento de la incidencia, por lo cual es una patología de importancia para estudio según tendencias de su comporta-miento.

Primary adenocarcinoma of the vermiform appendix is the least common carcinoma of this organ; its exact frequency is unknown. Primary malignant tumors of the appendix are rare; they are generally found in 1 to 2% of all appendices examined. Most appendiceal malignancies arise from a primary tumor in the adjacent organs, and in some cases, may be metastases from distant tumors. The case of a 43-year-old patient with a history of emergency surgery who was presumptively diagnosed with acute appendicitis is presented. The presence of an adenocarcinoma at the base of the appendix was reported by the pathology department. Because of the rarity of the condition, the publication of this case is considered scientifically important.