Delayed Awareness of the History of Barium Examination: Perforated Barium Appendicitis
A 41-year-old man presented to our hospital with lower abdominal pain and a high-grade fever. Physical examination revealed rebound tenderness and guarding in the lower abdomen. Abdominal X-ray examination showed a radiopaque object in the right lower quadrant of the abdomen. Abdominal computed tomo...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Case Reports in Gastrointestinal Medicine |
| Online Access: | http://dx.doi.org/10.1155/2017/6316175 |
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| author | Susumu Saigusa Masaki Ohi Satoshi Oki Takashi Ichikawa Minako Kobayashi Yasuhiro Inoue Chikao Miki |
| author_facet | Susumu Saigusa Masaki Ohi Satoshi Oki Takashi Ichikawa Minako Kobayashi Yasuhiro Inoue Chikao Miki |
| author_sort | Susumu Saigusa |
| collection | DOAJ |
| description | A 41-year-old man presented to our hospital with lower abdominal pain and a high-grade fever. Physical examination revealed rebound tenderness and guarding in the lower abdomen. Abdominal X-ray examination showed a radiopaque object in the right lower quadrant of the abdomen. Abdominal computed tomography (CT) demonstrated that the object had a strong artifact with over 10,000 Hounsfield units, as well as ascites around the terminal ileum. We diagnosed acute peritonitis with a suspicion of the perforation due to unknown foreign body and performed an emergency laparotomy. Operative findings showed a contained perforation of a phlegmonous appendicitis, and appendectomy was performed. The resected specimen demonstrated that the appendix contained a fecalith, and histopathological examination showed the crystal structure of barium sulfate in the lumen of the appendix. Unfortunately, we did not obtain the history of screening for gastric cancer using a barium examination one month prior to our appendectomy. Our experience demonstrates the importance of establishing a history of barium examinations of the gastrointestinal tract in a patient with a radiopaque object in the right lower quadrant of the abdomen for early diagnosis of barium appendicitis. Additionally, early diagnosis of barium appendicitis may affect the selection of surgical procedures. |
| format | Article |
| id | doaj-art-da71d2498ad04a4aa1e9d092acff9863 |
| institution | Kabale University |
| issn | 2090-6528 2090-6536 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Gastrointestinal Medicine |
| spelling | doaj-art-da71d2498ad04a4aa1e9d092acff98632025-02-03T01:31:00ZengWileyCase Reports in Gastrointestinal Medicine2090-65282090-65362017-01-01201710.1155/2017/63161756316175Delayed Awareness of the History of Barium Examination: Perforated Barium AppendicitisSusumu Saigusa0Masaki Ohi1Satoshi Oki2Takashi Ichikawa3Minako Kobayashi4Yasuhiro Inoue5Chikao Miki6Department of Surgery, Iga City General Hospital, 831 Shijuku-cho, Iga, Mie 518-0823, JapanDepartment of Gastrointestinal and Pediatric Surgery, Mie University Hospital, 2-174 Edobashi, Tsu, Mie 514-8507, JapanDepartment of Gastrointestinal and Pediatric Surgery, Mie University Hospital, 2-174 Edobashi, Tsu, Mie 514-8507, JapanDepartment of Gastrointestinal and Pediatric Surgery, Mie University Hospital, 2-174 Edobashi, Tsu, Mie 514-8507, JapanDepartment of Gastrointestinal and Pediatric Surgery, Mie University Hospital, 2-174 Edobashi, Tsu, Mie 514-8507, JapanDepartment of Gastrointestinal and Pediatric Surgery, Mie University Hospital, 2-174 Edobashi, Tsu, Mie 514-8507, JapanDepartment of Surgery, Iga City General Hospital, 831 Shijuku-cho, Iga, Mie 518-0823, JapanA 41-year-old man presented to our hospital with lower abdominal pain and a high-grade fever. Physical examination revealed rebound tenderness and guarding in the lower abdomen. Abdominal X-ray examination showed a radiopaque object in the right lower quadrant of the abdomen. Abdominal computed tomography (CT) demonstrated that the object had a strong artifact with over 10,000 Hounsfield units, as well as ascites around the terminal ileum. We diagnosed acute peritonitis with a suspicion of the perforation due to unknown foreign body and performed an emergency laparotomy. Operative findings showed a contained perforation of a phlegmonous appendicitis, and appendectomy was performed. The resected specimen demonstrated that the appendix contained a fecalith, and histopathological examination showed the crystal structure of barium sulfate in the lumen of the appendix. Unfortunately, we did not obtain the history of screening for gastric cancer using a barium examination one month prior to our appendectomy. Our experience demonstrates the importance of establishing a history of barium examinations of the gastrointestinal tract in a patient with a radiopaque object in the right lower quadrant of the abdomen for early diagnosis of barium appendicitis. Additionally, early diagnosis of barium appendicitis may affect the selection of surgical procedures.http://dx.doi.org/10.1155/2017/6316175 |
| spellingShingle | Susumu Saigusa Masaki Ohi Satoshi Oki Takashi Ichikawa Minako Kobayashi Yasuhiro Inoue Chikao Miki Delayed Awareness of the History of Barium Examination: Perforated Barium Appendicitis Case Reports in Gastrointestinal Medicine |
| title | Delayed Awareness of the History of Barium Examination: Perforated Barium Appendicitis |
| title_full | Delayed Awareness of the History of Barium Examination: Perforated Barium Appendicitis |
| title_fullStr | Delayed Awareness of the History of Barium Examination: Perforated Barium Appendicitis |
| title_full_unstemmed | Delayed Awareness of the History of Barium Examination: Perforated Barium Appendicitis |
| title_short | Delayed Awareness of the History of Barium Examination: Perforated Barium Appendicitis |
| title_sort | delayed awareness of the history of barium examination perforated barium appendicitis |
| url | http://dx.doi.org/10.1155/2017/6316175 |
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