Appendicitis after age 40 is unusual, and appendicitis two days after laparoscopic hysterectomy is very rare and has not been reported to date. We describe a 44-year-old woman who had abdominal pain two days after laparoscopic hysterectomy. The pathology report indicated early appendicitis and the pain disappeared after appendectomy. In our opinion, the cause of appendicitis may have been related to the use of monopolar and bipolar coagulation during laparoscopic hysterectomy, although the coincidence of appendicitis and laparoscopic surgery may be accidental.

Introduction: Acute appendicitis in children is associated with morbidity and mortality due to late diagnosis. Several scoring systems, such as Alvarado and PAS have been developed to help diagnose acute appendicitis in children to make the most accurate and prompt decision. The purpose of this study was to compare the efficacy and diagnostic value of these scoring systems. Materials and Methods: In this cross-sectional study, 130 children aged 5-14 with suspected acute appendicitis were included. After the collection of demographic data, all patients were scored by Alvarado and PAS systems. The decision for surgery was made by a surgeon, independently of these scores. The diagnosis of acute appendicitis was affirmed by surgical and pathologic findings. Results: Male: Female ratio was 1. 32: 1, and the average age of the patients were 9. 2± 2. 7 years. The mean Alvarado and PAS scores were higher in patients with positive pathologic findings. Neutrophilia >75% and RLQ tenderness had the highest relationship with the diagnosis of the disease. The diagnostic value of Alvarado was higher than PAS concerning the area under the ROC curve. The cutoff point of 7 was associated with a sensitivity of 74. 5% and specificity of 66. 7% for the Alvarado score, and a sensitivity of 58. 5% and specificity of 79. 2% for the PAS score. Conclusions: The results showed the high sensitivity of Alvarado and the high specificity of PAS. However, the sensitivity, specificity, PPV, and NPV of these criteria were not satisfactory for the confirmation of the diagnosis.

Introduction: Identification and promotion of diagnostic methods has been a continuous effort to reduce disease and its complications and reduce costs associated with treatment. Despite all these efforts and improving our knowledge of diseases and diagnostic tools, pediatric appendicitis remains part of the diagnostic challenge in the surgical field. The aim of this is to compare the two diagnostic criteria of appendicitis (Children's Appendicitis Score [PAS] Versus Pediatric Appendicitis Score [CAS]) and evaluation of the diagnostic features of them. Methods: A retrospective cohort study was conducted on all children admitted to the hospital's emergency center with a possible diagnosis of appendicitis (270 patients) during 2018 and 2019 at Tabriz Pediatric Hospital. Based on the clinical examinations and para-clinical findings some of the patients were underwent the surgical intervention (220 cases) and some discharged and followed up for a period of 2 and 4 weeks later (50 cases). The data were analyzed through SPSS ver. 16 software. Results: The results of the present study indicated that if CAS was associated with ultrasound, the specificity of these criteria would improve and could be more acceptable compared with the PAS. In addition, it was revealed that WBC≥ 11000, as well as PMN≥ 65% and guarding were very specific for diagnosis and complication of acute appendicitis. There was a significant relationship between US findings and pathology reports (P<0. 05). Conclusion: In conclusion, the CAS criteria were more sensitive and the PAS was more specific in diagnosing pediatric acute appendicitis.

Background: Situs inversus is often detected incidentally in adults during imaging for an acute surgical emergency. We present a case of acute appendicitis in an adult who was previously unaware about his situs anomaly. A laparoscopic approach is helpful to deal with this condition.Case Report: A 16-year-old girl was admitted with history of acute abdominal pain. Clinically, she was diagnosed as acute appendicitis without any localized peritonitis. Subsequent imaging studies and lapartomy confirmed the diagnosis of situs inversus and acute left-sided appendicitis. She successfully underwent laparotomic appendectomy. Her postoperative recovery was uneventful. Morever, the patient had lagre and hemorrhagic cytes in every two ovaries that excisioned during the operation. Technically, more challenging because of the reverse laparoscopic view of the anatomy, the laparoscopic diagnosis and management of acute appendicitis is indicated in situs inversus.

Background: Neonatal acute apendicitis in the newborn is an extremely rare surgical entity, its incidence is 0. 04% to 0. 2%, and it represents a diagnostic challenge in this group of patients. For this reason, it is not usual to suspect this pathology when we are facing an acute neonatal abdomen,mostly there is a delay in diagnosis and management. And although the literature shows a decrease in mortality, it is still around 28% in some reviews. Case report: We report a female neonate with complicated acute appendicitis, who at the beginning did not present evident symptoms and did not respond to medical management. On the sixth day, due to poor evolution, he was admitted to surgery with findings: free meconium in the abdominal cavity with a 1-cm-diameter punch-type perforation in the distal ileum (4 cm from the ileus-caecal valve), which was crushed with phlegmonous cecal appendix,Cecum and omentum with abundant fibrin around. Conclusion: The timely diagnosis of acute appendicitis in neonates continues to represent a challenge for neonatologists. Due to its low frequency but high lethality, it should be considered as a diagnostic option against a baby with an acute abdomen that does not show clinical findings of frequent pathologies in addition to an unusual clinical course.

Appendecitis is one of the most frequent surgeries. Inflammation of appendix may be due to variable causes such as fecalit, hypertrophy of Peyer’s plaques, seeds of fruits and parasites. In this study we presented an uncommon type of appendicitis which occurred after abdominal blunt trauma.In this article three children present who involved acute appendicitis after blunt abdominal trauma. These patients were 2 boys (5 and 6-year-old) and one girl (8-year-old) who after blunt abdominal trauma admitted to the hospital with abdominal pain and symptoms of acute abdomen and appendectomy had been done for them.Trauma can induce intramural hematoma at appendix process and may cause appendicitis. Therefore, physicians should be aware of appendicitis after blunt abdominal trauma.

Background & Objectives: Appendicitis is the most common and the most important medical emergency and most of these patients undergo appendectomy. The diagnosis of appendicitis is critical and value of diagnostic laboratory tests has always been discussed. The purpose of this study was to determine the diagnostic value of increasing of CRP in the diagnosis of acute appendicitis.Materials & Methods: This was a cross- sectional study.105 persons of recourse to Shahid Motahari hospital emergency of Marvdasht in 2012, were examined. Before giving any preoperational Antibiotics, blood samples for measurement of serum CRP levels were prepared. After surgery, the relationship between serum levels of CRP and appendix tissue biopsy and the surgeon about the type of tissue to be investigated. All data were analyzed by SPSS version 18 (ANOVA and Tukey test).Result: 81 patients of participants that were studied had acute appendicitis and 24 of them had normal appendix. Among patients with acute appendicitis, 65 patients had increased serum CRP levels and 16 patients had normal serum CRP levels. The sensitivity and specificity of CRP respectively were 80% and 63% in this study.Conclusion: The results showed that evaluation of serum CRP levels can be useful and beneficial in the diagnosis of acute appendicitis.

Backgrounds: Appendicitis is the most common and important emergency condition, in which most of the patients undergo appendectomy. The diagnosis of appendicitis is critical and the values of diagnostic laboratory tests are always discussed. The current study aimed at determining the diagnostic value of C-Reactive Protein (CRP) increase in the diagnosis of acute appendicitis.Methods & Materials The current cross sectional study examined 105 individuals referred to the emergency department of Shahid Motahari Hospital, Marvdasht, Iran, in 1012. Before the administration of any preoperational antibiotics, blood samples were obtained from the subjects to measure the serum CRP level. After surgery, the relationship among serum levels of CRP and appendix tissue biopsy, and the surgeon’s comments about the type of tissue were investigated. All data were analyzed by SPSS version 18, employing ANOVA and Tukey test.Results: A total of 81 patients had acute appendicitis, out of which 24 had normal appendix. Among patients with acute appendicitis, 65 subjects showed increased serum CRP level and 16 subjects had normal serum CRP level. The sensitivity and specificity of CRP level in the study were 80% and 63%, respectively.Conclusion: The results showed that evaluation of serum CRP levels can be useful and beneficial to diagnose acute appendicitis.