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A Case Study of Appendicitis with Mikel’s Diverticulum

Journal of Bio Innovation

An appendectomy is one of the most commonly performed abdominal surgical procedures. During this operation, a Meckel's diverticulum (MD) can occasionally be found as an incidental finding, but the coexistence of both appendicitis and a MD is fairly rare. Complications associated with an MD commonly occur in males, but the frequency of complications decreases with aging. Here, we present a rare case with a simultaneous coexistence of appendicitis and MD in a patient.When Meckel's diverticulum is suspected or diagnosed, patients should be surgically treated to prevent any complications to the patient.

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A Case Study on Appendicitis: Diagnosis, Management, and Nursing Care

A Case Study on Appendicitis: What is Appendicitis? , Diagnosis, Management, and Nursing Care,

Table of Contents

What is Appendicitis ?

Appendicitis is a common medical emergency that requires prompt diagnosis, management, and nursing care to prevent complications and improve patient outcomes. The purpose of A Case Study on Appendicitis is to discuss the clinical presentation, diagnosis, management, and nursing care of a patient with appendicitis.

A Case Study on Appendicitis

A 35-year-old male presented to the emergency department with a 24-hour history of right lower quadrant abdominal pain, nausea , and vomiting. He reported a loss of appetite and a low-grade fever. The patient denied any recent changes in bowel movements or urinary symptoms. His medical history was unremarkable, and he was not taking any medications. On physical examination, the patient appeared uncomfortable and had a temperature of 100.4°F. Abdominal examination revealed tenderness in the right lower quadrant, guarding, and rebound tenderness. Laboratory tests showed an elevated white blood cell count and C-reactive protein level.

Diagnosis of Appendicitis

Based on the patient’s clinical presentation and laboratory findings, the diagnosis of acute appendicitis was suspected. An abdominal ultrasound was ordered, which revealed a dilated and inflamed appendix with a diameter of 1.2 cm. A CT scan was also performed, which confirmed the diagnosis of acute appendicitis and ruled out any complications such as perforation or abscess formation.

Management of Appendicitis

The patient was admitted to the hospital and started on intravenous fluids and broad-spectrum antibiotics to cover for possible bacterial infections. The patient was taken to the operating room for an emergency laparoscopic appendectomy. During the surgery, the appendix was found to be inflamed and edematous, but no signs of perforation were noted. The surgery was completed without any complications, and the patient was transferred to the post-anesthesia care unit for monitoring. The patient was able to tolerate a regular diet and was discharged home after 2 days of hospitalization with a prescription for oral antibiotics.

Nursing Care of Appendicitis

During the hospital stay, the nursing care of the patient with appendicitis included monitoring vital signs, administering medications, providing pain management, assessing for signs of infection, and promoting ambulation and deep breathing exercises to prevent postoperative complications. The nurse also provided patient education on wound care, signs of infection, and the importance of completing the course of antibiotics. The nurse encouraged the patient to report any adverse reactions to the medication and advised the patient to avoid heavy lifting and strenuous activity for at least 2 weeks after surgery.

Where is pain appendicitis?

The pain from appendicitis usually starts around the belly button and then moves to the lower right side of the abdomen. The pain may be dull and achy at first, but it can become sharp and severe as the condition progresses. The pain may also worsen with movement or coughing. Some people may also experience pain in the back or rectum, especially if the appendix is located in a different position than usual. It is important to seek medical attention if you experience any of these symptoms, as untreated appendicitis can lead to complications.

What food can cause appendicitis?

There is no clear evidence to suggest that any specific food causes appendicitis. Appendicitis is typically caused by a blockage of the appendix, usually from fecal matter, a foreign object, or enlarged lymphoid tissue. Bacteria can then infect the blocked appendix, causing inflammation and the symptoms of appendicitis.

While there is no food that is known to cause appendicitis, there are some dietary habits that may increase your risk of developing the condition. For example, a diet high in processed foods and low in fiber can lead to constipation, which in turn can increase the risk of a blockage in the appendix. Additionally, a diet high in red meat and low in vegetables has been associated with an increased risk of appendicitis.

It is important to maintain a balanced and healthy diet to reduce the risk of developing appendicitis and other gastrointestinal conditions. This includes consuming plenty of fruits, vegetables, whole grains, and lean proteins. Drinking plenty of water and staying hydrated is also important for maintaining a healthy digestive system.

Conclusion:A Case Study on Appendicitis

Appendicitis is a common medical emergency that requires prompt diagnosis, management, and nursing care to prevent complications and improve patient outcomes. Early recognition of the signs and symptoms of appendicitis and prompt referral to a healthcare provider is crucial in the timely diagnosis and management of the condition. The nurse plays a critical role in the assessment, management, and education of the patient with appendicitis to ensure optimal outcomes.

Please note that this article is for informational purposes only and should not substitute professional medical advice.

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Case report: a safe laparoscopic technique for complicated appendicitis

Case Report
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Published: 27 August 2024
Volume 1 , article number 30 , ( 2024 )

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A case of complicated appendicitis is presented to illustrate a safe laparoscopic appendectomy technique. What makes extirpation so difficult in complicated appendicitis ? Infection and tissue injury initiate the release of cytokines, which attract the omentum and cause contiguous loops of bowel to adhere, effectively isolating the inflammatory locus. Surgical dissection must reverse this process. Visualization is excellent in laparoscopy; however, operators lack tactile sensation; and when organs are fused together, touch is a valuable aid to accurate dissection. Injury to the adjacent organs (small bowel, colon, fallopian tubes, or ureter) may occur and require repair or resection (cecectomy or hemicolectomy). What is needed is an operative technique that is safe and effective in these challenging situations, especially when the appendix is adherent to adjacent structures and encased in a cocoon of (highly vascularized) fibrous tissue, a phlegmon . The technique presented is derived from open surgery . It is utilized to avoid injuring vulnerable structures in the pelvis, when performing a proctectomy for ulcerative colitis or Hirschsprung’s Disease. This goal is accomplished by maintaining a plane of dissection that abuts the rectal wall. The same technique is applied in complicated appendicitis to avoid injuring adjacent organs. This procedure is contrasted with an alternate (simpler) technique applicable to uncomplicated appendicitis.

Laparoscopic Appendectomy

Acute Appendicitis

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1 Introduction

Laparoscopy changed how surgery was performed, not what was done (the procedure) nor why (the indications). Appendicitis is a notable exception. Remarkably, changing operative access altered how disease was treated—surely an unforeseen consequence.

The initial change was to downgrade the classification of appendicitis from emergent to urgent . No longer were appendectomies done in the middle of the night; they were scheduled next day, first available . Studies were done to verify that this change had no detrimental effect upon patient outcome.

But this change applied only to patients with uncomplicated appendicitis . Patients with complicated appendicitis were treated non-operatively with parenteral antibiotics, frequently necessitating long-term venous access. Source control was delegated to Interventional Radiology, and surgery was delayed 6–8 weeks to permit quiescence of a presumably hostile abdomen [ 1 ]. Some physicians even questioned whether (interval) appendectomy was necessary [ 2 ].

Why were sicker patients treated less aggressively? The answer is that only basic laparoscopy skills are required for uncomplicated appendicitis , whereas greater technical prowess is required for complicated appendicitis [ 2 ].

The laparoscopy learning curve is steep; but finally, it appears that we have come full circle, as more recent studies conclude that substantial benefit accrues from Same Admission Appendectomy (SAA)—the modus operandi prior to laparoscopy [ 4 , 5 , 6 , 7 , 8 , 9 ].

This report contrasts what are really two different operations: laparoscopic appendectomy for simple versus complicated appendicitis; and a technique is presented that is useful in instances where inflammation obscures the anatomy, especially the demarcation between the appendix and adjacent structures. Our hope is that surgeons who have not yet embraced SAA will do so with confidence.

1.1 Case presentation

A 17-year-old young lady complained of worsening abdominal pain of several days’ duration. Her pain was initially peri-umbilical but gradually migrated to the right lower quadrant. It was exacerbated by movements, especially extension of her right hip; and it was associated with anorexia but no nausea or vomiting. She was otherwise healthy. Her menses were regular, and she was mid-cycle.

Appendicitis Scoring (A score of 4 or more is significant.)

Clinical Variable	Response	Value
Anorexia	Yes	1
Nausea or Vomiting	No	0
Migration of Pain	Yes	1
Fever > 100.4F/38C	No	0
Pain with Cough/Percussion	Yes	1
RLQ Tenderness	Yes	1
Leukocytosis	Yes	1

Her vital signs were normal. Blood work included a basic metabolic panel and a complete blood count. Abnormal values were a leukocytosis of 13,300/cm and an elevation of C-reactive protein 1.6 (normal < 1). Physical examination was unremarkable, except that her abdomen was mildly distended and tympanitic. Bowel sounds were diminished, and she was tender in the right lower quadrant with guarding. Psoas sign was positive on the right side. No hernia or organomegaly was appreciated.

The appendix was not visualized by Ultrasound. A CT scan demonstrated an acutely inflamed, retrocecal appendix with fat stranding but no abscess (Figs. 1 and 2 ).

CT Coronal and Sagittal Views. Arrows indicate a well demarcated, inflamed appendix

Arrows indicate a well demarcated, inflamed appendix

It is noteworthy that appendicitis with phlegmon is sometimes, but not always, apparent on CT scan [ 7 ].

Because radiographs reflect gradations in water density, an appendix with phlegmon may be more easily delineated on CT than by direct visualization.

Parenteral fluids and antibiotics, as well as an analgesic and antiemetic were given.

Consent for laparoscopic appendectomy was obtained. A retrocecal appendicitis with phlegmon was identified and excised, as described below. The young lady’s recovery was prompt; and she was discharged the day following surgery. Analgesics, but no antibiotics, were prescribed.

The pathology report described acute and chronic inflammation with peri-appendicitis, which is consistent with the supposition that an extended period of time is required to create fibrous encasement of the appendix.

1.2 Operative Procedure

The usual arrangement of the ports for laparoscopic appendectomy places the camera in the left lower quadrant, and the two working ports in the midline: one supra-pubic and the other at the umbilicus.

Because a child’s abdomen is smaller than an adult’s, the ports are arranged differently: the camera is placed at the umbilicus, and the working ports are situated in the left lower and right upper quadrants respectively. This creates an equilateral triangle, which facilitates dissection and tying intracorporeal knots.

If the appendix is retrocecal, the inferior and lateral peritoneal attachments of the cecum are divided to facilitate its medial rotation. In this case, the appendix was adherent to the posterolateral aspect of the cecum, buried in a trough and covered by a thick veil of fibrovascular tissue (Fig. 3 ).

Phlegmonous Appendicitis

In simple appendicitis, the appendix derives its blood supply from a well-defined vascular pedicle that can be divided en mass with a stapler or stepwise with cautery (Fig. 4 ). An appendix that is adherent to the cecum shares its blood supply, which consists of multiple small vessels that must be individually coagulated and divided. Footnote 1

Appendix with a well-defined mesentery (arrow)

Excising the appendix, without injuring the cecum, is dauntingly hazardous. The appendix is least inflamed at its base, proximal to the fecalith. A space is created beneath this portion of the appendix by gentle dissection, dividing the small blood vessels as they penetrate the wall of the appendix (Fig. 5 ).

The appendix is doubly ligated and divided (Figs. 5 and 6 ). If a surgeon prefers to divide the appendix with a stapler, the encircling ties will assist in creating an adequate space for the stapler and situating it correctly.

Ties are placed; the appendix is divided

Dissection proceeds proximal to distal

The ports’ equilateral arrangement facilitates intra-corporeal knot tying. By pulling the short end of a square knot up and the long end down, a sliding knot is created [ 10 ]. The distal end of the appendix is elevated away from the cecum, and nutrient blood vessels are cauterized and divided.

Dissection proceeds in an antegrade direction (towards the tip) along the appendiceal wall, dividing the overlying fibrovascular tissue and underlying blood vessels (Figs. 7 and 8 ).

The appendix is elevated, and dissection proceeds directly on the appendiceal wall

Safe division of blood vessels and inflammatory tissue

1.3 Laparoscopy in uncomplicated appendicitis

“Follow the omentum!” An acutely inflamed appendix stands out like a sore thumb (Fig. 4 ). The vascular pedicle is a distinct structure that is readily coagulated and divided. Retrograde dissection proceeds towards the cecum; and the appendiceal base is secured by stapler or Endo-Loops and transected (Fig. 9 and 10 ).

Placement of Endo-Loops

Division of the appendix between ties

1.4 Discussion one size (does not) fit all!

1.4.1 anatomy dictates the surgical technique.

Searching the literature for “Appendectomy Technique” yields comparisons of open versus laparoscopic surgery outcomes or single port versus multi-port techniques. Operative technique is learned from mentors; there is scant guidance in the literature regarding how to perform a difficult appendectomy. Technical competence is assumed. After all, is not an appendectomy a junior resident case? Usually, two firings of the stapler are all that is required. The technique is quick and efficacious, but it has no utility when contending with phlegmonous appendicitis.

Admittedly, this report addresses a niche; however, it is an important niche, because appendicitis is encountered so frequently, and a phlegmon may not be apparent preoperatively. The technique espoused allows a surgeon to navigate obfuscated anatomy safely. It is a valuable addition to one’s armamentarium.

1.4.2 Pathogenesis dictates the treatment

Diagnostic accuracy is enhanced by clinical algorithms and sophisticated imaging techniques: CT, Ultrasound, and MRI. Diagnostic criteria are:

Can the appendix be identified?

Is it dilated? If so, how much?

Is it compressible? Does the patient experience pain in response to this maneuver?

Is there inflammation of the appendiceal wall and/or contiguous tissues (“fat stranding”)?

Is there intra-luminal obstruction, a fecalith?

Is there evidence of perforation/ abscess/intestinal obstruction?

A vestigial organ is deemed a relic, useful to our ancestors, but without a present function. Such a belief, however, negates the impetus to investigation; and its potential function (if any) will never be discovered. Thankfully, this conundrum, this tautology, is itself a remnant of the past.

The appendix is currently thought to have a role in the development of gastrointestinal immunity, especially extrathymically derived T and B lymphocytes [ 13 ]. Unobstructed appendicitis is attributed to dysfunction in the interaction of host immunity and gastrointestinal pathogens; hence, the efficacy of antibiotics in some instances.[ 1 , 11 , 12 ].

In patients whose appendices are obstructed and dilated, diagnosis and treatment are clear. But what about patients whose studies show inflammation, but no luminal obstruction or significant dilatation (Fig. 11 )?

The narrow portion of the appendix (read as 6 mm) may be more obvious to the radiologist; and the report cause confusion, when coupled with a description of inflammation

Antibiotics are usually begun in the emergency room based upon the radiologist's report. Should they be continued? Should the child be observed, or should an appendectomy be done? Only if the pathologist identifies mucosal inflammation is the radiologic diagnosis corroborated.

Is there a subset of appendicitis that is primarily infectious in etiology, rather than primarily obstructive and secondarily infectious? (Fig. 12 ) Could obstruction be caused by lymphoid hyperplasia, rather than a fecal concretion? Ambiguous cases may represent viral infections (mesenteric adenitis).

The etiology of obstructed appendicitis accords with the classic model. Obstruction of the appendiceal lumen (by a fecalith) increases the intra-luminal pressure through glandular secretion and bacterial overgrowth. This causes ischemia and release of cytokines that recruit leukocytes, mobilize the omentum and cause proliferation of fibro-vascular tissue, which circumscribe and isolate the septic locus. This reaction takes time, which accords with the pathology report's description of acute and chronic inflammation .

Whereas antibiotics may be efficacious in treating unobstructed appendicitis , appendectomy is generally considered necessary to resolve obstructed appendicitis [ 13 ]. Clinical corroboration is provided by instances of “Stump Appendicitis,” wherein the anatomy is obscure, and a portion of an obstructed appendix is inadvertently left behind leading to recurrent appendicitis.

Contrast the appearance of the mucosa proximal versus distal to the obstructing fecalith

1.4.3 The over-riding question is, “What is best for the patient?"

An exhaustive study of 63,627 pediatric patients compared Same Admission Appendectomy ( SAA) versus Non-Operative/Interval Appendectomy ( NO/IA) and reported data that favored SAA [ 7 , 8 ].

SAA patients did have longer hospitalizations, but only if the IA days were excluded in reporting NO/IA data. SAA had more initial complications: sepsis, bacteremia, pneumonia, ileus, and wound infections, but NO/IA had more unplanned hospitalizations (prior to IA), more imaging studies, and more ancillary procedures, such as lysis of adhesions and IR drainage of abscesses; and consequently, their over-all cost was greater. There was no difference in the incidence of serious complications, such as intestinal resections, anastomoses, or creation of ostomies [ 3 , 14 , 15 , 16 , 17 ]. The authors of these studies concluded that “health-related” quality of life was better with SAA.

Patients with appendicitis and phlegmon recover promptly, since there is usually no contamination, only encasement of the appendix in vascularized fibrous tissue. Recovery in ruptured appendicitis is hastened by removal of the infected, necrotic organ. Parenteral antibiotics are required for an extended time- period; but generally, this is shorter than prescribed in NO/IA .

The rational for delay (NO/IA) is that laparoscopic appendectomy is rendered less hazardous. In our opinion, delay is unnecessary. Laparoscopic appendectomy (even if ruptured or phlegmonous) is feasible and safe during the initial hospitalization and much to be preferred.

2 Conclusion

The conclusion, SAA is better than NO/IA, is based upon clinical experience and the references cited.

"If this is true, why is NO/IA so widely practiced?" The answer and impetus for writing this report is that SAA can be extremely difficult, fraught with peril. Occasionally one hears, bantered about the operating room, that a “radical appendectomy” (appendix plus colon) was performed. Tumor may warrant such an operation, but the pejorative terminology suggests rather a technically flawed appendectomy. It is this conundrum, this niche, that we address.

Data availability

Physicians rightly ask themselves, “What is best for the patient?” The conclusion that ‘Same Admission Appendectomy’ is better than ‘Non-Operative/Interval Appendectomy’ is based upon the studies referenced in the text. The impetus for writing this report is, “If this claim is true, why is NO/IA still widely practiced?” The answer is that laparoscopic appendectomy (in complicated appendicitis) is difficult and hazardous; hence, surgeons shy away from it. This paper describes a technique that is safe and efficacious.

A video is available— https://youtu.be/63yao7k0l9o

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Acknowledgements

Dr. Omar Syed Hassan managed the camera and assisted with the surgery. His contribution made possible this report. Dr. Brian Jones assisted with the operation and the recording of the video supplement.

The author declares that he has no competing financial interest or personal relationships that could appear to influence the work reported in this paper.

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James G. Glasser MD is the sole author. He also performed the surgery and edited the photographs and the video; in addition, he prepared and edited the manuscript.

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Glasser, J.G. Case report: a safe laparoscopic technique for complicated appendicitis. Discov Med 1 , 30 (2024). https://doi.org/10.1007/s44337-024-00037-3

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Appendicitis (Case Study)
This case study examines 10-year-old Harry who was diagnosed with ruptured appendicitis with localized peritonitis. It provides background on Harry's health history and Gordon's assessment, which revealed he had abdominal pain and vomiting prior to admission. The case study objectives are to understand appendicitis, related anatomy and physiology, risk factors, pathophysiology, appropriate ...
Acute Appendicitis Case Study
Acute Appendicitis Case Study - Free download as Word Doc (.doc / .docx), PDF File (.pdf), Text File (.txt) or read online for free. A full case study regarding Acute Appendicitis.
Appendicitis Case Study
appendicitis case study - Free download as Word Doc (.doc / .docx), PDF File (.pdf), Text File (.txt) or read online for free. The patient is a 21-year-old Filipino man who was admitted to the hospital with abdominal pain. He underwent an appendectomy and was diagnosed with a peri-appendical abscess. His medical history includes smoking 5 cigars per day and a family history of asthma and ...
Case-Study Appendicitis
CASE-STUDY APPENDICITIS - Free download as PDF File (.pdf), Text File (.txt) or read online for free.
Case Study (Appendicitis)
Case Study (Appendicitis) - Free download as Word Doc (.doc / .docx), PDF File (.pdf), Text File (.txt) or read online for free. The document provides information about a case study of appendicitis, including: 1) An overview of the anatomy and function of the appendix, as well as the signs and symptoms of appendicitis. 2) A description of the pathophysiology of appendicitis, from obstruction ...
Appendicitis Case Study
Appendicitis Case Study - Free download as Word Doc (.doc / .docx), PDF File (.pdf), Text File (.txt) or read online for free. The document provides information about appendicitis including: - Appendicitis is caused by obstruction and infection of the appendix, which can lead to inflammation. It is one of the most common causes of abdominal pain.
Appendicitis Case Study
Appendicitis Case Study - Free download as Word Doc (.doc / .docx), PDF File (.pdf), Text File (.txt) or read online for free. The document discusses appendicitis and provides information about anatomy and physiology of the digestive system. It describes the process of digestion from the mouth to the anus. It then focuses on the appendix, explaining its location and function.
Appendicitis Study cases
Case Study 110 Appendicitis. Scenario R. is a 12-year-old girl who lives with her family on a farm in a rural community. R. has 4 siblings who have recently been ill with stomach pains, vomiting, diarrhea, and fever. They were seen by their primary care provider (PCP) and diagnosed with viral gastroenteritis. A week later R. woke up at 0200 ...
Appendicitis Case Study: Symptoms Diagnosis and Treatment
Appendicitis case study Very common Don't know the exact function of appendix Younger age. A 24-year-old male with no significant past medical history presents to the emergency department with diffuse abdominal pain that began yesterday. The patient describes the pain as a "pressure-like pain", most intensely in the mid- abdomen.
Case Appendicitis
Patient A, a 15-year-old female, was diagnosed with acute appendicitis based on symptoms of rebound tenderness in the right lower quadrant of the abdomen, continuous pain, anorexia, low-grade fever, nausea, and vomiting. Appendicitis is inflammation of the appendix, a small tube attached to the cecum. Left untreated, it can rupture and cause a serious infection. The patient's history and ...
A Case Study of Appendicitis with Mikel's Diverticulum
The incidence of appendicitis peaked at 15 to 19 years for males, and subsequently, the incidence decreased gradually and reached a low point in the 55-59-year age group in both sexes. Although the incidence of appendicitis and symptomatic MD decreased during the fifth decade, a coexistence of both diseases was found in the present case.
Appendicitis Case Study
Case Study: Appendicitis. Scenario. R. is a 12-year-old girl who lives with her family on a farm in a rural community. R. has 4 siblings who have recently been ill with stomach pains, vomiting, diarrhea, and fever. They were seen by their primary care provider (PCP) and diagnosed with viral gastroenteritis. A week later R. woke up at 0200 ...
A Case Study on Appendicitis: Diagnosis, Management, and Nursing Care
A Case Study on Appendicitis. A 35-year-old male presented to the emergency department with a 24-hour history of right lower quadrant abdominal pain, nausea, and vomiting. He reported a loss of appetite and a low-grade fever. The patient denied any recent changes in bowel movements or urinary symptoms. His medical history was unremarkable, and ...
Case study of Acute Appendicitis
Appendicitis Case Study-1f4a6166-3315-41da-a60f-af746c9ba515. Maternal and Pediatrics 100% (1) 42. Essay Appendix Essay Appendix. Directed Studies in Library Instruction 100% (1) 4. End Stage Kidney Disease. Med Surge 100% (1) Recommended for you. 11. Lesson 1 - Critical Thinking Skills.
Appendicitis Case Study
t i '-r~ Co~+to w. PART 2 PEDIATRIC, MATERNITY, AND WOMEN'S HEALTH CASES CASE STUDY 124 ##### J Case Study 124 Appendicitis. Difficulty: Adv anced Setting : Hospital Index Words: appendicitis, assessm ent. developmental care , differenti al diag no sis, maint ena nce fluid calculati ons , discharge teaching, leg al aspects, outcomes management, pr eoperative care , po stopelat ive ...
Case report: a safe laparoscopic technique for complicated appendicitis
A case of complicated appendicitis is presented to illustrate a safe laparoscopic appendectomy technique. What makes extirpation so difficult in complicated appendicitis? Infection and tissue injury initiate the release of cytokines, which attract the omentum and cause contiguous loops of bowel to adhere, effectively isolating the inflammatory locus. Surgical dissection must reverse this ...
Case Study: Patient With Appendicitis: Submitted By: Farzaneh ...
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Appendicitis case study
Appendicitis Causes -It is most likely caused by an infection caused by blockage in the appendix lining. -The infection can also cause blockage, as appendix swells in reaction to any infection in the body. Appendicitis also occurs when the appendix becomes obstructed, most commonly by stool, foreign body, or cancer tumor.
An acute appendicitis; case study
An acute appendicitis; case study. An acute appendicitis; case study Zambia Nurse J. 1977 Dec-Jan;8(3):6-7. Author M P Phiri. PMID: 587578 No abstract available. Publication types Case Reports MeSH terms Acute Disease Appendectomy Appendicitis / surgery* ...
Case Study on a Patient with Appendicitis
Case 2 Pathology Report. GROSS DESCRIPTION: The specimen is received in formaling and labeled with patient's name, patient's ID number, and appendix. It consists of an appendix measuring 6 x 1.5 x 1.5 cm. There is periappendiceal fat attached to it which measures 6 x 4x 1 cm. The serosal surface is hemorrhagic.
Case study of appendicitis scribd / ceuta.uta.cl
The study of the Nurse Practitioner Exams are to use a standardized testing process to scribd an scribd assessment of a appendicitis taker's knowledge and skills. Preterm labor and delivery constitute the most significant threat to the fetus in the management of acute maternal intra-abdominal disease.
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