A CASE REPORT ON SURGICAL INTERVENTION ON APPENDICITIS – AN AYURVEDIC TREATMENT PROCEDURE

Abstract

Introduction - Appendicitis is a common abdominal emergency, resulting from inflammation of the appendix, often complicated by the presence of an appendicolith, which can lead to obstruction. Imaging techniques, particularly ultrasound and CT, play a crucial role in accurately diagnosing appendicitis, identifying complications, and aiding in appropriate management. This case presents diagnostic findings from a CT scan in a patient with suspected appendicitis. Aim and Objectives -To identify and evaluate about the appendicitis and its complications. Material and Methods -A 34-year-old female presented with lower abdominal pain and signs suggestive of appendicitis. A spiral volumetric study of the whole abdomen was conducted with and without intravenous contrast. Sagittal, coronal, and axial reconstructions were reviewed in abdominal, bone, and lung windows to evaluate the appendix and associated abdominal structures. Observations were made based on image findings. Results -The CT imaging revealed a prominent appendix, measuring 7.5 mm in diameter, located at the 6 o’clock position, with an appendiculolith measuring 8.5 x 6.5 mm within the lumen. No periappendiceal fat stranding was noted, suggesting a subacute stage of inflammation. Minor lymph nodes were observed in the right iliac fossa, indicative of a localized inflammatory response. Additionally, a 2.2 mm concretion was seen in the upper pole calyx of the right kidney, and the sigmoid colon appeared redundant and distended with fecal matter. The liver, gall bladder, pancreas, spleen, kidneys, urinary bladder, uterus, and adnexa were normal. Discussion Appendicitis often presents with classical signs of inflammation; however, the absence of periappendiceal fat stranding in this case indicates a subacute phase, suggesting a milder, less aggressive inflammation. The presence of an appendiculolith is a known risk factor for developing appendicitis, as it may obstruct the lumen, leading to inflammation and increased intraluminal pressure. The findings highlight the importance of CT imaging in diagnosing and assessing the severity of appendicitis. The detection of minor lymphadenopathy further supports an inflammatory process, albeit localized. The incidental finding of a renal concretion warrants clinical correlation, although it may be unrelated to the primary condition. Conclusion - CT imaging is crucial for diagnosing subacute appendicitis, especially in cases with an appendiculolith, which raises the risk of disease progression. In this case, early identification without advanced inflammation signs, such as fat stranding, allows for timely surgical intervention, which is often the definitive treatment to prevent complications like perforation or abscess formation. Comprehensive imaging also revealed incidental findings, aiding in broader patient management. Accurate imaging supports prompt surgical decisions, reducing adverse outcomes and improving prognosis in appendicitis cases.

Keywords: Appendicitis, Subacute Appendicitis, Abdominal Imaging, Sigmoid Colon Distention.