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Acute Suppurative Appendicitis Diagnosed by Acute Lower Gastrointestinal Hemorrhage

Authors
Kim D.-H.Lee J.H.Kim D.Hwang S.Kang K.Koo J.S.
Issue Date
2019
Publisher
NLM (Medline)
Keywords
Appendectomya; Appendicitis; Appendix; Colonoscopy; Gastrointestinal hemorrhage
Citation
The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi, v.73, no.1, pp.45 - 49
Indexed
SCOPUS
KCI
Journal Title
The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi
Volume
73
Number
1
Start Page
45
End Page
49
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/2683
DOI
10.4166/kjg.2019.73.1.45
ISSN
1598-9992
Abstract
A 49-year-old man visited the emergency room of Korea University Ansan Hospital with hematochezia starting the day before the visit. Recently, he was on anti-platelet medication due to hypertension. The patient had no definite symptoms other than hematochezia. Digital rectal exam was positive and laboratory tests showed severe anemia. Sigmoidoscopy was initiated and almost no fecal material was observed in the intestinal tract, allowing insertion into the cecum. Active bleeding from the appendiceal opening was noted. On abdominal CT, contrast enhancement was observed at the tip of the appendix. Under suspicion of acute appendicitis, we consulted with a surgeon. The patient underwent appendectomy with partial cecal resection. Pathologic examination revealed a diagnosis of appendix bleeding due to acute suppurative appendicitis. The patient had no further bleeding after surgery and was discharged in a stable state. Careful observation by the endoscopist is necessary for accurate diagnosis of lower gastrointestinal hemorrhage. Appendiceal hemorrhage is very rarely reported, but it has various pathophysiologies. CT scan is useful when appendiceal hemorrhage is confirmed by endoscopic findings. Surgical treatment was needed in almost all cases reported worldwide. If bleeding from the appendix is confirmed, surgical treatment should be considered for both therapeutic and diagnostic purposes.
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Koo, Ja Seol
Ansan Hospital (Department of Gastroenterology and Hepatology, Ansan Hospital)
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