Appendicitis Secondary to Trauma following a Camel Kick: Case Report and Review of Literature

Table 1

Summary of the case reports with publication year showing the cases of acute appendicitis secondary to traumatic abdominal injuries.

Study

Sex

Age

PH

MOI

Presentation

D

Examination

Labs

XR

US

CT

Surgery

Intraop

Histo

HS

Current study; Qatar

M

35 y

UR

Camel kick

RLQ pain few hours after the kick, anorexia, V

2 d

Vit: Nr, RLQ bruise, tenderness

WBC: 15.5, CRP: 90.5, bilirubin: 29.1

NR

NR

Ap 16 mm, wall enhancement, periappendiceal fat stranding

L Appy

AA

AA

12 h

Zvizdic; 2019; Bosnia & Herzegovina; Cc; [2]

M

7 y

UR

Horse kick

Sudden, progressive pain in RLQ, V

10 h

BP: 95/55, P: 110, T: 38.3, RR: 18. Abrasions, swelling tenderness and guarding RLQ

WBC: 11.5, Hb: 13.2, Plt: 280

NR

Pericecal free fluid, extending to pouch of Douglas

Small focus of free peritoneal air, free pelvic fluid

Lap, Appy

Perf AA with localized peritonitis

Perf AA, full thickness inflammation of Ap wall

6 d postop

Cobb; 2017; U.S; [6]

M

17 y

AD

MVC

Diffuse progressive Abd pain 24 h after MVC, V 10 times

NR

Vit: Nr, tender in both LQ’s (Lt>Rt) and Lt upper quadrant

WBC: 10.8, Hb: 15.8, Plt: 243

Abd XR: abnormal bowel loop RLQ

NR

Dilated Ap 1.3 cm surrounding fluid in RLQ and pelvis

L Ex, Lap, Appy

Inflamed Ap, dark fluid in RLQ concerning for viscus injury

AA

10 d postop

Ahmed; 2014; India; [4]

M

12 y

UR

Hit disk’s corner

Periumbilical Abd pain 1 d after trauma, fever

1 d

P: 114, BP: 90/56, minimal Abd movement with resp, bruise RLQ, rigid diffusely tender abdomen

WBC: 17, Hb: 10.5

Abd XR: air under diaphragm

Pelvic free fluid

NR

Ex Lap, Appy

Pus in pelvis, Perf AA at tip

AA

>4 d

Paschos; 2012; Greece; [7]

F

17 y

UR

Bicycle accident

Abd pain 12 h after trauma, discharged and came back with pain, anorexia, N&V

1 d

Vit: Nr, ecchymosis and tenderness RLQ

WBC: 9.1, on readmission: 12.7, Hb: 1.95 mmol/L

NR

Abd free fluid

NR

Lap, Appy

Free fluid, AA, contusion cecal base

AA

2 d

Torres-Grau; 2012; UK; [3]

M

15

UR

Fall from bicycle

Abd pain 30 m after fall

6 h

BP: 105/47, P: 57, T: 36.7, RLQ tenderness

WBC: 16.2, Neu: 13.6, Hb: 14.4, CRP: 1 Amy

NR

Free fluid in the peritoneum

NR

L Ex, Appy

Necrotic, non-Perf Ap

AA

NR

Atalla; 2010; Australia; [8]

M

53 y

UR

Fall on edge of car door

Abd pain 7 h after fall

7 h

P: ↑, BP: ↓, RLQ tenderness and guarding

WBC: ↑

NR

UR

Thickened Ap (10 mm) with fat stranding

L Ex, Appy

AA

AA

1 d postop

Toumi; 2010; UK; [1]

M

11 y

UR

Injury by elbow to RLQ

Abd pain after trauma, N&V, anorexia, fever

3 d

T: ↑, P: ↑, RLQ tenderness

UA: trace blood; Inf m: ↑

NR

NR

AA with adjacent collection

Appy

AA

AA serositis

4 d postop

Etensel; 2005; Turkey; [9]

M

9 y

NR

Fall

Polytrauma

1 h

BP: 80/50, P: 86, T: 36.7, confused, resp dist, head and Lt chest abrasions, ↓ breath sounds Lt chest

Hb: 11.2, WBC: 17.2

Chest and Abd XR: Lt lung contusion, free peritoneal air

Free air

Head CT: brain edema, Lt parietal bone fx; Abd CT: free air

Lap, Appy

AA, no bowel Perf

AA

10 d

Houry; 2001; Colarado; [10].

M

5 y

UR

Fall

Abd pain

1 h

BP: 114/75, P: 149, RR:32, T: 37.7, Abd tenderness and guarding more in RLQ

N

N

Free fluid in pouch of Douglas

Pelvic free fluid, AA

Ex Lap, Appy

AA, Perf at the base

AA

NR

Serour; 1996; Israel; [11]

M

11 y

UR

Punch

RLQ pain, N&V

18 h

BP: 115/60, P: 100, T: 37, looked ill, RLQ tenderness

Hb: 13.7, WBC: 4.5

NR

NR

Calcified appendicolith, prerectal fluid

Lap. Appy

Gangrenous Ap

Gangrenous appendicitis with periappendicitis

NR

Serour; 1996; Israel; [11]

M

8 y

UR

Fall

Abd pain, N and fever

3 h

BP: 95/55, P: 96, T: 38.2, ecchymosis over right side of the face, RLQ tenderness, guarding, and rebound

Hb: 12.5, WBC: 20.1

NR

NR

NR

Appy

AA

Phlegmonous appendicitis with periappendicitis

NR

Serour; 1996; Israel; [11]

M

7 y

UR

Fight

Abd pain, fever, V

Few d

T: 40, acute Abd

NR

NR

NR

Abscess in RLQ

Appy, drainage of abscess

Gangrenous Perf Ap

Gangrenous Perf appendicitis

NR

Ciftci; 1996; Turkey; [12]

M

8

NR

MVC

Abd pain

2 h

NR

NR

NR

NR

NR

Appy

Perf Ap

AA

Average hospital stay 6.4 d

Ciftci; 1996; Turkey; [12]

F

5

NR

Fall

Abd pain

6 h

NR

NR

NR

NR

NR

Appy

AA

AA

Ciftci; 1996; Turkey; [12]

F

13

NR

Ball

N

12 h

NR

NR

NR

NR

NR

Appy

AA

AA

Ciftci; 1996; Turkey; [12]

M

14

NR

MVC

Abd pain

4 h

NR

NR

NR

NR

Dilated bowel loops, free fluid

Appy

Perf Ap

AA

Ciftci; 1996; Turkey; [12]

M

7

NR

Assault

Abd pain

12 h

NR

NR

NR

NR

Dilated bowel loops, free fluid

Appy

AA

AA

For space considerations, only the first author is cited; AA: acute appendicitis; Abd: abdomen/al; AD: atopic dermatitis; Ap: appendix/appendiceal; Appy: appendectomy; BP: blood pressure in mmHg; CRP: C-reactive protein; D: duration of symptoms; d: days; diaph: diaphragm/atic; Ex: exploratory/ion; fx: fracture; h: hour/s; Hb: hemoglobin g/dL; Hem: hematoma; Histo: histology; HS: hospital stay postoperatively; Intraop: intraoperative findings; Inf m: inflammatory markers; I.O: intestinal obstruction; L: laparoscopic; Lap: laparotomy; LQ: lower quadrant; Lt: left; M: male; m: month/s; min: minute/s; McB: McBurney’s point; MOI: mechanism of injury; MVC: motor vehicle collision; N: nausea; Neu: neutrophils; NR: not reported; Nr: normal; P: pulse in beats per minute; Perf: perforation; PH: past history; pneumomed: pneumomediastinum; Plt: platelets K/μL; postop: postoperative; resp: respiration; Retro: retroperitoneal; resp dist: respiratory distress; RLQ: right lower quadrant; RR: respiratory rate; Rt: right; T: temperature °C; UA: urine analysis; UR: unremarkable; V: vomiting; Vit: vital signs; WBC: white blood cell count K/μL; y: year/s; ↑: high; ↓: low.