{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:09:02Z","timestamp":1790831342502,"version":"4.1.0"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2012,1,1]],"date-time":"2012-01-01T00:00:00Z","timestamp":1325376000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2013,7,16]],"date-time":"2013-07-16T00:00:00Z","timestamp":1373932800000},"content-version":"vor","delay-in-days":562,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2012,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>INTRODUCTION:<\/jats:title>\n                    <jats:p>Abdominal pain is the primary presenting complaint of patients with acute appendicitis. Acute appendicitis presenting as chest pain is extremely rare and according to our search such presentation due to herniation of appendix into thorax through congenital diaphragmatic defect has not yet been reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PRESENTATION OF CASE:<\/jats:title>\n                    <jats:p>We present a case of a 12 year old male child who presented with acute chest pain. ECG was suggestive of ischemic changes. Echocardiogram and cardiac enzymes were within normal limits. Chest X-ray and gastrograffin contrast study confirmed the diagnosis of congenital diaphragmatic hernia. On exploration inflamed appendix was found herniated through the diaphragm along with caecum, ascending colon and transverse colon. Histology confirmed the diagnosis of acute appendicitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION:<\/jats:title>\n                    <jats:p>Acute appendicitis may sometimes have very varied and rare presentation. In late presenting CDH, the most important factor responsible for acute or chronic presentation seems to be the type of herniated viscera.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>This report presents a rare case of late-presenting CDH with herniated appendix along with caecum, ascending colon and transverse colon. Unusual presentation of chest pain was due to an attack of acute appendicitis. Late-presenting CDH is a very intriguing defect with a wide spectrum of clinical manifestations. It should be suspected in cases of unexplained acute or chronic respiratory or gastrointestinal symptoms, and abnormal chest radiographic findings. The prognosis is favorable with correct diagnosis and prompt surgical repair.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2011.12.004","type":"journal-article","created":{"date-parts":[[2012,1,9]],"date-time":"2012-01-09T23:47:28Z","timestamp":1326152848000},"page":"128-130","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":9,"title":["Acute appendicitis presenting as chest pain"],"prefix":"10.1097","volume":"3","author":[{"given":"Ashok Yadavrao","family":"Kshirsagar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumit Suresh","family":"Bansal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shreyas Ramesh","family":"Somnath","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek Narayan","family":"Prabhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vithal","family":"Dhulkhed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhiraj B.","family":"Nikumbh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-2-20260114","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/00000441-190408000-00001","article-title":"Two thousand operations for appendicitis, with deductions from his personal experience","volume":"128","author":"Murphy","year":"1904","journal-title":"Am J Med Sci"},{"key":"R3-2-20260114","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1016\/j.amjsurg.2005.05.035","article-title":"Congenital diaphragmatic hernia: searching for answers","volume":"190","author":"Gosche","year":"2005","journal-title":"Am J 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abscess","volume":"156","author":"Bologna","year":"1996","journal-title":"J Urol"},{"key":"R8-2-20260114","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/0022-3468(76)90176-7","article-title":"Acute appendicitis presenting as a scrotal mass","volume":"11","author":"Alvear","year":"1976","journal-title":"J Pediatr Surg"},{"key":"R9-2-20260114","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1007\/s00595-009-4172-9","article-title":"Gangrenous intrathoracic appendicitis, a rare cause of right-sided chest pain: report of a case","volume":"40","author":"Schellhaas","year":"2010","journal-title":"Surg Today"},{"key":"R10-2-20260114","doi-asserted-by":"crossref","first-page":"1839","DOI":"10.1016\/j.jpedsurg.2005.08.023","article-title":"Late-presenting congenital diaphragmatic hernia","volume":"40","author":"Kitano","year":"2005","journal-title":"J Pediatr Surg"},{"key":"R11-2-20260114","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1007\/s00383-004-1269-5","article-title":"Late-presenting congenital diaphragmatic hernia in children: a clinical spectrum","volume":"20","author":"Baghaj","year":"2004","journal-title":"Pediatr Surg Int"},{"key":"R12-2-20260114","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1136\/adc.88.6.532","article-title":"Bochdalek diaphragmatic hernia: not only a neonatal disease","volume":"88","author":"Mei-Zahav","year":"2003","journal-title":"Arch Dis Child"}],"container-title":["International Journal of Surgery Case 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