{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T16:30:31Z","timestamp":1777307431587,"version":"3.51.4"},"reference-count":8,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,3,26]],"date-time":"2022-03-26T00:00:00Z","timestamp":1648252800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>A six-year-old boy visits a general practitioner due to diarrhea and abdominal pain with a moderate fever of up to 39 \u00b0C for 2 days. Treatment is initiated; however, the recurrence of abdominal pain is observed. Physical examination of the child at the emergency department reveals abdominal guarding and visible, palpable, painful intestinal loops in the left iliac and hypogastric regions\u2014this is referred to as an \u2018acute abdomen\u2019. An X-ray shows single levels of air and fluid indicative of bowel obstruction. Ultrasound reveals distended, fluid-filled intestinal loops with diminished motility. The intestinal wall is swollen. Laboratory tests indicate increased inflammatory indices. Contrast-enhanced computed tomography examination of the abdominal cavity and lesser pelvis shows intestinal dilation. The loops were filled with liquid content and numerous collections of gas. The patient is qualified for a laparotomy. An intraoperative diagnosis of perforated gangrenous appendicitis with autoamputation was made. In addition, numerous interloop and pelvic abscesses, excessive adhesions, signs of small intestine micro-perforation, and diffuse peritonitis are found. The patient\u2019s condition and laboratory parameters significantly improve during the following days of hospitalization. Despite the implementation of multidirectional, specialized diagnostics in the case of acute abdomen, in everyday practice we still encounter situations where the final diagnosis is made intraoperatively only.<\/jats:p>","DOI":"10.3390\/diagnostics12040818","type":"journal-article","created":{"date-parts":[[2022,3,27]],"date-time":"2022-03-27T21:27:51Z","timestamp":1648416471000},"page":"818","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Chronic Appendicitis\u2014From Ambiguous Clinical Image to Inconclusive Imaging Studies"],"prefix":"10.3390","volume":"12","author":[{"given":"Agnieszka","family":"Brodzisz","sequence":"first","affiliation":[{"name":"Department of Pediatric Radiology, Medical University of Lublin, 20-059 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7869-9841","authenticated-orcid":false,"given":"Maryla","family":"Kuczy\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, 20-059 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monika","family":"Zbroja","sequence":"additional","affiliation":[{"name":"Students\u2019 Scientific Society at the Department of Pediatric Radiology, Medical University of Lublin, 20-059 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weronika","family":"Cyranka","sequence":"additional","affiliation":[{"name":"Students\u2019 Scientific Society at the Department of Pediatric Radiology, Medical University of Lublin, 20-059 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Czes\u0142aw","family":"Cielecki","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Traumatology, Medical University of Lublin, 20-059 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7436-2432","authenticated-orcid":false,"given":"Magdalena Maria","family":"Wo\u017aniak","sequence":"additional","affiliation":[{"name":"Department of Pediatric Radiology, Medical University of Lublin, 20-059 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,26]]},"reference":[{"key":"ref_1","first-page":"159","article-title":"Evaluation and Management of Intestinal Obstruction","volume":"83","author":"Jackson","year":"2011","journal-title":"Am. Fam. Physician"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1007\/s13304-020-00749-y","article-title":"Risk factors for intra-abdominal abscess following laparoscopic appendectomy for acute appendicitis: A retrospective cohort study on 2076 patients","volume":"72","author":"Tartaglia","year":"2020","journal-title":"Updates Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1002\/bjs.10873","article-title":"Meta-analysis of in-hospital delay before surgery as a risk factor for complications in patients with acute appendicitis","volume":"105","author":"Dijkgraaf","year":"2018","journal-title":"Br. J. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Bobillo-Perez, S., Rodr\u00edguez-Fanjul, J., and Jordan Garcia, I. (2018). Is Procalcitonin Useful in Pediatric Critical Care Patients?. Biomark. Insights, 13.","DOI":"10.1177\/1177271918792244"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"E7","DOI":"10.1016\/j.amjmed.2012.05.032","article-title":"Chronic appendicitis: An often forgotten cause of recurrent abdominal pain","volume":"126","author":"Shah","year":"2013","journal-title":"Am. J. Med."},{"key":"ref_6","first-page":"e304","article-title":"Chronic appendicitis in children","volume":"62","author":"Kim","year":"2016","journal-title":"Can. Fam. Physician"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1186\/s13256-022-03273-2","article-title":"Chronic appendicitis: Two case reports","volume":"16","author":"Holm","year":"2022","journal-title":"J. Med. Case Rep."},{"key":"ref_8","first-page":"A9127","article-title":"Chronisch recidiverende appendicitis: Een contradictio in terminis? [Chronic recurrent appendicitis: A contradiction in terms?]","volume":"59","author":"Kager","year":"2015","journal-title":"Ned. Tijdschr. Geneeskd."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/4\/818\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:44:07Z","timestamp":1760136247000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/4\/818"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,26]]},"references-count":8,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,4]]}},"alternative-id":["diagnostics12040818"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics12040818","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,26]]}}}