Neutrosophic multicriteria method for the evaluation of acute appendicitis with intestinal malrotation

Abstract

Acute appendicitis is the most common abdominal pathology reported with 4-8% of visits to emergency services. Its diagnosis is based specifically on the patient's symptoms, physical and radiological examination, however, in certain cases abnormal positions of the appendix occur, complicating its diagnosis and timely treatment. Within these, a variety can be found, which is left-sided acute appendicitis, which is associated with two types of congenital anomalies, such as situs inversus totalis and malrotation of the midgut. Intestinal malrotation is a congenital abnormality of the embryological rotation of the intestine, which develops: Ladd bands or a narrow mesenteric base, which predispose to gastrointestinal obstruction. It is estimated that more than 90% of patients will present in the first 12 months of life. In newborns, malrotation presents with acute obstruction or volvulus, however, in some patients it may go unnoticed. The clinical presentation in adults usually manifests itself insidiously during the postprandial period with intermittent vomiting, abdominal pain, food intolerance, peritonitis, among others, and may present as acute symptoms suggestive of intestinal obstruction. The treatment of choice for MRI is elective surgery, with the Ladd procedure, by laparoscopy or open surgery, in which duodenal fibers are cauterized. Regarding the management of asymptomatic patients, prophylactic surgical correction is recommended in the case of children, and observation in adults since acute presentation in these is very rare.