Clinical Cases

Appendicitis in a Man of 22

Appendicitis Complicated with Abscess In a 9 Year Old Boy with Achondroplasia

Drs. Shruti Gaur and Sharma Bhawani Shankar share a case of appendicitis in a man of 22. Pain extending to ilium and aggravated by motion, vomiting after eating and low grade fever with chill were among the symptoms leading to the simillimum.

Abstract: Appendicitis is the condition in which the appendix becomes inflamed, swollen, or infected causing the pain in lower right side of the abdomen. Surgical intervention is the choice of treatment in most of the cases. In many cases, this surgical intervention can be avoided through proper homoeopathic treatment. This case of Appendicitis treated with homeopathic medicine, is such an example.

This is a diagnosed case of appendicitis, of a 22-year-old male patient, scheduled for surgery who came to our clinic on 18/8/2020 with the complaint of acute abdominal pain with vomiting.

History of present illness

The patient came with complaints of off and on pain in the umbilical region extending to right lower abdomen since the day before. The pain was aggravated by motion. He also had low grade fever with chill since the previous day. He also complained of vomiting after eating food.

On examination –
Psoas test – + tenderness of right lower quadrant of abdomen.
Roving sign – +

Ultrasound of the abdomen and pelvis on 17/8/2020:
There is approx. 6.4mm diameter blind ended aperistaltic, non-compressible tubular structure with gut signature seen in right iliac fossa. Probe tenderness presents in right iliac fossa with surrounding echogenic mesentery noted P/O Appendicitis.

Past history –
No history of major illness in the past

Family history:
Mother – nil
Father – hypertension
Grandmother – nil
Grandfather – nil

Physical general:
Thermal reaction – chilly
Desire – sweets
Appetite – loss of appetite
Thirst- thirstless
Food aversion – not so specific
Sleep – disturbed due to pain
Dreams – not remembered
Perspiration- normal
Normal – normal
Urine –normal

Mental state-
Fear of surgery
Wants the complaints cured fast
Shy in nature
Anxious about health
Sad mood

Physical examination
Weight – 52 kg
Temperature- 99.50F
Pulse – 84/min
Blood pressure – 130/85 mmHg

Systemic examination –
GIT: pain in rt. Lower quadrant of abdomen
CNS: NAD
CVS: NAD
RESP: NAD
SKIN:NAD
Analysis and evaluation of symptoms-

Mentals

  1. wants complaints to be cured fast
  2. fear of surgery
  3. sad
  4. shy
  5. nervous

Physicals generals

  1. appetite – loss of appetite
  2. thirstless
  3. desire- sweets
  4. sleep –disturbed due to pain

Particulars

  1. pain in umbilical region extending to right lower abdomen
  2. Pain aggravated by motion
  3. vomiting after eating food
  4. low grade fever with chill

Totality of symptoms

  1. Mind –fear – doctors
  2. Mind – timidity
  3. Mind – Anxiety – health, about
  4. Mind – Sadness
  5. Stomach – Appetite – diminished
  6. Stomach – Thirstless
  7. Generals – Food and Drinks – sweets – desire
  8. .Sleep – disturbed – pains, by – abdomen
  9. Abdomen – Pain – umbilicus – extending to – ilium
  10. Abdomen – inflammation – Appendix
  11. Abdomen – pain – motion, on
  12. Stomach – Vomiting _ eating –after
  13. Fever – pain, fever from – stomach, in
  14. Fever – chill with

Repertory selected – synthesis repertory from RADAR software

Process of repertorization – total addition process

Remedy differentiation

Lycopodium Rhus tox Phosphorus Sepia
Abdomen Shooting pain across lower abdomen from right to left. Ileo-cecal symptoms, appendicitis. Violent pains, relieved by lying on abdomen. Soreness of navel Abdomen distended and painful to touch. Pressure above epigastrium. Painful pulsation in right hypochondrium. Violent pain in umbilical region. Lax feeling in abdomen. Heavy, bearing down feeling in hypogastrium.

Remedy selectedRhus Tox best fit his mental and physical generals and was chosen as the simillimum.  Rhus tox 200 was prescribed.

First follow up (18/8/2020)
Rhus tox 200/ 1 dose
Rubrum 30 for 7 days

Follow ups:

Date Symptoms Treatment
25/8/20 Pain was reduced. Vomiting was cured Rhus tox 200 /1 dose.

Rubrum B.D. for 7 days

2/9/20 Pain was reduced. His thirst was improved. Appetite was increased. Mentally he was calm. Rhus tox200 / 1 dose

Rubrum B.D. for 7 days

11/9/20 Pain was reduced. Thirst and appetite  increased. Mentally patient became calm. Rhus tox 200/  1 dose

Rubrum B.D. for 7days

20/9/20 Improvement Rhus tox 200/  1 dose

Rubrum B.D. for 7days

29/9/20 Improvement Rhus tox 200/  1 dose

Rubrum B.D. for 7days

7/10/20 Improvement Rhus tox 200/  1 dose

Rubrum B.D. for 7days

16/10/20 Improvement Rhus tox 200/  1 dose

Rubrum B.D. for 7days

25/10/20 Improvement Rhus tox 200/  1 dose

Rubrum B.D. for 7days

2/11/20 Improvement Rhus tox 200/  1 dose

Rubrum B.D. for 7days

U.S.G. of whole Abdomen on 10/11/2020

Normal abdominal scan with full U. bladder capacity

Discussion: From the repertorization, Rhus Tox 200 was prescribed based on the symptom totality. Appendicitis was cured by homeopathic treatment.

Conclusion: This case demonstrates that in some cases appendicitis can be cured with homoeopathy and appendectomy can be avoided.

Sonography Reports Below:

Before

After

Bibliography:
1.Shenoy K. Rajgopal, Manipal Manual of Surgery, CBS Publishers and Distributors (Pvt.) Ltd., 2009
2. .Nan A.K., Undergraduate Surgery, Academic Publishers(P) Ltd., 2007
3. Murphy Robin., Lotus Materia Medica, B. Jain Publishers(P) Ltd.,2014
4. RADAR software version 10

About the author

Shruti Gaur

Shruti Gaur

Dr. Shruti Gaur, MD Scholar Part II, M.N. Homeopathic Medical College and Research Institute, Bikaner.

About the author

Bhawani Shankar Sharma

Dr. Sharma Bhawani Shankar, MD Part 1, M.N. Homeopathic Medical College and Research Institute, Bikaner.

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