Homoeopathic Management of Sub-acute Appendicitis—A Case Report

Abstract

Sub-acute appendicitis is a condition where some episodes of acute appendicitis apparently subside spontaneously before they reach the acute stage. A 29-year-old man presented with pain in the right iliac fossa for the last 1 week with periumbilical radiation of pain associated with continual nausea, occasional bouts of vomiting, chill and rigours. Computed tomography scan report suggested a case of sub-acute appendicitis. On the basis of presenting features, the patient was treated with Belladonna and Calcarea carbonica in 30c and 200c (centesimal) potencies, respectively, with repetitions. The patient was under treatment for nearly 6 months with favourable improvement of the generalities along with the underlying pathology. The case was indicative of further studies with adequate sample size in such pathological condition to come to any decisive conclusion.

Keywords

sub-acute appendicitis - International Classification of Diseases—Clinical Modification - computed tomography - individualised homoeopathy

Declaration of Patient Consent

The patient gave voluntary written consent to share his clinical information in the journal. He had understood that his name and initials would not be included in the manuscript and efforts would be made to hide his identity, though the anonymity could not be guaranteed. He was free to withdraw from the treatment at any point of time.

Authors' Contribution

AN and DKP were involved in concept, literature search, clinical study, data acquisition, data interpretation and preparation of the article; NK and SSL were involved in literature search, clinical study and preparation of the article. All the authors reviewed and approved the final paper.

Publication History

Article published online:
08 September 2022

• References

• 1 Gebbers JO, Laissue JA. Bacterial translocation in the normal human appendix parallels the development of the local immune system. Ann N Y Acad Sci 2004; 1029: 337-343
• 2 Randal Bollinger R, Barbas AS, Bush EL, Lin SS, Parker W. Biofilms in the large bowel suggest an apparent function of the human vermiform appendix. J Theor Biol 2007; 249 (04) 826-831
• 3 Schumpelick V, Dreuw B, Ophoff K, Prescher A. Appendix and cecum. Embryology, anatomy, and surgical applications. Surg Clin North Am 2000; 80 (01) 295-318
• 4 Ghorbani A, Forouzesh M, Kazemifar AM. Variation in anatomical position of vermiform appendix among Iranian population: an old issue which has not lost its importance. Anat Res Int 2014; 2014: 313575
• 5 Addiss DG, Shaffer N, Fowler BS, Tauxe RV. The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol 1990; 132 (05) 910-925
• 6 Petroianu A, VillarBarroso TV. Pathophysiology of acute appendicitis. JSM Gastroenterol Hepatol 2016; 4: 1062-1065
• 7 Stein GY, Rath-Wolfson L, Zeidman A. et al. Sex differences in the epidemiology, seasonal variation, and trends in the management of patients with acute appendicitis. Langenbecks Arch Surg 2012; 397 (07) 1087-1092
• 8 Humes DJ, Simpson J. Acute appendicitis. BMJ 2006; 333 (7567): 530-534
• 9 Andersson RE, Lambe M. Incidence of appendicitis during pregnancy. Int J Epidemiol 2001; 30 (06) 1281-1285
• 10 Berk DR, Sylvester KG. Subacute appendicitis. Clin Pediatr (Phila) 2005; 44 (04) 363-365
• 11 Miller GC, Wright RG. Does subacute appendicitis exist?. Pathology 2010; 42: S72
• 12 Lamps LW. Infectious causes of appendicitis. Infect Dis Clin North Am 2010; 24 (04) 995-1018 , ix–x
• 13 Dzabic M, Boström L, Rahbar A. High prevalence of an active cytomegalovirus infection in the appendix of immunocompetent patients with acute appendicitis. Inflamm Bowel Dis 2008; 14 (02) 236-241
• 14 Carr NJ. The pathology of acute appendicitis. Ann Diagn Pathol 2000; 4 (01) 46-58
• 15 Bhangu A, Søreide K, Di Saverio S, Assarsson JH, Drake FT. Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management. Lancet 2015; 386 (10000): 1278-1287
• 16 Khaneja HS. Illustrated Guide to the Homoeopathic Treatment. 3rd edition. New Delhi: B. Jain Publishers (P) Ltd.; 2008: 51-52
• 17 Dhama KPS, Dhama S. Homoeopathy—The Complete Handbook. 1st edition. New Delhi: UBS Publishers' Distributors Pvt. Ltd.; 1994: 31-32
• 18 MEDLINE. US: US National Library of Medicine; Last reviewed on 2020 August 11. Accessed June 8, 2021 from: https://www.nlm.nih.gov/bsd/medline.html
• 19 PubMed. US: US National Library of Medicine; 1996. Accessed June 8, 2021 from: https://pubmed.ncbi.nlm.nih.gov/
• 20 CORE-Home database. London: Homeopathy Research Institute. Accessed June 8, 2021 from: https://www.hri-research.org/resources/research-databases/core-hom/
• 21 AYUSH RESEARCH PORTAL. India: Ministry of AYUSH, Government of India. Last Updated: 2020 Aug 18. Accessed June 8, 2021 from: http://ayushportal.nic.in/
• 22 Chakraborty PS, Khurana A, Singh AKN. et al. Iris tenax – a multicentric clinical verification study. Indian J Res Homoeopathy 2010; 4: 18-22
• 23 Human Diseases in ICD -10 Classification by World Health Organization. [Accessed December 05, 2020]. Available from: URL: https://www.icd10data.com/ICD10CM/Codes/K00K95/K35K38/K35-/K35.80
• 24 Human Diseases in ICD -10 Classification by World Health Organization. [Accessed December 05, 2020]. Available from: URL: https://www.icd10data.com/ICD10CM/Codes/K00–K95/K35–K38/K36-/K36
• 25 Das S. A Concise Textbook of Surgery. 5th edition. Calcutta: S. Das, Old Mayor's Court; 2008: 1028
• 26 Lamba CD, Gupta VK, van Haselen R. et al. Evaluation of the modified Naranjo criteria for assessing causal attribution of clinical outcome to homeopathic intervention as presented in case reports. Homeopathy 2020; 109 (04) 191-197
• 27 van Haselen RA. Homeopathic clinical case reports: development of a supplement (HOM-CASE) to the CARE clinical case reporting guideline. Complement Ther Med 2016; 25: 78-85
• 28 Yu CW, Juan LI, Wu MH, Shen CJ, Wu JY, Lee CC. Systematic review and meta-analysis of the diagnostic accuracy of procalcitonin, C-reactive protein and white blood cell count for suspected acute appendicitis. Br J Surg 2013; 100 (03) 322-329
• 29 Terasawa T, Blackmore CC, Bent S, Kohlwes RJ. Systematic review: computed tomography and ultrasonography to detect acute appendicitis in adults and adolescents. Ann Intern Med 2004; 141 (07) 537-546
• 30 Gamanagatti S, Vashisht S, Kapoor A, Chumber S, Bal S. Comparison of graded compression ultrasonography and unenhanced spiral computed tomography in the diagnosis of acute appendicitis. Singapore Med J 2007; 48 (01) 80-87
• 31 Cuschieri J, Florence M, Flum DR. et al; SCOAP Collaborative. Negative appendectomy and imaging accuracy in the Washington State Surgical Care and Outcomes Assessment Program. Ann Surg 2008; 248 (04) 557-563
• 32 Leeuwenburgh MM, Wiezer MJ, Wiarda BM. et al; OPTIMAP study group. Accuracy of MRI compared with ultrasound imaging and selective use of CT to discriminate simple from perforated appendicitis. Br J Surg 2014; 101 (01) e147-e155
• 33 Varadhan KK, Neal KR, Lobo DN. Safety and efficacy of antibiotics compared with appendicectomy for treatment of uncomplicated acute appendicitis: meta-analysis of randomised controlled trials. BMJ 2012; 344: e2156
• 34 Adisa AO, Alatise OI, Arowolo OA, Lawal OO. Laparoscopic appendectomy in a Nigerian teaching hospital. JSLS 2012; 16 (04) 576-580
• 35 Allen JH. The Chronic Miasms. Vol I & II. Low priced edition. New Delhi: B Jain Publishers Pvt. Ltd.; 2002: 23 ,49
• 36 Clarke JH. The Prescriber. 3rd edition. New Delhi: B. Jain Publishers (P) Ltd; 2015: 80
• 37 Faris RS. Did the remedy save him?. The Hahn Glean 1983; 50: 476-478
• 38 Madan KP. Appendicitis. The Hahn Glean 1959; 26: 369-370
• 39 Cash AM. Notes on appendix cases without operation. The Hahn Glean 1983; 50: 84-87
• 40 Singh M, Singh S. First Corrected, re-translated & redacted edition of Organon of Medicine with word meanings below each aphorisms 6th & 5th editions by Samuel Hahnemann. 2nd edition. Kolkata: Homoeopathic Publications; 2015: 322-323
• 41 Ali M, Iqbal J, Sayani R. Accuracy of computed tomography in differentiating perforated from non perforated appendicitis, taking histopathology as the gold standard. Cureus 2018; 10 (12) e3735