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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A rare case report of leiomyosarcoma of Meckel's diverticulum, which caused torsion and strangulation of the diverticulum, is presented. The clinical picture was similar to acute appendicitis, which was the working diagnosis when the 42-yr-old Arab woman was sent to surgery. Although rare, leiomyosarcoma is the most common tumor of Meckel's diverticulum, and has to be considered in the differential diagnosis of right lower abdominal pain.
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PMID:Torsion of leiomyosarcoma of Meckel's diverticulum. 396 55

We conducted a retrospective study of 305 patients hospitalized with abdominal pain suggestive of acute appendicitis. Signs, symptoms, and laboratory findings were analyzed for specificity, sensitivity, predictive value, and joint probability. The total joint probability, the sum of a true-positive and a true-negative result, was chosen as a diagnostic weight indicative of the accuracy of the test. Eight predictive factors were found to be useful in making the diagnosis of acute appendicitis. Their importance, according to their diagnostic weight, was determined as follows: localized tenderness in the right lower quadrant, leukocytosis, migration of pain, shift to the left, temperature elevation, nausea-vomiting, anorexia-acetone, and direct rebound pain. Based on this weight, we devised a practical diagnostic score that may help in interpreting the confusing picture of acute appendicitis.
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PMID:A practical score for the early diagnosis of acute appendicitis. 184 49

One hundred eighteen patients with acute appendicitis operated on at Kawasaki Medical School Hospital during the 8-year period from Aug. 1, 1976 to Feb. 29, 1984 were reviewed. There were 78 children and 40 adults. The clinico-pathological types of acute appendicitis were: simple acute in 35 cases (29.7%); phlegmonous in 30 cases (25.4%); gangrenous in 24 cases (20.3%) and perforated in 29 cases (24.6%). Of the 78 children, 27 (34.6%) had perforated appendixes, whereas of the 40 adults only 2 (5.0%) showed perforated appendicitis. The initial symptoms were abdominal pain in 96.6%; nausea, vomiting or both in 33.1%, and fever in 11.9%. The physical findings on admission were abdominal tenderness in 99.2%, rebound tenderness in 52.5% and palpable mass in 17.8%. The mean body temperature on admission was 37.2 degrees C, and mean WBC count was 12,900/mm3. The roentgenography of the abdomen revealed the "sentinel loop sign" in 66.3%. In the patients under 15 years of age, the frequency of perforation seen in those underwent operation within 24 hours after onset and in those after 24 hours was 12.7% and 56.4%, respectively. From this result, it is advised that all the young patients suspected of having acute appendicitis should be admitted to the hospital promptly, and the diagnosis should be made within 24 hours.
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PMID:[Acute appendicitis: a study on 118 patients]. 400 Jan 2

A retrospective study was performed to identify factors associated with perforation in 150 children with acute appendicitis. The children's parents were interviewed about the nature and timing of care, family history of appendicitis, and history of abdominal pain episodes, and the children's medical records were reviewed. Delay in treatment--the interval between first recognized symptoms of abdominal pain and surgery--was most predictive of perforation. A treatment delay of more than 36 hours was associated with a 65% or greater incidence of perforation. Mean delay for the group with perforation of the appendix was 66.7 hours compared with 35.8 hours for the group having appendicitis without perforation (P less than .01). Mean professional delay was significantly longer in the group with perforated appendicitis than in the group having appendicitis without perforation (P less than .01), but mean parental delay was not. Children aged 1 to 4 years and those aged 5 to 8 years had a 74% and 66% incidence of perforation, respectively, compared with a 30% to 42% incidence in older children (P less than .01). Age had a significant effect upon perforation even when adjusted for delay in treatment. Other factors associated with perforation were family history of appendicitis, social class, advice given by the first health professional contacted, and the presence of fecaliths. When all factors were considered simultaneously by using logistic regression techniques, delay in treatment, age, and absence of a family history of appendicitis were all significant predictors of perforation.
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PMID:Childhood appendicitis: factors associated with perforation. 402 4

Disorders of the epiploic appendages are rarely diagnosed preoperatively and usually result from torsion with subsequent infarction. No diagnostic test or clinical symptoms are pathognomonic of this process, which is a disease of middle age and rarely life-threatening, and the most common preoperative diagnosis is acute appendicitis. An analysis of case information reported in the surgical literature has been combined with our recent experience involving ten cases. Fifty-eight percent of the patients in this collected series were male, and the average age in both sexes was 42 years. The sigmoid colon was the most frequent site of these disorders (41.5%), and acute appendicitis was the most common preoperative diagnosis (37.7%). The treatment is ligation, excision, and occasionally seromuscular inversion. When encountered at exploration, this entity may represent the sole etiology of the abdominal pain if exploration is otherwise negative.
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PMID:Epiploic disorders. Conditions of the epiploic appendages. 403 60

Twelve patients underwent appendectomy during pregnancy or in the puerperium. The clinical presentation of acute appendicitis is altered during gestation, and diagnosis becomes increasingly difficult when close to term. Abdominal pain, nausea, and vomiting are important symptoms. Peritoneal signs occur in the right lower quadrant early in pregnancy, but the upper quadrant or entire right side are more common locations, as the appendix is displaced upward by the enlarging uterus. Delay in treatment is common because of uncertainty in making the diagnosis and hesitancy to proceed with surgery. In the group of six patients with perforation, there was one maternal death and a loss of three fetuses. There were no complications in the absence of perforation. Prompt diagnosis is the cornerstone of a good outcome, and early surgical intervention is indicated if acute appendicitis is suspected. Pregnancy is not a reason to delay surgery. We review the literature on this topic and present and analyze principles of management.
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PMID:Acute appendicitis during pregnancy. Diagnosis and management. 406 42

Life events were recorded for the year preceding appendicectomy in 119 patients aged 17-30. In 63 appendicitis was confirmed histologically and in 56 the appendix was not acutely inflamed. Both groups had experienced significantly more events than a community comparison group when those events which carry some degree of threat to the individual are considered. In the case of severe events, however, the patients whose appendix was normal or only mildly inflamed demonstrated a pattern similar to that found in depression, whereas those with acute appendicitis were similar to the community comparison group. A follow-up study demonstrated that the number of people experiencing threatening events fell to the expected level postoperatively and that depression was associated with continued abdominal pain. These findings may be relevant to the understanding of the irritable-bowel syndrome.
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PMID:Life events and appendicectomy. 611 50

During the 45 month period beginning January 1977, 251 patients with a pathologically confirmed diagnosis of acute appendicitis underwent celiotomy at the Medical College of Virginia Hospital. A preoperative serum or urine amylase determination was recorded in 155 of the patients (62 percent). Of this group, 15 patients (10 percent) had elevation of serum amylase or 2 hour urine amylase. Hyperamylasemia or hyperamylasuria directly led to misdiagnosis or treatment delay in 5 of the 15 patients. Appendiceal rupture occurred in three patients, two of whom had prolonged (greater than 1 month) hospitalizations directly attributable to the misdiagnosis. As a result of this study, we conclude that (1) acute appendicitis and elevated amylase levels may occur concurrently, (2) hyperamylasemia or hyperamylasuria should not dissuade the surgeon from early operation if other clinical features suggest appendicitis, and (3) abdominal pain and elevation of amylase level define significant intraabdominal disease, not specifically pancreatic disease.
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PMID:Clinical significance of elevated serum and urine amylase levels in patients with appendicitis. 617 43

Abdominal pain and fever after an uncomplicated elective abortion usually point to incomplete abortion and endometritis. We treated a woman for acute suppurative appendicitis one week after such an abortion. When fever, nausea, vomiting and pain are not relieved by the standard doses of medication, acute appendicitis must be added to the usual gynecologic differential diagnoses.
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PMID:Ruptured appendix after elective abortion. A case report. 622 52

A 66-year-old man was admitted because of right lower abdominal pain and was operated on for acute appendicitis on March 12, 1983. It was found that his appendix was not inflamed, but a bleeding tumor was encountered in the posterior segment of the liver. Bleeding was controlled by suturing the liver above the tumor. Postoperative celiac angiography revealed many daughter tumors scattered in, but restricted to, the right lobe of the liver. The patient was treated by transcatheter arterial embolization combined with transcatheter arterial infusion of lipiodol and Adriamycin on April 25. Subsequently, a curative operation (right hemihepatectomy) was performed on May 24. The patient is still alive without recurrence 6 months after the resection. In case of ruptured hepatocellular carcinoma, it appears to be better to perform a two-stage operation with careful estimation of functional reserve of the liver, and to conduct transcatheter arterial embolization between operations to prevent the growth of the tumor during that period.
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PMID:[A case of hepatocellular carcinoma (acute abdominal type) misdiagnosed as acute appendicitis and satisfactorily treated by a two-stage operation]. 633 25


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