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Query: UMLS:C0003615 (appendicitis)
 4,439 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Forty patients with colorectal schistosomiasis who failed to respond to medical therapy were studied. They had dysentery with bloody mucus and anemia, polyps, pericolic masses, and schistosomal ulcers. Two patients had cecal masses which appeared to be intussusception and appendicitis. Three patients had chronic intestinal obstruction. Diverting transverse colostomy, followed by other surgical procedures, is the safest method of management.
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PMID:Colorectal schistosomiasis: clinicopathologic study and management. 49 94

We have studied two types of emergency cases that occurred in the surgical unit who were found to have gynaecological aetiology: 1) patients with the so-called "morbus acutum dexter", i.e. appendicitis, or a gynaecological disease and 2) late complications in patients who had earlier benign gynaecological disease, usually such as tumour and surgery for it. The material with seven years follow-up consisted of 97 patients, who were treated during the periods 1959--60 and 1969--70. The relative numbers in both groups increased during the latter period. Of the patients in the reproductive age with suspected appendicitis, gynaecological diseases--mostly ovarian tumours with complications--constituted 7.6% of patients who had undergone appendicectomy in the surgical unit during the former period and 9.6% during the latter. The late complications consisted mainly of small bowel obstruction, resulting from adhesions caused by previous gynaecological surgery. The time interval between initial surgery and the obstruction was rather long, 3.5 years on the average. In the surgical unit the surgery was carried out in about two thirds of these patients. Our analysis demonstrates the necessity of recognizing cases with gynaecological aetiology as a significant factor in surgical practice; it has to be taken into consideration both in surgical and gynaecological education.
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PMID:Abdominal gynaecological emergencies in the surgical unit. 50 38

The most common nontraumatic acute surgical lesions of the infant abdomen are considered. These abdominal lesions are divided into those which do and do not cause bowel obstruction. Lesions causing bowel obstruction are almost always identified as being surgical and are usually appropriately treated. Most common in this group are incarcerated inguinal hernia and malrotation. Among the non-obstructive lesions, appendicitis is the most common and frequently very difficult to diagnose in this age group. The early use of a barium enema is advocated if appendicitis is a diagnostic possibility. Profound ileus can be seen in a variety of medical conditions and several examples are cited.
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PMID:Radiology of the acute surgical abdomen in infants and young children. 52 37

Twenty-seven patients with peritonitis to whom a drain was applied were given sulbenicillin (SBPC), a broad-spectrum antibiotic, which has so little hepatic and renal toxicity that massive doses may be feasible, and examination was made as to its therapeutic effects and concentrations of the antibiotic in the ascites. Daily dosage of SBPC was 10g in two divided doses in most cases given by the intravenous infusion. Medication was continued for 3 approximately 15 days. The highest daily dosage was 20g and the largest total dosage reached 190g, but there was no adverse reaction except for one case of a slight anemia. Peritonitis complicated appendicitis, adnexitis, duodenal ulcer perforation, intestinal obstruction or trauma as its primary disease. No difference in the therapeutic effect existed among the primary diseases. The response to SBPC treatment was excellent in 8 of the 27 patients and good in 17. Two patients failed to respond to the therapy. When SBPC was given just before operation, the SBPC concentration in ascites obtained at operation was 112 microgram/ml in 2 cases. The SBPC concentrations in ascites were examined following intravenous infusion of 5g over an hour, and a peak concentration of 94.7 microgram/ml was obtained at the completion of infusion (an hour after the start of infusion), which gradually decreased thereafter. In the ascites excreted from the drain after operation, a high concentration of 12.7 approximately 90.2 microgram/ml (mean: 51.7 +/- 7.7 microgram/ml) was obtained on the day after the operation day, but the concentration was lower thereafter. The SBPC concentrations in ascites were compared as regards the sites of drainage (Winslow's foramen, ileocecum and Douglas' fold), but no particular difference was observed. The SBPC concentrations in ascites after operation were in inverse proportion to the alleviation of peritonitis. They were higher when the inflammation was severer.
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PMID:[Chemotherapy of peritonitis with particular reference to concentrations of sulbenicillin in human ascites (author's transl)]. 65 Aug 86

The diagnosis of Crohn's disease in 13 patients (ten females and three males) at the Howard University Hospital during the ten-year period, 1965-1975, is examined. The most common presenting symptoms were right lower quadrant (RLQ) pain, diarrhea, anorexia, weight loss, and vomiting, while the most common physical finding was RLQ tenderness. Ileocolic involvement occurred most frequently. Eight patients had surgical resection. The most frequent operation was ileocolic resection with ileo-ascending colostomy. The chief indications for surgery were: (1) presumed appendicitis, (2) intestinal obstruction, and (3) internal fistulae.Crohn's disease seems to occur in blacks much less frequently than in whites. When compared to series of white patients reported by others, the series studied here has more females and more ileocolic involvement. In most other series, the greatest involvement is in the "ileum only" group.
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PMID:Crohn's disease in black patients. 85 35

Among 976 children with acute appendicitis 966 were operated upon, 169 of them (17.4%)-for common appendicitis, 401 (41.2%)-for phlegmonous appendicitis, 396 (40.4%)-for gangrenous appendicitis; 10 children were subjected to surgery due to the presence of appendicular infiltration. Preoperatively, in 137 (13.7%) patients peritonitis was observed: local-in 90, diffuse and progressive-in 47. There was noted a dependence of complications on the terms of the disease and patients' stay at the hospital prior to surgery. Following the operation in 98 (10.1%) patients different complications were observed: the postoperative wound suppuration (61), inflammatory processes in the abdomen (infiltrations, abscesses-in 33), intestinal obstruction (2), intra-abdominal hemorrhage (1), enteric fistula (1). There were no lethal issues. The preoperative complications were conditioned by gravity and advanced forms of the principal lesion, technical drawbacks in operation and treatment of purulent peritonitis.
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PMID:[Complications of acute appendicitis in children]. 122 23

In the majority of patients in this series of 1,000, acute abdominal pain was due to conditions that required neither surgical intervention nor hospitalization. Eleven of the 1,000 patients had an early missed diagnosis in the emergency clinic for which a subsequent operation was needed, and twenty underwent an operation which subsequent diagnosis showed was not required. All false-negative evaluations occurred in patients with early appendicitis or small bowel obstruction. Most false-positive results were due to acute infections of the female genitourinary tract in patients operated on to exclude appendicitis or a tubo-ovarian abscess. The following factors help identify the high risk patient with an acute surgical abdomen: (1) pain for less than 48 hours; (2) pain followed by vomiting; (3) guarding and rebound tenderness on physical examination; (4) advanced age; (5) a prior surgical procedure. The presence of these features demands careful evaluation and a liberal policy of admission and observation. White blood cell counts, body temperature, and abnormal abdominal roentgenograms may add confirmatory evidence but are not particularly helpful as screening devices.
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PMID:Abdominal pain. An analysis of 1,000 consecutive cases in a University Hospital emergency room. 125 63

Between 1 January 1988 and 31 December 1989, 525 patients were admitted to one hospital with a diagnosis of acute abdominal pain. Of these, 182 (34.7%) underwent an emergency operation and 14 (7.7%) of these patients subsequently died within 30 days. Death was due to intestinal obstruction in 69%, and there was a 28% mortality rate for emergency colonic resection. Non-specific abdominal pain (NSAP) was the most common diagnosis (36.0%), followed by appendicitis (14.9%) and urological causes (12.8%). There was an unnecessary appendicectomy rate of 25.0%. Admission with pain because of urological causes was over twice that of previous reports. Duration of stay increased greatly with age. Results from this study confirm the high mortality rate in the elderly from emergency colonic resection. Greater care in diagnosis and a conservative approach to appendicitis, with laparoscopy in females of reproductive age, may produce a lower unnecessary appendicectomy rate without an increase in morbidity. If the diagnosis of NSAP could be made earlier and patients discharged sooner, a large saving in resources would result. This early diagnosis is not yet possible.
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PMID:Abdominal pain as a cause of acute admission to hospital. 751 36

Fifty-one children under the age of 10 years admitted to a general hospital in Trinidad had a confirmed diagnosis of malrotation of the intestines. This was the primary diagnosis in 20 cases. Analysis of the records of these 20 revealed that one-half were less than 1 month of age at first presentation. Vomiting was a universal complaint, and nearly two-thirds were malnourished. Disturbed bowel habit, anorexia and abdominal pain were also reported. In 30% (six of 20) there were signs of dehydration; an equal number had features of intestinal obstruction. Radiological investigation provided the diagnosis in all but one child, who underwent surgical exploration with a provisional diagnosis of appendicitis. Although a volvulus was found in 35% of cases, no resections were necessary. A high rate of morbidity and a mortality rate of 15% highlight the problems involved in the surgical care of young infants.
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PMID:Intestinal malrotation in Trinidad. 140 41

An individual who has cystic fibrosis (CF) may suffer from gastrointestinal problems related to inadequately controlled intestinal absorption secondary to the pancreatic insufficiency. These include neonatal meconium ileus, distal intestinal obstruction syndrome (DIOS), constipation and acquired megacolon, rectal prolapse and rarely pancreatitis. If the intestinal malabsorption is well controlled with an effective pancreatic enzyme preparation, DIOS, constipation and rectal prolapse are infrequent. Persisting gastrointestinal symptoms should be investigated thoroughly to exclude other disorders not directly related to the cystic fibrosis; these include cows' milk intolerance, coeliac disease, giardiasis, Crohn's disease and intra-abdominal malignancy. Both appendicitis and intussusception may cause difficult diagnostic problems particularly in patients who may also have distal ileal obstruction syndrome.
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PMID:Cystic fibrosis: gastrointestinal complications. 145 4


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