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

Recent reports indicate that colonization or infection of the genital tract with Actinomyces israelli (an anaerobic, gram-positive, non-acid fast, obligate parasite classified between the true bacteria and complete fungi) may be related to IUD use. To determine the incidence of Actinomyces infection in IUD users and a comparable samples of nonusers, a prospective controlled study was undertaken using 50 study and 50 control patients from the Grady Memorial Hospital's gynecology and family planning clinics. The age and parity of the 2 groups ranged from 17 to 52 years, and 1.9 to 2.8, respectively. Selected risk factors predisposing to colonization or infection with Actinomyces were considered and included frequency of intercourse per week; contraceptives used; and histories of appendicitis and pelvic inflammatory disease (PID). Both groups were divided into women less than 35 years of age and those more than 35 years of age. There were 29 control and 9 study patients in the older group. Of the 9 study patients, 4 (44.4%) had Actinomyces compared to none of the 29 control patients (p .01). The Lippes loop, which was used by 50% of the IUD users, was the most commonly removed IUD. The characteristics of the 4 patients were described in Table 5. Cervical cytology was used in detecting the Actinomyces infection or colonization of the 4 study patients, who were managed by IUD removal and follow-up biopsies or Pap smears. Symptomatic patients should have their IUDs removed and should be treated with antibiotics to provide both aerobic and anaerobic coverage.
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PMID:Pelvic colonization with Actinomyces in women using intrauterine contraceptive devices. 50 19

In September-December 1988 in Australia, at least 1495 couples in metropolitan Perth completed a questionnaire as a part of a study to measure the extent of infertility (inability to conceive after 12 months on unprotected intercourse) and sterility (surgical procedure responsible for end of reproductive function) and to examine their characteristics and associations. 22.6% of all couples had no children. 53 couples (3.5%) suffered from current infertility. It was highest among 30-34 year old women (4.2%). 285 women (19.1%) had experienced infertility at some time in their lives. Lifetime cumulative incidence of ever having been infertile was 22.8%. Lifetime infertility was significantly associated with multiple sexual partners (p = .04), pelvic inflammatory disease (p = .0001), and appendicitis with rupture (p .0001). Tubal pathology and male problems were the leading causes of infertility. 555 couples (37.1%) experienced surgical sterility. Just 2% of these 555 couples had an associated reproductive disability (inability to achieve desired level of reproductive function). Sterility prevalence was greatest among 40-44 year old women (72.2%). Contraceptive sterilization was the major reason for surgical sterility. 47 couples (3.1%) had reproductive disability. They comprised 36 infertile couples and 11 surgically sterile couples. 10 of the surgically sterile couples regretted their decision to undergo sterilization. 48.9% of all reproductive disabled couples had at least 1 child. 23 of the 47 couples sought medical treatment for reproductive disability. Reproductive disability peaked at 30-34 years old (female partner's age). Medical intervention allowed .9% of all women (14 women) in the survey to conceive. These results indicated a need to develop a strategy to prevent reproductive disability, especially infertility.
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PMID:A survey of infertility, surgical sterility and associated reproductive disability in Perth, Western Australia. 129 86

Infertility is secondary to pelvic adhesions in 15-20% of cases. Pelvic adhesions result from pelvic inflammatory disease, previous pelvic surgery, foreign bodies and previous appendicitis with pelvic abscess. As a result of the insult to the peritoneal surfaces of the pelvic organs, the concentrations of peritoneal fluid leukotriene, B4 and prostaglandin E2 are increased. Also, there is a decrease in plasminogen activity. The end result will be the formation of fibrin deposits, which will end in the formation of pelvic adhesions. The diagnosis of adhesions can be achieved by a high index of suspicion in patients with a history of pelvic infections or surgery. A pelvic examination with fixation of the uterus and/or adnexa is also highly suggestive. A hysterosalpingogram might lead to a suspicion of the presence of pelvic adhesions; however, there is some degree of false-positive and -negative results. The definitive diagnosis depends on laparoscopy. The use of an internationally accepted classification, such as that of the American Fertility Society, allows investigators to compare the results of treatment. Various adjuvants have been used following lysis of adhesions to prevent their recurrence; they yield various results. The most significant recommendation is to prevent the occurrence of adhesions by following the principles of microsurgical technique during every surgical procedure.
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PMID:Pathophysiology of pelvic adhesions. Modern trends in preventing infertility. 137 47

From 1987 to 1990, 99 patients were treated for appendicitis. 67 patients were treated by endoscopic appendectomy, 32 patients underwent laparotomy for appendectomy. Among these 67 patients we found 4 patients with endometriosis, 6 with pelvic inflammatory disease, and 4 pregnant patients. In no case did we have difficulties during the laparoscopic operation; only 4 patients developed severe inflammatory complications during the postoperative period. For this reason, we do not perform a prophylactic appendectomy during gynaecological laparoscopies. We recommend careful postoperative treatment after laparoscopic appendectomy.
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PMID:[Endoscopic appendectomy in gynecology and obstetrics]. 153 57

Tubo-ovarian abscesses are uncommon complications from pelvic inflammatory disease. The theoretical basis for bacterial seeding of the Fallopian tube and ovary is an ascending infection through the uterus. This paper presents a case of a tubo-ovarian abscess in a woman 6 years after a hysterectomy. Although it is known that tubo-ovarian abscesses can occur in the presence of adjacent appendicitis or diverticulitis, neither of these was present in this patient. Therefore, the mechanism for infection in this patient was either a subacute condition preceding her hysterectomy or hematogenous seeding of her adnexal structures. Either of these mechanisms for infection challenge the currently held theories that have been put forth to describe the formation of tubo-ovarian abscesses.
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PMID:A case of tubo-ovarian abscess 6 years after hysterectomy. 155 75

The reliability of the signs and symptoms of acute appendicitis are reviewed. The wide variation in clinical findings when the different studies are compared can probably be explained by the huge quantity of retrospective studies. Migration of pain to the right iliac fossa and/or guarding/rigidity support the diagnosis of appendicitis. The diagnosis of appendicitis should be doubted when anorexia, nausea and vomiting are absent, when symptoms have persisted for more than 72 h without apparent perforation, or when tenderness in the right iliac fossa is absent. Presentation in proximity to menstruation, cervical dislocation tenderness and bilateral adnexal tenderness indicates pelvic inflammatory disease. Small children have high perforation rates because of their uniform response to many illnesses and relative inability to express themselves and cooperate. The clinical findings in young and old patients are similar, except for a higher rate of abdominal distension in old patients. With a more thorough knowledge of the signs and symptoms of acute appendicitis and a constant awareness of its possible presence, it should be possible to increase the diagnostic accuracy.
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PMID:Assessment of the reliability of the symptoms and signs of acute appendicitis. 140 57

Unnecessary abdominal explorations in severely injured patients can be reduced by employing emergent or urgent laparoscopy in blunt abdominal trauma and the obscured, acute abdominal cases. In 150 blunt abdominal trauma cases, a mini-laparoscopy was used in the emergency room or the intensive care unit without major complications. In 56%, the findings were negative. In 19%, the laparoscopic findings were corroborated by surgery. In 25%, a minimal to moderate hemoperitoneum was found and the laparoscopic impression dictated close observation. Unnecessary exploration was avoided except in one case. In the elderly high-risk patient with a poor history, abdominal examination can be noninformative. Laparoscopy can detect acute appendicitis or organ perforation. In the young female, appendicitis can be differentiated from pelvic inflammatory disease. Laparoscopy is more accurate and gives a larger latitude for decision-making than lavage. It can also be useful in the obscured problematic abdominal case.
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PMID:Emergency laparoscopy. 182 52

The diagnostic and therapeutic value of laparoscopic surgery is known for ovarian cysts and ectopic pregnancies. The diagnostic of appendicitis is difficult and laparoscopy is useful. The aim of this study is to assess the feasibility, the efficacy and the advantages of a new technique of laparoscopic appendectomy. From August 1, 1989 to July 31, 1990 the women seen for pelvic pain have been divided in three groups: appendicitis, pelvic inflammatory disease (PID) and doubt. Intra peritoneal appendectomy has been performed if the laparoscopic diagnosis was not PID. Via three supra symphyseal trocars the appendix has been exposed and his meso coagulated. The appendix stump has been closed with a clip applicator (Ethnor T1300). Thirty-one women have been involved in this study. Twenty women had a laparoscopic appendectomy. Mean operation time was 36 minutes. In no occasion laparotomy was necessary. There was no post-operative complication and stool was obtained on the second post operative day. Patients and nurses appreciation was excellent. This operative procedure was possible in each attempt. This technique is sure, quick and easily reproducible. Comfortable post operative period and esthetic advantage have been noticed by the women. This operation has been possible in each attempt. This technique is sure, quick and easily reproducible.
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PMID:[Intra-peritoneal appendectomy by celioscopy. Preliminary results of a new technique]. 183 79

The diagnostic and therapeutic value of laparoscopic surgery has been established for ovarian cysts and ectopic pregnancies. The diagnosis of appendicitis is difficult and laparoscopy is useful. The aim of this study is to assess feasibility, efficacy and advantages of a new technique of laparoscopic appendectomy. From 1st August to 15th December 1989, the women seen for pelvic pain were divided into three groups: appendicitis, pelvic inflammatory disease (PID) and doubtful. Intra-peritoneal appendectomy was performed when the laparoscopic diagnosis was not PID. Via three supra symphyseal trochars, the appendix was exposed and its mesentery was coagulated. The appendix stump was closed with a clip applicator. Twelve women were included in this study. In two thirds of cases, laparoscopy confirmed the clinical diagnosis. Mean operation time was 39 minutes. Laparotomy was never necessary. There were no post-operative complications and intestinal transit was always complete on the second post-operative day. The patient's and nurse's appreciation was excellent. This operation was possible on every occasion. This technique is sure, quick and easily reproducible. A comfortable post-operative period and esthetic advantages were reported by the women.
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PMID:[Pelvic pain in women. Evaluation of a celioscopic intraperitoneal appendectomy technique]. 183 17

The diagnostic worth and therapeutic value of laparoscopic surgery are known for ovarian cysts and ectopic pregnancies. Diagnosis of appendicitis is difficult, and laparoscopy is useful in these cases. The present study was done to assess the feasibility, efficacy, and advantages of a new laparoscopic appendectomy technique. Between August 1, 1989, and July 31, 1990, patients exhibiting right pelvic pain associated with fever were divided into three groups according to the pre-operative diagnosis: appendicitis, pelvic inflammatory disease (PID), and diagnostic doubt between appendicitis and PID. An intra-peritoneal appendectomy was performed if the diagnosis was not PID. Via three suprasymphyseal trocars, the appendix was exposed and the mesoappendix was coagulated. The appendix stump was closed using a clip applier (Ethnor T1300). In all, 20 patients underwent laparoscopic appendectomies. The mean duration of the procedure was 36.5 min; in no case was laparotomy necessary. There were no post-operative complications, and digestive transit returned on the 2nd day post-surgery. Both patients and nurses appreciated the technique. The subjects experienced comfortable post-operative periods and gained aesthetic advantages. The operative procedure could be completed on each attempt. We conclude that this technique is sure, quick, and easily reproducible in young patients presenting with right pelvic pain associated with fever.
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PMID:Laparoscopic appendectomy using a clip applier. 183 75


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