Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0003615 (appendicitis)
 4,439 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acute pelvic pain is a common syndrome in women and is an emergency. Management requires rapid diagnostic evaluation to enable immediate treatment. Blood tests (beta-HCG assay, etc.), bacteriological studies and pelvic ultrasonography may be required. Gynecological problems are the commonest etiology: ectopic pregnancy, miscarriage, PID. The possibility nevertheless remains of appendicitis, sigmoid diverticulitis, UTI or renal colic, all of which are medical or surgical emergencies.
 ...
PMID:[Acute pelvic pain syndrome. Diagnostic and therapeutic approach in women]. 781 82

Sterilization by tubal occlusive methods is not always successful. This fact is not, however, well recognized among general surgeons. When failures occur, ectopic pregnancy is the usual outcome, most commonly in the Fallopian tube. Ectopic pregnancy has a reported mortality of approximately 3.5/1000, with the majority of deaths associated with delay in diagnosis. The failure to consider this possibility of ectopic pregnancy after tubal ligation when female patients present with right-sided abdominal pain causes health personnel to commonly misdiagnose the condition of appendicitis. A 26 year old woman presented to the Accident and Emergency Department of the Royal Hobart Hospital with lower abdominal pain mainly in the right iliac fossa. Pain was intermittent for two weeks prior to presentation. On the morning of presentation, the pain became severe and was exacerbated by coughing and movements. The patient was nauseated, but had not vomited; there was neither fever nor rigors. Four years earlier, in England, the patient had undergone elective laparoscopic sterilization. Sexually active, she believed that she was menstruating at the time of presentation, especially since her last menstruation occurred four weeks previously. The patient was noted upon examination to have a "grey look," pulse rate of 80 beats/minute, blood pressure of 120/80 mmHg, and a generally tender abdomen, maximally in the right iliac fossa. There were no bowel sounds and rectal examination proved to be extremely painful in all directions. The accident and emergency staff took blood for a full blood count, serum human chorionic gonadotrophin, and arranged surgical consultation. The surgical diagnosis was for acute appendicitis and the patient was transferred to the operating theater for appendectomy. Just prior to anesthetic induction, the pathology results became available, indicating a hemoglobin of 10.3 g/dl and a positive serum HCG. The diagnosis was thus revised to ruptured ectopic pregnancy and laparotomy was performed through a Pfannenstiel incision. 1000 ml of blood was removed from the peritoneal cavity, a ruptured tubal pregnancy was found in the right distal tube, and the appendix was normal. A right salpingo-oophorectomy was performed after which the patient recovered uneventfully and was discharged five days postoperatively. Histopathology confirmed a ruptured ectopic gestation.
 ...
PMID:Misdiagnosis of appendicitis in tubally sterilized women. 846 65

We describe a case of ovarian hyperstimulation syndrome (OHSS) complicated by peritonitis due to perforated appendicitis. A 29-year-old woman presented with abdominal distension after ovarian stimulation with HMG followed by ovulation induction with HCG. Massive ascites with swollen ovaries was observed on ultrasound, and she was admitted on the diagnosis of OHSS. Daily infusion of serum albumin and low dose dopamine failed to increase her urine output and her abdominal symptoms became increasingly deteriorated after her urine pregnancy test turned out to be positive. Paracentesis performed for alleviation of her abdominal distension revealed infected, foul-smelling fluid. An emergency laparotomy was performed, and the definite diagnosis was made as panperitonitis due to perforated appendicitis with right tubal pregnancy. Appendectomy, right tubectomy and vigorous irrigation with drainage were performed. The case implies that OHSS might not only mask typical manifestations of appendicitis, but could also compromise concurrent intraperitoneal infection.
 ...
PMID:Ovarian hyperstimulation syndrome complicated by peritonitis due to perforated appendicitis. 1192 91