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

A special study of the character and sensitivity of microbic flora of the abdominal cavity exudate in acute appendicitis was carried out upon 192 patients. The predominance of infection caused by colibacillus (44%) and correlation between the severity of the inflammatory process and the presence of the agent in the exudate were proved. The identification of the sensitivity of the cultured microbes to the most widely used antibiotics allows to recommend a combined use of the preparations of neomycin sulfate group and synthetic penicillins for the treatment of complicated appendicitis.
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PMID:[Characteristics of the microbial flora of the abdominal cavity in acute appendicitis]. 71 49

Surgical interventions for nonobstetric reasons during pregnancy are reported to occur in 0.2% to 2.2% of all gestations with obvious perinatal implications. In this retrospective study, 57 parturients were identified who underwent nonobstetric abdominal surgery. Thirty-one patients underwent exploratory celiotomy for suspected appendicitis, 16 for adnexal disease other than ectopic pregnancy, six for cholecystectomy, three for intestinal disorders, and one with a pheochromocytoma. Alterations in disease expression are related to the severity of the disease and advancing gestational age, being more important in cases of appendicitis. Preterm labor reflecting fetal morbidity relates to the presence of peritonitis and then only during the third trimester. In this retrospective study, tocolysis with intravenous magnesium sulfate had an uncertain effect on the incidence of preterm delivery. Prospective studies will be required to assess the indications and limitations of tocolysis for nonobstetric abdominal surgical conditions.
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PMID:Perinatal aspects of abdominal surgery for nonobstetric disease. 278 37

Surgical infection remains a leading cause of hospital morbidity and mortality. We compared the efficacy and toxicity of imipenem-cilastatin sodium in 32 patients with that of clindamycin phosphate and gentamicin sulfate in 25 patients. In the imipenem-cilastatin group, 87.5% had a favorable outcome, with a 12.5% failure rate and 13 adverse reactions. In the clindamycin-gentamicin group, 80% had a favorable outcome, with a 20% failure rate and ten adverse reactions. Two significant superinfections with Pseudomonas and Candida were noted in patients treated with impenem-cilastatin. Each group had one case of Clostridium difficile-associated colitis. Cost analysis showed no differences between treatment arms, except in the appendicitis subgroup. For serious surgical infections, single-agent therapy with imipenem-cilastatin appears to be as efficacious as combination therapy with clindamycin and gentamicin.
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PMID:Prospective study comparing imipenem-cilastatin with clindamycin and gentamicin for the treatment of serious surgical infections. 327 87

One hundred five patients with peritonitis were randomized to receive either tobramycin sulfate plus clindamycin phosphate or moxalactam alone before surgical intervention. Fifty-nine patients were evaluable. A mean of 3.1 (moxalactam) and 3.5 (tobramycin-clindamycin) pathogens per patient were identified. Overall success rate was 85% (tobramycin-clindamycin, 24/30; moxalactam, 26/29). When patients with appendicitis were excluded, there was an observed but not statistically significant advantage of moxalactam over tobramycin-clindamycin (85% vs 67%). There were five deaths (tobramycin-clindamycin, four; moxalactam, one). Other complications included hypoprothrombinemia (tobramycin-clindamycin, five; moxalactam, five), renal dysfunction (tobramycin-clindamycin, three; moxalactam, one), and superinfection (tobramycin-clindamycin, nine; moxalactam, six). More wound infections were noted in the group given tobramycin-clindamycin. These data suggest that moxalactam is as safe and efficacious as tobramycin plus clindamycin. The observed benefits of this agent warrant study in a larger sample to verify advantages of moxalactam over combination therapy.
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PMID:Moxalactam vs tobramycin-clindamycin. A randomized trial in secondary peritonitis. 328 9

From 1976 to 1985, 233 consecutive children were treated for appendicitis by a standardized protocol. Forty-nine percent of these cases were complicated: 11% by gangrene, 33% by perforation, and 4% by perforations with well-developed abscesses. Treatment of gangrenous and perforated appendicitis consisted of administration of ampicillin sodium, gentamicin sulfate, and clindamycin phosphate; appendectomy; and saline peritoneal irrigation. Transperitoneal drainage was not used. Skin and subcutaneous tissues were left open for delayed primary wound closure. Perforations with well-developed abscesses were treated with triple antibiotic therapy and interval appendectomy. The only infectious complication was one intra-abdominal abscess. There were no wound infections or deaths. The rate of infectious complications was 0.9%, and the overall morbidity was 4.4%. This standardized treatment of complicated appendicitis in children prevents wound infection and significantly decreases the incidence of intra-abdominal abscess formation and mortality.
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PMID:The treatment of complicated appendicitis in children. What is the gold standard? 356 25

Single doses of clindamycin hydrochloride and gentamicin sulfate given preoperatively, combined with intraoperative topical application of povidone-iodine were given to patients with perforated or gangrenous appendicitis. The incidence of wound sepsis was reduced from 36% to 5%; severe infections were reduced from 25% to 0% when compared with a control untreated group of patients. When used alone, povidone-iodine had little effect in these patients. No toxic effects of the antibiotics or antiseptic were recorded nor were any resistant strains of pathogenic organisms grown from cultures.
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PMID:Combined preoperative antibiotic therapy and intraoperative topical povidone-iodine. Reduction of wound sepsis following emergency appendectomy. 637 44

The areas of controversy in appendicitis management in children include antibiotic usage, drainage of the peritoneal cavity, and closure of contaminated incisions. Our results and bacteriologic data suggest that gentamicin sulfate and clindamycin phosphate should be routinely used in cases of suspected perforation, that only selective and limited use of drains is warranted, and that delayed primary closure should be used in all cases with perforation.
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PMID:Controversial aspects of appendicitis management in children. 725 89

The objective of this study was to determine if judicious dosing of morphine sulfate can provide pain relief without changing important physical examination findings in patients with acute appendicitis. We conducted a prospective, randomized, double-blind crossover design. Patients scheduled for appendectomy were randomized to two groups. Group A received 0.075 mg/kg intravenous morphine sulfate and 30 minutes later received placebo. The sequence of medication was reversed in group B. Patients were examined by a surgical resident and an EM attending before and after receiving medication. Six explicit physical examination findings were documented as absent, indeterminate, or present. Physicians were also asked if they felt overall examination findings had changed after medication. Patient's visual analog scale (VAS) was recorded before each medication and at study completion. Thirty-four patients were enrolled and full data were available for 22 patients. Neither morphine nor placebo caused a significant change in individual examination findings. Three patients in both groups were judged to have a change in their examination after medication. The median change in VAS was 20 mm after morphine and 0 mm after placebo (P =.01). In this pilot study, patients with clinical signs of appendicitis were treated with morphine and had significant improvement of their pain without changes in their physical examination.
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PMID:Does morphine change the physical examination in patients with acute appendicitis? 1525 69

Because barium sulfate (BaSO(4)) is not harmful to the mucosa, it is widely used for gastrointestinal imaging. Barium appendicitis is a very rare complication of barium meals and barium enema. We report a case of acute appendicitis associated with retained appendiceal barium. A 47-year-old man presented with right lower abdominal pain after upper gastrointestinal imaging was performed using barium 1 month earlier. The abdominal plain roentgenogram showed an area of retained barium in the right lower quadrant. Multiplanar reconstruction of computed tomography scans showed barium retention in the appendix. Emergency appendectomy was performed. A cross section of the specimen revealed the barium mass. Barium-associated appendicitis is a very rare clinical entity but we should be cautious of this uncommon disease when we encounter barium deposits in the appendix after barium examination. This report is significant because barium was identified both macroscopically and microscopically.
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PMID:Barium appendicitis 1 month after a barium meal. 2329 68

Barium appendicitis is a rare complication that has only been reported in a small number of case reports in the medical literature. A 57-year-old male presented to the emergency room with a sudden onset of sharp right lower quadrant abdominal pain. He had undergone contrast barium examination of his stomach 2 months previously as part of a periodic examination for gastric cancer. The radiological findings showed that the shape and radiopaque levels were similar to those of a dental metal crown silhouette. The patient was strongly suspected to have a localized intra-abdominal abscess due to ileocaecal perforation with a foreign body such as a dental metal crown. Emergency surgery revealed acute phlegmonous appendicitis. The resected specimen demonstrated a phlegmonous appendix which contained solid coproma. Pathological diagnosis and composition analysis confirmed the onset of appendicitis to be a result of the patient's ingestion of barium sulfate.
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PMID:Barium-induced appendicitis mimicking accidental ingestion of a dental metal crown in radiological findings. 2618 27


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