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

In the summer of 1987-1988, an outbreak of 11 cases of Yersinia enterocolitica enteritis caused by 2 serogroups (0:3, 0:6,30) occurred prompting an investigation into possible environmental sources. Symptoms were present for a mean of 9 days and occurred in 2 distinct age groups--toddlers (7) who presented with diarrhea, and young adults (4), 3 of whom presented clinically with appendicitis. In a survey of 39 randomly chosen pasteurized milk samples, 9 were positive for growth of Y. enterocolitica and 1 each for Y. fredericksenii and Y. intermedia. An association between clinical and milk isolates of Y. enterocolitica was thus sought by comparison of biogroups, serogroups, virulence markers and biochemical and outer membrane profiles. All milk isolates belonged to biogroup 1, serogroup 0:6,30. Pathogenicity studies on the 0:6,30 serogroup isolates from feces and milk were performed with 3 in-vitro tests (Ca2+ dependency, autoagglutination, & serum resistance). The human isolates were positive in most of the 3 tests whilst none of the milk isolates were positive. Outer membrane protein analysis of 0:6,30 from human and milk isolates showed similar profiles suggesting a possible association, however the environmental source of the majority of isolates (0:3) remains unknown.
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PMID:Relationship between clinical and milk isolates of Yersinia enterocolitica. 174 67

Out of 334 patients operated on for PHPT in the years 1956-79, 34 (10.2%) had died before the end of the year 1980. In the sex and age matched control material of 334 patients operated on at the same time for varicose veins, appendicitis or haemorrhoids the mortality was 21 (6.3%). The difference in mortality between these groups was statistically significant (p less than 0.05). The mean age at death of the PHPT patients was 65 years and that of the control patients 67 years. The PHPT patients who died differed from the whole PHPT material in higher mean age at operation (61 years v. 53 years), higher preoperative serum calcium values (3.31 mmol/l v. 3.08 mmol/l), more frequently elevated serum creatine preoperatively (44% v. 17%) and higher mean weight of the removed adenomas (3300 mg v. 2000 mg). The PHPT patients who died had also more often the severe form of PHPT: 55% of the patients with hypercalcaemic crises and 24% of the patients with cystic bone changes had died, whereas the respective percentage was 4% in the renal stone group. Four of the PHPT patients had died of uraemia, and, in addition, four patients had progressive renal damage. 18 PHPT patients had died of cardiac disease, four patients of a cerebrovascular attack and one patient of other vascular disease. There were eight cardiovascular deaths in the control group (p less than 0.01). There were no differences in other causes of death, such as malignant tumours, between the groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Causes of death in patients previously operated on for primary hyperparathyroidism. 401 16

We report the case of an 11-year-old child with delayed development who developed signs of exercise-induced pain in the lower limb muscles after an acute attack of appendicitis. He had difficulty standing up from the sitting position and ascending and descending stairs. The physical examination revealed increased reflex activity in the lower limbs. Initially, blood tests, MRI and EMG were normal. Serum phosphorus and calcium were not assayed. Eight months later, the boy's condition worsened (myopathy gait, hyperlordosis) leading to the possible diagnosis of muscle disease. After muscle biopsy, blood tests revealed hypercalcemia at 3.5 mmol/l (normal 2.2-2.6), hypercalciuria, and hypophosporemia. The diagnosis of primary hyperparathyroidism was confirmed by the abnormal level of parathormone initially (19 ng/ml) and later (156 ng/ml) with hypercalcemia. Medical treatment failed and surgery was performed to remove three and a half parathyroid glands. After removal, blood tests returned to normal in six days and the physical examination in three years. The diagnosis of principal cell hyperplasia was retained at the pathology examination. We found no evidence of hypercalcemia or other endocrinopathy such as multiple endocrine neoplasia (MEN 1 or 2a). Study of the menine gene did not reveal any mutation. Muscle dysfunction suggest possible abnormal phosphocalcium regulation. A normal parathormone level with hypercalcemia reveals inappropriate synthesis and secretion.
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PMID:[Primary hyperparathyroidism revealed by pseudomyopathia]. 1595 13

We present an unusual case of a 55-year-old man with symptoms of recurrent appendicitis. Laparoscopy revealed a 1.5 cm gallstone impacted at the base of the appendix, leading to gangrenous appendicitis. This patient did not have any features of gallstone ileus. On imaging he had an inflammatory mass in the region of the right iliac fossa with a hyperintense shadow in the cecal area which was reported as an appendicolith. There was no demonstrable cholelithiasis or biliary-enteric fistula. There were dense omental adhesions in the pericholecystic area on laparoscopy. The case was successfully managed by laparoscopic appendectomy with retrieval of the gallstone. No surgery was undertaken for the gallbladder. Diagnosis was confirmed by biochemical analysis of the stone, which contained calcium bilirubinate and cholesterol. A gallstone obstructing the appendicular lumen is a very rare etiology of gangrenous perforation of the appendix peritonitis. This case was successfully managed laparoscopically.
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PMID:Laparoscopic management of gallstone presenting as obstructive gangrenous appendicitis. 1636 72

Appendicoliths are formed by calcium salts and fecal debris layered and lodged within the appendix. They are detected on unenhanced X-rays in <10% of patients with appendicitis. When an appendicolith is found extraluminally, it is pathognomonic for perforation of the appendix. Moreover, retained appendicoliths are likely to be infected and to be the source of a postoperative intraperitoneal abscess, whereupon the only definitive treatment is surgical excision. In this paper, we describe an asymptomatic patient with evidence of an extraluminal appendicolith on computed tomography following successful conservative treatment for a periappendicular abscess. She underwent a laparoscopic interval appendectomy that included the removal of an extraluminal appendicolith and was released home on the following day. We advocate this approach in order to prevent the possible formation of an intra-abdominal abscess caused by an infected nidus.
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PMID:Extraluminal appendicolith: an indication for interval appendectomy with intraoperative localization and removal of that potential cause of intra-abdominal abscess. 1872 Oct 14

Appendicoliths are formed by calcium salts and faecal debris layered and lodged within the appendix. They are detected on unenhanced x-rays in less than 10% of patients with appendicitis. When an appendicolith is found extraluminally, it is pathognomonic for perforation of the appendix. Moreover, retained appendicoliths act as a nidus for infection and are likely to be the source of a postoperative intraperitoneal abscess. However, this is very rare with only 30 reported cases of intra-abdominal abscess secondary to an appendicolith in the literature over the past 40 years. Retained, or dropped, appendicoliths most commonly present as an area of high attenuation less than 1cm in diameter with an associated abscess close to the caecum or Morrison's pouch on computed tomography (CT). A study published in 2006 showed that although there is initial success with CT-guided drainage of abscesses secondary to faecaliths, all will recur and formal surgical drainage with removal of the appendicolith is required. This case report highlights not only an unusual complication of a retained appendicolith but also the importance of taking a thorough history and interpreting investigations in the context of the patient's past medical history so as to produce a differential diagnosis and prevent treatment of incorrect conditions.
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PMID:A complication of a dropped appendicolith misdiagnosed as Crohn's disease. 2192 6

Acute appendicitis is one of the commonest surgical emergencies worldwide. There is considerable variation in prevalence of appendicoliths with appendicitis. Most of the patients with appendicoliths are asymptomatic and they are not pathognomic for acute appendicitis. However, appendicoliths show increased association with perforation and abscess formation. Appendicolith are quite common, being present in 3% of general population and in nearly 10% cases of appendicitis. However, giant appendicoliths measuring over 2 centimeters (cms) are extremely rare. Computed Tomography (CT) has increased their pre-operative diagnosis considerably. Use of spectral analysis can give us the details of composition of the stone pre-operatively. We present a young male diagnosed pre-operatively on Non-Contrast Computed Tomography (NCCT) to have a giant calcium struvite appendicolith. On laparoscopy he had a 3 cm stone and an incidental Meckel's diverticulum and underwent appendectomy. The case is presented for the unique size of the appendicolith alongwith review of literature.
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PMID:Giant appendicolith: Rare finding in a common ailment. 2707 12

We present the very unusual case of a 38-year-old woman with acute appendicitis and intestinal obstruction. During surgery, a 2.5 cm gallstone impacted at the base of the cecal appendix was found as the cause of a gangrenous appendicitis and obstruction; a choledochal-duodenal fistula was found during the same surgery with no gallstones remaining in the gallbladder or elsewhere. The case was managed by appendectomy with retrieval of the gallstones and no other procedure was performed for the gallbladder or the fistula, since no other gallstone was found on examination. Previously, she was found to have a round, radio-opaque image on the right iliac fossa on imaging, initially identified as an appendicolith, but after pathological examination it turned out to contain cholesterol and calcium bilirubinate. Gallstone ileus as the cause of an obstructive gangrenous appendicitis is a very unusual disease presentation that should be kept in mind when finding an unusual appendicolith presentation in or out the appendix.
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PMID:Gallstone ileus presenting as obstructive gangrenous appendicitis. 2821 Dec 83