Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This article discusses the findings of a study of pre-adolescent children to determine if the mode of presentation of appendicitis had changed over the past 10 years, if the incidence of perforations decreased with age, and if diagnosis related groups (DRGs) impacted the length of hospital stay. The charts of 42 children under the age of 12 years who were discharged from two inner-city hospitals with a diagnosis of acute appendicitis from 1980 to 1989 were reviewed. There were 20 blacks and 22 whites, 26 males and 16 females with an average age of 7.31 years (range: 2 to 11 years). Over 95% of patients presented with right lower quadrant pain, 78% with guarding, 80% with a positive psoas sign, 93% with a positive Rovsing's sign, and 65% with rectal tenderness. Over 85% of patients had a history of nausea, vomiting, and anorexia. The mean duration of pain was 52.8 hours and the mean temperature was 99.6 degrees F. The mean white blood cell count was 18,176 +/- 4682 for whites versus 14,615 +/- 5459 for blacks. At surgery 15/42 (36%) of patients had a perforation, 11 of whom had positive wound cultures. Escherichia coli was recovered in all 11 of these patients. The average duration of pain in the perforated group was 50.9 hours, and the average age was 7 years. Eleven of these patients had normal bowel sounds on admission. Only 31% of the total cohort had a fecalith identified by pathology. The average postoperative length of stay was 6.5 +/- 2.5 days before the initiation of DRGs and 7.5 +/- 3 days afterward.
 ...
PMID:Appendicitis in children: a continuing clinical challenge. 140 59

Appendicitis caused by a misplaced IUD was found in a 29-year-old pregnant woman. The woman had had the device inserted 8 years before. About 5 months after placement and a severe experience of right lower quadrant pain, medical examination revealed that she was pregnant. Abdominal and pelvic X-ray films were thought to be consistent with IUD expulsion, a fairly common occurrence, with an estimated rate of 2-20% within 1 year of placement. Over the next 7 years, the woman continued to experience right lower quadrant pain, but the pain was mild until 20 weeks into her next pregnancy when she was hospitalized with nausea, anorexia, fever, and severe pain. Surgery revealed that her appendix and cecum were bound to an inflamed mass of tissue. During the course of an appendectomy, this tissue mass was found to contain a copper-coated IUD, which was removed by blunt dissection and gentle traction. The IUD had probably partially perforated the uterus on insertion; complete perforation followed in 2-3 months; and copper from the device caused inflammation that eventually involved the appendix. Several months after the appendectomy, it was discovered that the inflammatory mass had been replaced by dense adhesions. This case shows that abdominal and pelvic X-ray examinations may not be sufficient to locate a misplaced IUD in a pregnant woman. If a misplaced device is not clearly visible on X-ray films, further workup may be necessary to avoid the possibility of chronic abdominal pain and complications.
 ...
PMID:IUD appendicitis during pregnancy. 307 60

A 35-year-old female presented with recurrent right lower quadrant pain, nausea, and vomiting. She was afebrile with diffuse abdominal tenderness. Plain x-ray of abdomen revealed small bowel obstruction. A barium x-ray of the small bowel showed stricture of the terminal ileum. A CT scan of the abdomen showed a 6-cm mass in right lower quadrant. She was empirically managed as having Crohn's disease. She underwent laparotomy after failure of medical management with high-dose steroids. There was ulceration and narrowing of terminal ileum. Frozen sections revealed endometriosis. Ileocecectomy was performed. Histopathology of resected specimen confirmed the diagnosis of endometriosis, and there was no evidence of chronic inflammatory bowel disease or neoplasia. Ileal endometriosis should be considered in the differential diagnosis of Crohn's disease in menstruating females presenting with perimenstrual symptoms.
 ...
PMID:Small bowel endometriosis masquerading as regional enteritis. 817 27

Eosinophilic gastroenteritis is a rare entity that can be treated successfully with glucocorticoid therapy if the appropriate diagnosis is made. However, it may present with symptomatology mimicking acute surgical conditions. We present the case of a 26-year-old man who presented with diffuse epigastric pain, nausea, vomiting, and diarrhea. Extensive workup including upper endoscopy and imaging study revealed gastritis with ulcer and ascites. The patient developed right lower quadrant pain with localized peritonitis and leukocytosis. He underwent appendectomy and small bowel biopsy. Pathology revealed eosinophilic cellular infiltrate of both the appendiceal and small intestinal wall. The unique features of this condition are reviewed and surgical approaches are discussed.
 ...
PMID:Eosinophilic gastroenteritis mimicking acute appendicitis. 1126 32

Appendiceal mucocele is a rare clinical condition that causes distension of the appendix lumen with mucus. A seventy-three-year-old female patient presented with complaints of abdominal pain, nausea, and vomiting. Abdominal examination revealed mild tenderness, right lower quadrant pain upon palpation, rebound tenderness and muscular rigidity, and a palpable mass. Abdominal ultrasonography and computed tomography scans demonstrated a cystic lesion in the right iliac fossa, adherent to the cecum, suggesting an abdominal abscess. An emergency operation was performed, during which a diagnosis of a mucocele of the appendix was made. Surgical treatment included appendicectomy, partial resection of the ileum, and resection of the cecum. Histopathologic examination confirmed the operative diagnosis. The role of imaging and clinical approach is emphasized in the treatment of an appendiceal mucocele, especially in emergency settings.
 ...
PMID:A case of giant appendiceal mucocele. 1475 91

Appendectomy for appendicitis is one of the most common procedures performed in the United States. Residual tissue left after an initial appendectomy risks the development of stump appendicitis. A comprehensive review of the English-language literature revealed 36 reported cases of stump appendicitis. Typically, patients present with signs and symptoms similar to acute appendicitis; however, due to prior surgery, the diagnosis is difficult and the rate of appendiceal stump perforation is extremely high. Herein, we present a case of a 32-year-old female presenting with right lower quadrant pain, nausea, and fever 5 months after laparoscopic appendectomy. Upon surgery, an appendiceal stump was discovered.
 ...
PMID:Stump appendicitis: a comprehensive review of literature. 1653 49

Appendicolithiasis is a condition characterized by a concretion in the vermiform appendix. Appendicoliths are found in 10% of patients with acute appendicitis, but they are seen more frequently in perforated appendicitis and in abscess formation. We herein report a case of acute appendicitis due to appendicolithiasis, which mimics acute disorders of the genitourinary tract and causes diagnostic confusion. A38- year-old man presented to our emergency department with a history of intense, acute, recurrent, crampy right lower quadrant pain radiating to the right groin region, accompanied by nausea. Physical examination revealed muscular defense and rebound tenderness in the right lower quadrant, tenderness in the line of the right ureter and right costovertebral angle tenderness. On X-ray examination, a right kidney stone was identified as was an incidental 3-cm density in the right lower quadrant. The patient underwent appendectomy. The diagnosis was made by operation and also X-ray examination of the appendectomy material showing appendicolithiasis. Acute appendicitis may manifest as a variety of genitourinary disorders. The possibility of an appendicolith with or without acute appendicitis must always be considered in the differential diagnosis of acute lower abdominal and pelvic disorders, and in the consideration of common acute urological disorders.
 ...
PMID:Appendicolithiasis causing diagnostic dilemma: a rare cause of acute appendicitis (report of a case). 1898 58

Abdominal pain is a frequent presenting symptom among HIV-positive patients seeking care at emergency departments. We report a case of a 45-year-old HIV-infected Hispanic man who presented with right lower quadrant pain accompanied by fever, decreased appetite, nausea, and vomiting. The results of a CT scan of his abdomen were normal with no evidence of appendicitis. A colonoscopy was performed and revealed an impacted pill in the appendiceal orifice. The pill was removed endoscopically, and pill impaction has not recurred.
 ...
PMID:Pill impaction mimicking appendicitis in an HIV-positive patient. 1920 55

An 11-year-old boy presented with acute nausea and right lower quadrant pain. A contrast-enhanced CT demonstrated a 10-cm left retroperitoneal mass and no other suspicious findings. An fluorodeoxyglucose positron emission tomography/computed tomography performed 2 days later demonstrated inflammatory findings in the region of the appendix, hypermetabolic right psoas adenopathy, and the known retroperitoneal mass, which was less hypermetabolic. At laparoscopic surgery, an acute perforated appendicitis, walled-off by omentum, was discovered. Biopsy of the retroperitoneal mass was compatible with ganglioneuroma. This case exemplifies the utility of fluorodeoxyglucose positron emission tomography/computed tomography for detecting an inflammatory or infectious process coincident with a neighboring neoplastic process.
 ...
PMID:Coincidental presentations of ganglioneuroma and atypical perforated appendicitis detected by fluorodeoxyglucose positron emission tomography/computed tomography. 1989 13

Omental torsion is an underdiagnosed cause of abdominal pain in children. It resembles appendicitis, and the diagnosis is often made surgically. We review the presentation, treatment, and outcomes in the largest reported series to date. We recorded demographics, diagnostics, treatment, and histopathology in 18 children with omental torsion between May 2000 and 2007. We found a 4:1 male to female ratio and 85 per cent met criteria for obesity based on Centers for Disease Control and Prevention body mass index-for-age growth chart calculations. Fourteen of 18 (78%) presented with right lower quadrant pain concerning for appendicitis and seven of 18 (39%) with fever, nausea, or vomiting. Mild leukocytosis was found in 78 per cent of patients. All but one was taken to surgery with a diagnosis of appendicitis. Partial omentectomy, either open (50%) or laparoscopic (50%), was performed in all cases. The appendix, resected in 17 patients, was grossly normal. However, 30 per cent of specimens had histopathologic findings of appendicitis. Hospital discharge, after symptom resolution, averaged 33 hours. Surgeons should have a high index of suspicion for omental torsion when evaluating obese children for right lower quadrant pain. Both surgical approaches provide the diagnosis and treatment with minimal morbidity and rapid recovery. We advocate simultaneous appendectomy because appendicitis is often encountered with the torsion.
 ...
PMID:Clinical presentation and treatment considerations in children with acute omental torsion: a retrospective review. 2042 Feb 48


1 2 Next >>