Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0031154 (peritonitis)
 15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A reduction in wound infection after appendicectomy for acute appendicitis in children is described and attributed to the use of preoperative prophylactic antibiotics. In 118 consecutive children with appendicitis proven on histological examination there were three wound infections (2.5%) and only one of these was a serious wound abscess (0.8%). There was no postoperative abdominal abscess. Twenty-four of these children had appendicitis complicated by gangrene, perforation, peritonitis or abscess formation. This wound infection rate is compared with the author's previous unpublished rate of 8%, and a rate of 37% in a previously published series. It is comparable to the current wound infection rate for clean heriniorrhaphy procedures. The ideal is a single antibiotic effective against aerobic and anaerobic organisms with few side effects and little hypersensitivity. In early appendicitis, cefoxitin alone is likely to be effective, but in patients with complicated appendicitis, cefoxitin with metronidazole or lincomycin with an aminoglycoside are recommended.
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PMID:Appendicitis in childhood: reduction in wound infection with preoperative antibiotics. 695 52

An antibiotic drug of aminoglycoside group, amikacin (AMK) for parenteral use was used to 8 hospitalized patients: 4 with acute or subacute cholecystitis and cholangitis, 4 with acute peritonitis (3 cases were due to acute appendicitis and a case was torsion of right ovarian cyst). AMK in a dose of 200 mg were administered by intravenous drip infusion for 1 to 2 hours, twice a day for 4 to 9 days. To the cases with biliary tract infection, AMK was treated to preoperatively and to the cases with acute peritonitis, AMK was treated to the postoperatively. Clinical response was excellent in 2 cases, good in 6 cases, fair and poor in none. No adverse effect was observed. The organisms were isolated in 4 cases, 4 were Escherichia coli, 1 was Klebsiella pneumoniae and 1 was Bacteroides fragilis. The MIC for AMK were 3.13-1.56 micrograms/ml in 10(8) and 10(6) cells/ml, except Bacteroides fragilis. Before the operation of above cases, AMK in a dose of 200 mg were administered by intravenous drip infusion in 2 cases (acute and subacute cholecystitis and cholangitis with cholelithiasis), 5 cases by intramuscularly and 1 case by intravenously (acute appendicitis with localized peritonitis). The materials of A-bile, B-bile, wall of gallbladder, the appendix, ascites and serum samples were taken during the operation. AMK concentration was measured by bioassay method with Bacillus subtilis ATCC 6633 as test organism. AMK concentration in B-bile were higher than those in the A-bile. AMK concentrations in wall of gallbladder were much higher than those in A and B-bile. The concentrations after intravenous drip infusion were higher than those after intramuscularly administration. AMK changes of inflammation. In a case of gastric ulcer, AMK 200 mg by intravenous drip infusion was administrated, the AMK concentrations of the tissues at 25 minutes after end of infusion, they were 15.00 micrograms/g in gastric ulcer, 7.20 micrograms/g in normal gastric wall, 9.14 micrograms/g in duodenal wall and 8.12 micrograms/g in the omentum, respectively. Serum concentration of AMK on this case at 58 minutes was 15.7 micrograms/ml. Therefore, it was supposed that AMK could be used safety and effective by intravenous drip infusion.
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PMID:[Clinical studies on amikacin for infectious diseases following intravenous drip infusion (author's transl)]. 709 87

Laparotomy with a preoperative diagnosis of acute appendicitis disclosed a normal appendix in 105 children (22.1 percent). In less than half of these, another condition was found or later identified, which explained the symptoms leading to operation. Ovarian lesions, acute ileocolitis, and serositis were the most frequently identified abnormalities. Twelve patients (11 percent) underwent definitive procedures in addition to appendectomy. Among patients in whom no abnormality was identified at laparotomy, peritoneal cultures yielded a broad range of organisms in 42 percent of those who had cultures. This may represent a mild form of acute primary peritonitis and may explain the symptoms which were confused with acute appendicitis.
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PMID:Appendectomy in childhood. Analysis of 105 negative explorations. 711 74

1728 appendectomies were performed in our institution between the years 1973 and 1978, only 18 of them below the age of 5 years. Acute appendicitis in this age is characterized by a very low incidence (1%); an overwhelming male predominance (8:1), a short history, and a rapid progress of the disease. In 72% perforation of appendix and peritonitis were present at operation. The triad of fever, abdominal pains and vomiting was present in all cases. A high leucocyte count was noted in all cases except one. All patients were operated upon within 16 h of admission. No mortality, a low morbidity and a short hospital stay were recorded.
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PMID:Acute appendicitis in early childhood. 711 53

An open study was carried out on patients with acute appendicitis to assess the effectiveness of taurolin, a new antiseptic which destroys both bacteria and endotoxin, when used intraperitoneally in cases of purulent peritonitis associated with perforated or gangrenous appendicitis. Seventy-four out of 319 patients received taurolin; the others were treated by operation only or by operation and antibiotics as required. The results suggest that taurolin was effective as monotherapy in peritonitis and endotoxic shock and its use avoids the problems associated with antibiotics.
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PMID:The treatment of peritonitis by an antiseptic - taurolin. 725 7

One of the most frequent causes for peritonitis is acute appendicitis. Extent and degree of peritonitis determine the further course of the disease. A retrospective analysis of acute appendicitis with concomitant peritonitis relates pre- and intraoperative findings to the postoperative development. Resulting aspects may simplify therapy in special cases and permit a more reliable prognosis.
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PMID:[Peritonitis in acute appendicitis: prognostic aspects, personal results]. 727 53

The authors analyze 120 observations of children admitted to the hospital with suspected acute appendicitis for the period from 1977 till 1978. Positive thermographic results were obtained in 71 of 83 operated patients and in 22 of 32 non-operated patients the diagnosis of acute appendicitis was rejected. Thermographic data on different stages of peritonitis and destructive forms of appendicitis are presented. These data combined with others allowed the stage of the inflammatory process and the degree of the severity of the condition to be established. The dynamic observation during the postoperative period suggests that the thermographic method is a necessary and timely one for revealing postoperative complications and choice of therapeutic tactics.
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PMID:[Thermographic studies in acute appendicitis and its complications in children]. 738 45

Between September 1990 and December 1993, 283 consecutive patients were admitted with clinical symptoms of acute appendicitis. These patients underwent primary laparoscopic approach so that an appendicectomy could be performed by this method. In 49 cases (17.3%), primary laparoscopic examination corrected the preoperative diagnosis and the appendix was left in situ. Appendicectomy was performed in 234 cases (149 women, 85 men) with a mean age of 30 years. Requirement for open surgery occurred in 29 cases. The main cause of unsuccessful procedures was inflammation due to local or generalized peritonitis. Median operative time for a successful procedure was 60 min (range, 25-160). Four postoperative complications (one related to laparoscopic procedure), one case of wound infection, and no mortality resulted. After laparoscopic appendicectomy, the median hospital stay was 3 days (range, 1-16). These results suggest that a laparoscopic approach for suspected appendicitis is reliable, allowing abdominal exploration and safe appendicectomy.
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PMID:Laparoscopic procedure for suspected appendicitis. A prospective study in 283 consecutive patients. 748 12

The work is based on lymphogenous methods of treatment, i.e. direct endolymphatic therapy with antibiotics and other agents in complications of acute appendicitis. On the basis of information in the literature, among the antibiotics we chose gentamicin, claforan, and a new antibiotic fortum. In addition to antibiotics, for the correction of disturbed blood rheological properties we gave endolymphatic infusions of trasylol, aspisol, and trental. The purpose of our study was the development of methods and treatment of complications of acute appendicitis. In view of this, we chose the patients according to the nosological groups with appendicular infiltrate, appendicular abscesses, and localized peritonitis of appendicular origin.
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PMID:[Endolymphatic drug infusion in the treatment of complicated acute appendicitis]. 752 25

Patients often present to the surgeon with abdominal pain, tenderness, and fever. Many exhibit progressive sepsis due to abdominal pathology. Delay in diagnosis and treatment often occurs due to the use of multiple, time-consuming, expensive diagnostic studies. We delineate the use of diagnostic laparoscopy in subsets of patients in whom confusion exists as to the cause of abdominal sepsis--i.e., females in child-bearing years, elderly patients, obese patients, immunosuppressed patients, and patients with suppression of physical findings. The methodical assessment of the entire abdominal cavity is performed utilizing manipulation of the patient's position (Trendelenburg, supine, reverse Trendelenburg, left side up, right side up) and meticulous inspection of the entire small bowel. Diagnoses included acute appendicitis, gangrenous appendicitis, perforated appendicitis with peritonitis or abscess, gangrenous cholecystitis, ischemic bowel disease, perforating carcinoma of the colon, perforating diverticulitis with abscess or peritonitis, tubo-ovarian abscess, closed-loop small-bowel obstruction, megacolon, and perforation of the colon. Laparoscopic treatment of 96% of the patients was performed successfully and a laparoscopic-assisted approach was used in the remainder. There was one mortality (cardiac) and no major morbidity. The development of a Formal Diagnostic Exploratory Laparoscopic (FDEL) approach has aided in the assessment of each of the diagnoses of sepsis in the abdominal cavity. The diagnostic and therapeutic approach laparoscopically avoids extensive preoperative studies, avoids delay in operative intervention, and appears to minimize morbidity and shorten the postoperative recovery interval.
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PMID:Use of laparoscopy in the diagnosis and treatment of patients with surgical abdominal sepsis. 759 89


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