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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Appendicitis is the first 3 years of life is uncommon and most cases are perforated at laparotomy. Case records at the Adelaide Children's Hospital were reviewed over a 12-year period. The findings were that acute appendicitis in this age group is commonly associated with respiratory symptoms and diarrhoea, the appendix was gangrenous or perforated in 92% of cases, and there was a significant delay in diagnosis. It is concluded that full evaluation of any child of this age with fever, vomiting, abdominal pain and tenderness is mandatory, and should include rectal examination, abdominal radiographs, differential white cell count and urinary examination. Examination under sedation may be necessary.
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PMID:Appendicitis in the first three years of life. 327 Mar 21

Lymphoid adenohypophysitis is an autoimmune disorder. Eighteen percent of the multipartums are reported to have autoantibodies to pituitary tissues. The symptoms in lymphoid adenohypophysitis, such as hypopituitarism and sellar tumors, exhibit spontaneous remission. The pituitary is a feasible target organ in other autoimmune diseases of the endocrine system. Of these patients, 19/287 showed a positive immune reaction with pituitary tissue antigens. Our three female patients with sellar and suprasellar mass were clinically diagnosed as having lymphoid adenohypophysitis, because of the spontaneous regression of tumors, or presence of immunologically and endocrinologically abnormal findings. The first case was a 31-year-old woman who had amenorrhea and galactorrhea syndrome for two years after delivery of her second child. CT scan revealed a supraseller enhanced mass lesion. She had concomitant signs of recurrent meningeal irritations. The number of cells in the CSF increased, though the protein concentration increased only slightly. During a one-year close observation, the suprasellar mass spontaneously regressed. The second patient was a 66-year-old woman. In 1945, she underwent hysterectomy and oophorectomy for appendicitis followed by adnexitis. She was admitted because of episodes of headache, vomiting and visual field defect in 1983. CT scan also showed a contrast enhanced mass in the suprasellar region. She had two episodes of high fever. After the treatment with antibiotics and anti-inflammatory agents for 4 months, the tumor disappeared. The third case was a 20-year-old female. She had neither neurological nor endocrinological abnormality, except for attacks of vertigo, nausea and vomiting.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Lymphoid adenohypophysitis, with special reference to 2 cases with sellar tumors spontaneously disappearing on the CT]. 377 4

One hundred eighteen patients with acute appendicitis operated on at Kawasaki Medical School Hospital during the 8-year period from Aug. 1, 1976 to Feb. 29, 1984 were reviewed. There were 78 children and 40 adults. The clinico-pathological types of acute appendicitis were: simple acute in 35 cases (29.7%); phlegmonous in 30 cases (25.4%); gangrenous in 24 cases (20.3%) and perforated in 29 cases (24.6%). Of the 78 children, 27 (34.6%) had perforated appendixes, whereas of the 40 adults only 2 (5.0%) showed perforated appendicitis. The initial symptoms were abdominal pain in 96.6%; nausea, vomiting or both in 33.1%, and fever in 11.9%. The physical findings on admission were abdominal tenderness in 99.2%, rebound tenderness in 52.5% and palpable mass in 17.8%. The mean body temperature on admission was 37.2 degrees C, and mean WBC count was 12,900/mm3. The roentgenography of the abdomen revealed the "sentinel loop sign" in 66.3%. In the patients under 15 years of age, the frequency of perforation seen in those underwent operation within 24 hours after onset and in those after 24 hours was 12.7% and 56.4%, respectively. From this result, it is advised that all the young patients suspected of having acute appendicitis should be admitted to the hospital promptly, and the diagnosis should be made within 24 hours.
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PMID:[Acute appendicitis: a study on 118 patients]. 400 Jan 2

Abdominal pain and fever after an uncomplicated elective abortion usually point to incomplete abortion and endometritis. We treated a woman for acute suppurative appendicitis one week after such an abortion. When fever, nausea, vomiting and pain are not relieved by the standard doses of medication, acute appendicitis must be added to the usual gynecologic differential diagnoses.
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PMID:Ruptured appendix after elective abortion. A case report. 622 52

The evaluation of gastrointestinal symptoms in patients with diabetic acidosis frequently challenges the physician's clinical acumen. Faced with a seriously ill patient, he must judge whether the abdominal pain, nausea, or vomiting are a consequence of the metabolic decompensation, and hence likely to resolve with correction of the ketoacidosis, or if these symptoms signal a serious underlying intra-abdominal process (e.g., cholecystitis, appendicitis, etc.) which may have precipitated the development of ketoacidosis. The pathogenesis of the reversible gastrointestinal symptoms which frequently accompany diabetic acidosis has not been rigorously defined and may be multifactorial, involving metabolic, humoral, and neural processes. Careful attention to the medical history and abdominal examination greatly facilitates distinguishing patients with intra-abdominal pathology from those with reversible symptoms secondary to ketoacidosis. Similarly, the judicious use of laboratory tests (electrocardiography, blood counts, urinalysis, serum enzyme profile, and abdominal roentgenograms) materially aids in differential diagnosis. Finally, clinical suspicion of an acute abdominal process should prompt early surgical consultation and, if required, surgical intervention as the acidosis is being brought under control.
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PMID:Gastrointestinal manifestations of diabetic ketoacidosis. 641 81

The essence of the problem, as previously reported, indicated that few complications of acute appendicitis occur as long as the infection is contained within the appendix, but once the invading bacteria have penetrated the peritoneal appendicular surface or have invaded the regional circulation, any one or more of a series of serious complications can develop. Thus, rightfully, emphasis has been placed upon early removal of the inflamed appendix before penetration has occurred as the best method of preventing complications. We have shown that early appendectomy is predicated on early diagnosis and that diagnostic delay is not limited to extremes of age. The diagnosis may be obscured by an accurate, although misleading, history of prior acute attacks, by precident acute disease, such as viral gastroenteritis and by unimpressive symptoms blunted by intercurrent chronic illness, such as diabetes mellitus. If the elements of periumbilical pain, anorexia, nausea or vomiting and the migration of pain to the right lower abdominal quadrant are contained within the clinical history, one must suspect transmural progression of acute appendicitis; frequent inpatient examinations will allow earliest diagnosis and, thereby, fewest perforations and their attendant serious complications. Misdiagnosis is common. Any patient observed for an ostensibly nonsurgical acute condition of the abdomen who fails to improve markedly during a brief course of appropriate specific or supportive therapy must be thoroughly re-evaluated as a potential surgical candidate. Despite the proliferation of accessible laboratory tests and imaging procedures, the early diagnosis of appendicitis rests upon the clinical skills of the physician. A high index of suspicion is crucial. As Doctor Warfield M. Firor, former senior surgeon commented: "Pain and tenderness at any point where the appendix can lie must raise the diagnostic possibility of appendicitis."
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PMID:Reasons for delay of the diagnosis of acute appendicitis. 670 39

In this study, the hypothesis that computer aided diagnosis could enable a more accurate differentiation between patients with acute appendicitis and those with abdominal pain but normal appendixes was examined. A data base was established by analyzing the records of 476 patients having an emergency measure appendectomy during a five year period. There were 360 or 76 per cent with acute appendicitis, 98 or 20 per cent with normal appendixes and 18 or 4 per cent with other diseases requiring operation. The records were analyzed with regard to history, physical examination and laboratory findings. The data base was then divided randomly into two parts. Part 1 was subjected to univariate discriminant analysis, using the chi-square test. The only quantities which were significantly different between appendicitis and a normal appendix were sex, duration of symptoms, anorexia and vomiting. Multivariate discriminant analysis was used to derive an abdominal pain index which discriminated between appendicitis and a normal appendix with a sensitivity of 0.82 and a specificity of 0.39. Using the abdominal pain index to evaluate the patients in part 2 of the data base, 23 or 40 per cent of the 58 patients with a normal appendix would have avoided operation. However, 31 or 18 per cent of the 169 patients with appendicitis would have not been operated upon; three of those 31 had perforated appendixes. Computer aided diagnosis was no more effective than unaided clinical diagnosis in appendicitis.
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PMID:A feasibility study of computer aided diagnosis in appendicitis. 675 99

In 942 emergency appendectomies, the clinical data of 77 patients with inflammatory changes confined to the mucosa of the vermiform appendix were compared with data from 622 patients with diffuse acute appendicitis and 243 patients without evidence of inflammation in the appendix. In all cases, routine histologic sections of the specimens were reviewed. Of the 77 patients with mucosal appendiceal inflammation, 50 were female and 50% were under 17 years of age. In several clinical aspects, such as incidence of nausea, vomiting, migration of pain, and localized muscular rigidity, there existed significant differences between patients with mucosal inflammation and patients with diffuse appendicitis. Conversely, no statistically significant differences were found between patients with mucosal inflammation and patients without evident appendiceal inflammation. These results in addition to the frequent finding of histologically indistinguishable changes in appendices removed incidentally suggest that the condition is not responsible for the actual complaint.
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PMID:Clinical significance of mucosal inflammation of the vermiform appendix. 683 Mar 43

Appendicitis in preschool children is not uncommon. A duration of greater than 40 hours usually implied perforation. The most common findings were abdominal pain, tenderness, temperature elevation and vomiting. In the presence of perforation or abscess formation, appendectomy followed by copious wound irrigation, abscess drainage and delayed secondary wound closure is the procedure of choice.
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PMID:Acute appendicitis in preschool age children. 735 10

Inferior pancreaticoduodenal aneurysms are uncommon. A 77-year-old woman was seen with a 1-week history of sharp pain in the right lower abdominal quadrant radiating to the back, associated with malaise, anorexia, vomiting and nonbloody diarrhea. Appendicitis was diagnosed, but at laparotomy a large retroperitoneal hematoma was found; no aneurysm was identified. The abdomen was closed and aortography was done. An aneurysm of the inferior pancreaticoduodenal artery arcade was demonstrated, with occlusion of the celiac artery at its origin. The arc of Buehler was patent and enlarged and supplied the hepatic and splenic arteries. Embolization with Gianturco coils placed proximal to the aneurysm was successful.
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PMID:Emergency embolization of a ruptured aneurysm of the pancreaticoduodenal arcade. 763 4


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