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

Although in most cases the diagnosis of acute appendicitis is straightforward, not all patients experience typical symptoms and other conditions may mimic appendicitis. In fact, 15-25% of appendectomies involve the removal of a normal appendix. To date, there is no literature evidence that herniation pit (HP) may mimic acute appendicitis. We report a case of a 30 year old woman admitted to the Emergency Department for severe, acute pain developing a few hours earlier in the lower right fossa, with irradiaton to the right thigh. She did not present any fever, nausea or vomiting, Blumberg's sign was absent but the psoas sign and obturator sign were both positive. WBC count was 16,000/mm3 and the Alvarado score was 4. Biochemistry profile was normal. US was unclear and transvaginal ultrasound did not show any gynecological disease. CT scan showed only an herniation pit of the right femoral neck. The patient was admitted to an orthopedic ward and treated with anti-inflammatory therapy. She was discharged after 2 days without any pain and in good conditions. Our case demonstrates that herniation pits of the right femoral neck should be considered a potential cause of right lower abdominal pain mimicking acute appendicitis, particularly if the psoas sign and obturator sign are positive and the patient is physically active.
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PMID:Can herniation pit of the femoral neck mimic an acute appendicitis? A case report. 2383 53

The authors present three cases of abdominal actinomycosis that were initially diagnosed as acute appendicitis, an abscess in the left groin and pelvic tumour, probably of gynaecological origin. Definitive diagnosis of abdominal actinomycosis was established as late as postoperatively. Abdominal actinomycosis is a chronic, infectious disease characterized most frequently by non-specific symptoms such as abdominal pain, fever, vomiting, bowel obstruction, weight loss, sometimes palpable resistance, and leukocytosis [1-9]. Diagnosis may be difficult and needs to be taken into account, especially in patients with risk factors.
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PMID:[Abdominal actinomycosis - 3 case reports and literature overview]. 2396 30

Enterobius vermicularis is a parasite that inhabits the human digestive tract. We present two pediatric patients with symptoms mimicking acute appendicitis who were found to have E. vermicularis infection. The first case is a 5-year-old female who presented with flank and abdominal pain associated with low-grade fever and anorexia. She had localized tenderness in the right lower quadrant and a leukocytosis with left shift. Intraoperative findings included a normal-appearing appendix, but ex vivo examination revealed Enterobius vermicularis. The second case is a 7-year-old female who presented with periumbilical abdominal pain, anorexia, and emesis. She had tenderness at McBurney's point, and ultrasound revealed a small echogenic focus within the appendix. Intraoperatively, the distal tip of the appendix appeared inflamed. Again, ex vivo examination revealed E. vermicularis. Enterobius vermicularis infection of the appendix can present with a clinical picture similar to acute appendicitis. In at-risk populations, it should be included in the differential diagnosis for children with right lower quadrant abdominal pain. Complete therapy requires treatment with mebendazole.
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PMID:Manifestations of pediatric appendicopathia oxyurica. 2406 79

Malrotation of gut is an intestinal gestational disorder which not only affects the positioning of the midgut, but also its vascular supply. It usually presents with the syndrome of bouts of colic and vomiting with little distention of abdomen and diarrhea. Though midgut malrotation is a common cause of intestinal obstruction in newborn, scant attention is given to this developmental anomaly as a cause of symptoms in adults. The development of midgut portion of alimentary canal suffers a large variety of variations. The surgical importance of abdominal situation of the portions of intestine derived from the midgut loop requires little attention. Sub-hepatic anatomical location of the appendix makes it more difficult to diagnose acute appendicitis at any age, including in older adults. Failure to recognize the nature and characteristic features of these misplacements may lead to grave errors in procedure, or to injurious prolongation of the operation. Here in we found a rare abnormality of caecum, which was present in the sub hepatic region with the absence of ascending colon during routine dissection classes for undergraduate students.
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PMID:Sub-hepatic caecum. 2417 18

Acute appendicitis is a common occurrence in childhood, but this diagnosis is considered rarely in differential diagnosis of acute abdomen in the neonatal period because its occurrence is very rare in neonates. We report a 20-day- old afghan female baby that was admitted to neonatal intensive care unit, because of irritability and abdominal distension. Complete ultrasound of abdomen and pelvis was normal. In plain Radiographs of chest and abdomen with the exception of Air-filled stomach and intestine, there was no abnormality. Due to the lack of improvement and severe abdominal distension, she was transmitted to the operating room and Surgical exploration revealed perforated appendix. Appendicitis should be considered in the differential diagnosis for a neonate with abdominal distension and bilious vomiting and needs strong clinical suspicion.
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PMID:Perforated acute appendicitis in a pre-term neonate. 2434 48

Emetophobia is an intense, irrational fear of vomiting including fear of feeling nausea, seeing or hearing another person vomit, or seeing vomitus itself. It may occur at any age and we need to understand its symptomatology. We report a case of emetophobic child whose fear of vomiting started after an attack of acute appendicitis. In the initial stage, fear was limited to vomiting, later it became generalized to a fear of seeing the vomitus, worries that parents may suffer vomiting, fear of vomiting in public places followed by avoiding social activities. Patient improved on short course of anti-anxiety drugs and Graded Exposure Therapy.
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PMID:Emetophobia: A fear of vomiting. 2445 14

We note a specific case report of a 38 year old patient, who presented to an emergency room with an 8-hour history of a continuous and progressive, abdominal pain syndrome. Without fever, nausea, vomiting, or urinary tract symptoms, and with a 36-hour history of constipation. We established as a first possibility the clinical diagnosis of, acute appendicitis vs. an ovarian cyst complication, such as rupture or torsion. After the initial basic diagnostic tests, we decided to do a laparoscopic approach for purposes of diagnosis and treatment.
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PMID:[Internal hernia to the broad ligament: report of a rare case solved with laparoscopy and review of the literature]. 2448 55

Isolated torsion of a fallopian tube in the third trimester of pregnancy is an uncommon event. Its common symptoms are lower abdominal pain, vomiting, and nausea. Because these symptoms are nonspecific, isolated torsion of a fallopian tube may be misdiagnosed, delaying treatment and the opportunity to preserve the tube. This is a case report of a primipara in her third trimester, whowas misdiagnosed as having acute appendicitis and ovarian cyst torsion. The ultrasound-assisted examination was useful, but the specific diagnosis was made after laparotomy and histopathology. The patient was managed by simultaneous salpingectomy and cesarean section. This surgical intervention prevented adverse obstetric sequelae. We summarize our experience, provide our conclusions, and review 17 relevant studies from the literature to aid clinicians in understanding, diagnosing, and managing this condition in a timely fashion.
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PMID:Isolated tubal torsion in the third trimester of pregnancy: A case report and review of the literature. 2565 60

Acute appendicitis is the most common surgical emergency that we encounter. Adynamic Intestinal obstruction due to appendicitis or its complication may be seen time and often. Mechanical obstruction because of appendicitis is uncommon and even rarer for a closed loop obstruction to occur. Although it was described as early as 1901, very few cases have been reported. We report the case of a 20 years male who presented with generalized colicky pain abdomen, abdominal distension, vomiting and obstipation for three to four days. Vital signs were stable. His abdomen was distended and peritonitic, especially in the right iliac fossa. Rest of the physical examination was unremarkable. Blood tests were normal except for leucocytosis with neutrophilia. An abdominal X-ray finding was indicating a small bowel obstruction. A midline laparotomy was performed. On intraoperative examination, distended loops of small bowel from the jejunum to the distal ileum was observed, and a constricting ring around the terminal ileum created by a phlegmonous appendicitis with its tip adherent to the root of mesentery was found, obstructing an edematous loop of small bowel without signs of ischemia. As the bowel was viable simple appendectomy was done. Postoperatively, he had an uneventful recovery and was discharged after 3 d.
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PMID:Appendiceal tie syndrome: A very rare complication of a common disease. 2591 85

Acute appendicitis after prior appendicectomy is highly difficult to diagnose, especially in face of definite history of appendicectomy and presence of appendicectomy scar in the right iliac fossa. We are highlighting a case report of a 40 year old woman who despite having had appendicectomy 2 years back presented with severe abdominal pain in the right iliac fossa in association with anorexia, nausea, vomiting and low-grade pyrexia of one day duration. On the basis of clinical evaluation and haematological and radiological investigations, diagnosis of perforated appendicitis was made. After thorough counselling of the patient and relatives, re-exploration of the patient was performed after excision of previous appendicectomy scar. The appendix was found to be perforated with an extraluminal faecolith and purulent exudate in the right iliac fossa. Appendicectomy and local peritoneal lavage resulted in uneventful recovery of the patient. Histopathology of the specimen revealed acutely inflamed appendicitis.
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PMID:Acute appendicitis after a prior appendicectomy: an unorthodox surgical paradox. 2593 50


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