Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0085693 (acute appendicitis)
 3,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acute appendicitis during pregnancy is a rare event, and large numbers of cases reported in the literature stem entirely from data stored in national registers. Between 1974 and 2000 relevant perioperative data on the treatment of appendicitis were collected consecutively and analyzed retrospectively. Surgical and obstetric data relating to the medical history, the clinical, intraoperative, and histologic findings, and the course of the pregnancy were recorded. Altogether, 9793 appendectomies were performed, 94 of which were in pregnant women (24.5% during the first trimester, 51% during the second trimester, and 24.5% during the third trimester). This represents 0.2% of the 46,960 deliveries during the period under observation. Fifty percent of the case histories during the second trimester were atypical. The overall perforation rate was 14.9%; it was 8.7%, 12.5%, and 26.1% during the three trimesters, respectively. Maternal mortality was 0%; the combined miscarriage/abortion rate was 8.5% (n = 8); and infant mortality was 3.2% (n = 3). The postoperative spontaneous abortion rate was 13.0% and the additional therapeutic/requested abortion rate 21.7% during the first trimester. In view of the elevated postoperative abortion rate and the facility of the clinical diagnosis during the first trimester, the indication for invasive diagnostic measures and surgery requires careful consideration. During the second and third trimesters the difficulty of establishing a clinical diagnosis makes it necessary to undertake exploratory surgery early.
 ...
PMID:Ninety-four appendectomies for suspected acute appendicitis during pregnancy. 1508 99

Over the last 20 years, the treatment of acute appendicitis has been transformed by the development of the laparoscopic approach. And yet the net value of this approach continues to be debated. Laparoscopic appendectomy is associated with a lower complication rate and a shorter period of disability in the general population. While operative costs are higher, the global cost of laparoscopic appendectomy is lower than for open appendectomy. There is a somewhat higher rate of abdominal abscess for the laparoscopic route. Laparoscopic appendectomy shows clear advantages in obese patients and in those with gangrenous or ruptured appendicitis. The laparoscopic approach is contra-indicated during pregnancy due to a higher incidence of miscarriage. Treatment of the appendiceal stump by ligature decreases the expense associated with the use of a surgical stapler. When Meckel's diverticulum is encountered during appendectomy, it should be removed in all pediatric patients; in adults, Meckel's diverticulectomy in adults should be performed only for clear-cut pathology. Surgeons continue to innovate and refine appendectomy techniques but many questions remain to be answered.
 ...
PMID:[Surgical techniques of appendectomy for acute appendicitis]. 1984 93

Acute pelvic pain is defined as lower abdominal or pelvic pain of less than three months' duration. It is a common presentation in primary care. Evaluation can be challenging because of a broad differential diagnosis and because many associated signs and symptoms are nonspecific. The most common diagnoses in reproductive-aged women with acute pelvic pain are idiopathic pelvic pain, pelvic inflammatory disease, acute appendicitis, ovarian cysts, ectopic pregnancy, and endometriosis. Among postmenopausal women, cancer must be considered. Findings from the history and physical examination can point to likely diagnoses, and laboratory testing and imaging can help confirm. Women of reproductive age should take a pregnancy test. In early pregnancy, transvaginal ultrasonography and beta human chorionic gonadotropin levels can help identify ectopic pregnancy and spontaneous abortion. For nonpregnant women, ultrasonography or computed tomography is indicated, depending on the possible diagnosis (e.g., ultrasonography is preferred when ovarian pathology is suspected). If ultrasonography results are nondiagnostic, magnetic resonance imaging can be helpful in pregnant women when acute appendicitis is suspected. If magnetic resonance imaging is unavailable, computed tomography may be indicated.
...
PMID:Common Questions About the Evaluation of Acute Pelvic Pain. 2676 Aug 39

Timely management of patients presenting to the ED while in their first trimester of pregnancy can improve outcomes for both the patient and the fetus. Common obstetric problems encountered include vaginal bleeding and miscarriage, ectopic pregnancy and pregnancy of undetermined location, and nausea and vomiting of pregnancy, including hyperemesis gravidarum. Optimal diagnostic approaches and management strategies are covered, including which antiemetics are safe to give in pregnancy. Common nonobstetric problems include asymptomatic bacteriuria, urinary tract infections including pyelonephritis, and acute appendicitis. This article also reviews the various imaging modalities available for pregnant patients and reviews the risks of ionizing radiation as well as various contrast media.
 ...
PMID:First trimester pregnancy emergencies: recognition and management. 3057 Feb 48

Timely management of patients presenting to the ED while in their first trimester of pregnancy can improve outcomes for both the patient and the fetus. Common obstetric problems encountered include vaginal bleeding and miscarriage, ectopic pregnancy and pregnancy of undetermined location, and nausea and vomiting of pregnancy, including hyperemesis gravidarum. Optimal diagnostic approaches and management strategies are covered, including which antiemetics are safe to give in pregnancy. Common nonobstetric problems include asymptomatic bacteriuria, urinary tract infections including pyelonephritis, and acute appendicitis. This article also reviews the various imaging modalities available for pregnant patients and reviews the risks of ionizing radiation as well as various contrast media.[Points & Pearls is a digest of Emergency Medicine Practice.]
 ...
PMID:Points & Pearls: First trimester pregnancy emergencies: recognition and management 3059 92


<< Previous 1 2