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Query: UMLS:C0085693 (acute appendicitis)
 3,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The relationship of acute appendicitis occurring previous to cancer in colon and rectum was studied in the consecutive records of 561 patients, of 40 years of age and older, operated upon with an appendectomy because of acute appendicitis. Sixteen (2.9%) of these patients were readmitted within three years because of a carcinoma in colon or rectum. The incidence of carcinoma in the colon and rectum in the population, of the same age, is only 0.1%, according to the Sweden Cancer Registry (1). This difference is statistically significant. Where acute appendicitis and colon carcinoma co-exist, the danger is that the carcinoma may be missed. Therefore, any patient over the age of 40 presenting with acute appendicitis should be carefully checked for carcinoma in the colon.
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PMID:Acute appendicitis as a sign of a colorectal carcinoma. 707 80

Four cases of adenocarcinoid of the appendix were studied. Two tumours were found among 28 cases primarily diagnosed as appendiceal carcinoids. They showed characteristic histological structures with features of both a conventional carcinoid tumour and a mucinproducing adenocarcinoma with goblet cells. All tumours were small and ill-defined; three were associated with fibrous obliteration of the appendiceal lumen. All were diagnosed incidentally by the pathologist in appendices removed "en passant" or because of acute appendicitis. Three of the tumours appeared well differentiated with a low degree of malignancy similar to that of the conventional carcinoid tumour. In one case however, the tumour was less differentiated with atypical foci and a high mitotic count and had metastasised to peritoneum and both ovaries.
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PMID:Adenocarcinoid of the vermiform appendix. 736 63

Diverticulosis of the colon is common in the descending and sigmoid part; the right colon is rarely involved. Inflammation of perforation of a cecal diverticulum is an uncommon condition that mimics acute appendicitis. The correct diagnosis is mostly made after operative exploration. Four cases were surgically treated between 1994 and 1995. Because of the severe inflammation, ileocecal resection or right hemicolectomy was necessary; in one case we performed a local excision. After removal of the inflamed mass the postoperative healing was uncomplicated. A malignancy could be histologically excluded in all cases. As in sigmoid diverticulitis, early resection seems to be a safe operative therapy. Laparoscopy can show the correct diagnosis before the laparotomy is carried out. Preoperative diagnostic measures, differential diagnosis and possible surgical procedures are discussed.
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PMID:[Diagnosis and surgical therapy of right-sided colonic diverticulitis]. 750 Aug 1

The right anterior extrarenal space is composed of the perirenal fascia, the right anterior perirenal space, the right anterior pararenal space, and the liver capsule. To clarify the probable causes of an increasing width of the right anterior extrarenal space, the width was measured using ultrasonography for a period of 8 months. The right anterior extrarenal space was measured 3 cm from the superior renal pole and the smallest width obtained in several different scan planes was used. In 1,114 ultrasound examinations, 35 patients were found to have an increased width of the right anterior extrarenal space. Among the 35 cases, the common probable causes for such a condition were found in 27 cases. Eight patients had hyperchogenicity in the right pararenal space, a condition considered to be due to an acute inflammation, including acute pancreatitis, acute cecal diverticulitis, acute appendicitis, ischemic bowel, acute cholangitis, liver abscess, and penetrated duodenal ulcer. Chronic inflammations of an adjacent organ, a previous history of laparotomy, a malignancy with peritoneal metastases, and treatment with corticosteroid were considered the causes behind the condition in the 19 patients with normal echogenicity. For the remaining 8 patients, causes were not found during the follow-up period. This study indicates that life-threatening diseases, such as acute or chronic inflammatory diseases and malignancy of the abdomen, could be the cause of an increase in the width of this space.
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PMID:Causes of increasing width of right anterior extrarenal space seen in ultrasonographic examinations. 764 66

Irritable bowel syndrome and (or) non complicated diverticulosis, associated with fever, could simulate diverticulitis. Cancer of the sigmoid colon appears the main differential diagnosis, when diverticulitis is associated with an atypical or complete colonic stenosis on opaque enema, with a vesicoenteric fistula or with a peritonitis due to a colonic perforation. Even at laparotomy, a pseudotumoral diverticulitis cannot easily be differentiated from a colonic carcinoma. Acute diverticulitis of the caecum or ascending colon is usually mistaken for acute appendicitis. When massive and life-threatening bleeding occurs, the diverticular origin is difficult to assess. Bleeding due to peptic ulcer disease and thermometric ulceration being precluded, arteriography performed on emergency is necessary to differentiate between diverticular bleeding and angiodysplasia.
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PMID:[Diagnostic pitfalls of complicated colonic diverticulosis]. 776 84

Crohn's disease of the appendix is an uncommon process that is more frequent in young people. The most common preoperative diagnosis is acute appendicitis. At exploratory laparotomy the appendix is enlarged and malignancy may be suspected. The differential diagnosis may be difficult. Serologic tests and cultures should be performed to exclude Yersinia infections. Appendicectomy is a safe procedure when the disease is limited to the appendix. The postoperative course is usually uncomplicated with a low rate of complications and recurrence. Although it may be a different process than Crohn's disease and the recurrence rate is low, it is suggested that all the patients should be followed-up so that recurrences may be recognized and treated as early as possible. A new case is presented after two years of follow-up without recurrence.
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PMID:[Appendiceal Crohn's disease]. 779 43

Gastrointestinal carcinoids are infrequent but at the same time hardly rare tumours. They are often chance findings but, as is clearly reported in the literature, their potential malignancy should not be overlooked. They are most commonly localised in the appendix. The authors describe two case reports of carcinoid tumours of the appendix, one of which was diagnosed during left hemicolectomy due to Crohn's disease and the other during acute appendicitis. Prognostic and therapeutic problems are discussed in the light of the most recent literature.
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PMID:[Carcinoid tumors of the appendix. Review of the literature and two case reports]. 850 40

The purpose of this prospective study was to elucidate the characteristics of adult patients with acute abdomen admitted to a Finnish university hospital. A total of 639 patients entered the study. The most common cause of acute abdomen was non-specific abdominal pain (NSAP) (33.0%) followed by acute appendicitis (23.3%) and acute biliary disease (8.8%). The male:female ratio was 47:53 in the whole study population, but there were differences in the age and sex distributions when studied by diagnosis. NSAP was mainly presented in young women, but also in patients over 75 years of age. Acute appendicitis was most frequently found in young men, and biliary disease was most common in elderly women. A male predominance was noted in cases of alcoholic pancreatitis and gastritis, renal stones and peptic ulcer. Young women and elderly patients were slightly over-represented in the study population when compared with the whole population residing within the study area. 43% of the patients were operated on, and surgery was most common in patients aged 55-64 years and 15-24 years. Altogether 15% of the patients were discharged without hospitalisation. Twelve patients (1.9%) died of various causes, the most common of which was malignancy (four patients). In conclusion, a considerably large proportion (one third) of cases with acute abdomen remained without any specific explanation. Further, age and gender seem to be important factors when the most probable cause of acute abdomen is to be considered. Operative treatment is necessary in almost half of cases, and mortality for acute abdomen is low.
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PMID:Acute abdominal pain in adults. 873 26

Nine patients (six females and three males), median age = 27.5 years (range 13-36) with caecal diverticulitis are presented. All underwent surgery with a suspected diagnosis of acute appendicitis. Per-operative diagnosis was possible in five cases, two cases were thought to have other benign pathology, but malignancy could not be excluded in the remaining two cases. Local excision was carried out in five cases, a right hemicolectomy was performed in the rest. Histology showed true diverticuli in eight cases, severity of the inflammation made it difficult to comment on the ninth case. Postoperative barium enema was carried out in six cases, which showed no further diverticuli in the colon. We conclude that preoperative diagnosis of caecal diverticulitis is difficult, and that true solitary caecal diverticuli present in a younger age group than the false caecal and ascending colon diverticuli and that they are probably congenital in origin.
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PMID:True caecal diverticulitis. 877 6

The preoperative diagnosis of both appendiceal carcinoma and pseudomyxoma peritonei is difficult because of the nonspecific nature of the associated symptoms. More than 50% of all patients with carcinoma of the appendix are diagnosed with and treated for acute appendicitis. In addition, there have been few reports on patients with an appendiceal carcinoma or pseudomyxoma peritonei in association with other synchronous or metachronous malignancies of the alimentary tract. We herein report the first known patient with synchronous early gastric cancer and pseudomyxoma peritonei, in which the origin was correctly identified preoperatively.
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PMID:Pseudomyxoma peritonei concomitant with early gastric cancer: report of a case. 893 Dec 26


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