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

Metastatic tumors to the appendix are not common. However, these tumors should be one of the differential diagnoses in patients with known primary malignancy, who present with signs and symptoms of acute appendicitis. We report a case of an elderly male with poorly differentiated bronchogenic adenocarcinoma which metastasized to the appendix.
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PMID:Acute appendicitis secondary to metastatic bronchogenic adenocarcinoma. 929 May 20

We report a case of colonic type adenocarcinoma of the appendix with perforating peritonitis in a 92-year-old man. The preoperative diagnosis was localized peritonitis due to acute appendicitis and emergency laparotomy was performed. A gray, hard tumor was palpated at the base of the appendix. Appendiceal cancer was suspected, and right hemicolectomy was performed. The histopathological diagnosis was moderately differentiated adenocarcinoma of the appendix. The tumor obstructed the orifice of the appendix, and this may have caused the perforation of the appendix. The patient had an uneventful postoperative course and there have been no signs of recurrence in the 2 years since the operation.
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PMID:Primary adenocarcinoma of appendix, colonic type associated with perforating peritonitis in an elderly patient. 934 93

Leukaemic and lymphomatous infiltration of the appendix is rare and even rarer is acute appendicitis as the initial manifestation. From our routine biopsy material we collected four cases of haematological malignancies presenting as acute appendicitis or acute abdomen, caused or accompanied by tumoral infiltration of the appendix. Appendicitis was the initial manifestation that allowed diagnosis of the underlying disease. The clinical histories and histological examinations of the appendices and of one autopsy are described. We report the first detailed description of acute myeloid leukaemia involving the appendix, and three cases of lymphomatous infiltration of the appendix presenting with appendicitis, and give an overview of the literature. In these days of budgetary cuts in national health services, where one may be tempted not to have seemingly commonplace cases of appendicitis histologically verified, our cases emphasize that careful histopathological examination of all appendectomy specimens should be mandatory. Despite the fact that leukaemia and lymphoma of the appendix are rare, our cases illustrate that these must be included in the differential diagnosis of acute appendicitis and that physicians and surgeons have to be aware of these conditions.
J Cancer Res Clin Oncol 1997
PMID:Leukaemia and lymphoma of the appendix presenting as acute appendicitis or acute abdomen. Four case reports with a review of the literature. 939 90

Carcinoid tumors are infrequent but not exceptional neoplasias. The gastroenteric tract is affected in 80% of cases and almost half of these involve the appendix where they almost always represent an occasional finding after appendicectomy due to acute or subacute appendicitis. Although they have a low malignancy potential in this site, with a reduced index of metastasization and scant capacity to determine clinical symptoms, they are of considerable clinical importance in view of the prognostic and therapeutic type problems that their diagnosis entails. The authors report the case of a female 14-years-old patient, operated for acute appendicitis, and the finding of a yellowish hard tumefaction with a diameter of around 2 cm near the appendicular cone which histological tests showed was a relatively benign classic carcinoid.
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PMID:[Carcinoid of the cecal appendix]. 947 76

Indications and contraindications to laparoscopic surgery continue to be refined. Laparoscopic appendectomy for acute appendicitis is frequently selected by patients and surgeons, and clinical studies show it to be a reasonable alternative. In this case study, laparoscopic surgery was used to resect an appendiceal mucocele caused by a nonperforated mucinous adenocarcinoma. Implants of mucinous tumor were found widely disseminated on peritoneal surfaces at laparotomy 9 months later. As a result of this case study, the authors suggest that when an appendiceal mucinous tumor is encountered at laparoscopy, a special situation requiring totally atraumatic appendectomy is indicated. This clinical situation should be considered an indication for conversion to open appendectomy. All appendiceal tumors, including the most benign-appearing adenomas, can result in diffuse peritoneal implantation. This is the first report of an appendiceal mucinous tumor resected by laparoscopy associated with subsequent diffuse peritoneal carcinomatosis. This patient presentation reaffirms that dissemination of cancer may be associated with laparoscopic resection of structures containing a malignancy.
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PMID:Appendiceal mucocele. Contraindication to laparoscopic appendectomy. 971 78

One-third of all cases of abdominal pain and a quarter of cases of right iliac fossa pain urgently admitted to hospital leave hospital with no precise diagnosis. Based on a series of 400 patients hospitalised for right iliac fossa pain, comprising 107 cases with no identified aetiology, this prospective study was designed to assess the medium-term outcome of these patients, with or without surgical exploration. 67 cases were reviewed at five years. No major diagnosis was missed. Over this 5-year period, 30 patients (45%) experienced another episode of abdominal pain. Among the third of patients (21 cases, 31%) reviewed for another episode of right iliac fossa pain, 7 were readmitted to hospital, with 5 operations, for histologically confirmed acute appendicitis in 3 cases (5% of the series). The patient and his attending physician must be informed of the nonspecific diagnosis established during the first hospitalisation. There is no significant evidence to suggest a psychological component in the recurrent nature of the pain. Cancer must be formally excluded in patients over the age of 50. When surgical exploration is performed, nowadays by laparoscopy, appendicectomy is recommended. This procedure does not decrease the risk of recurrent pain, but confirms the real absence of histopathological abnormality and decreases the number of subsequent hospitalisations.
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PMID:[Outcome of nonspecific right iliac fossa pain syndromes]. 995 Oct 94

An unexpected inflammatory cecal mass of uncertain etiology encountered during surgery for presumed appendicitis poses a dilemma to the surgeon when deciding the appropriate operative management. A retrospective study was performed to review the pathology and surgical management of this condition. Among 3224 patients who had emergency surgery for a diagnosis of acute appendicitis between January 1990 and December 1997, a group of 52 patients (1.6%) underwent either ileocecal resection or right hemicolectomy for an inflammatory cecal mass of uncertain etiology. The final pathologic diagnosis was cecal diverticulitis in 26 patients (50%), appendiceal phlegmon or abscess in 21 patients (40%), cecal carcinoma in 3 patients (6%), tuberculosis in 1 patient (2%) and schistosomiasis in another patient (2%). Altogether 34 patients underwent ileocecal resection, and 18 patients underwent right hemicolectomy, including the 3 patients with cecal carcinoma. Ileocecal resection was associated with a shorter mean operative time (144 vs. 201 minutes; p < 0.001), a lower morbidity rate (3% vs. 22%; p = 0.043), and a shortened mean postoperative hospital stay (6.8 vs. 11.2 days; p = 0. 011) than right hemicolectomy. There was no mortality in either group. In conclusion, most inflammatory cecal masses are due to benign pathologies and could be managed safely and sufficiently with ileocecal resection. Careful intraoperative assessment including examination of the resected specimen is essential to exclude malignancy, which would require right hemicolectomy.
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PMID:Inflammatory cecal masses in patients presenting with appendicitis. 1039 May 92

A 39 year-old febrile man with lower abdominal pain and peritoneal reaction was operated on suspicion of acute appendicitis. During the past eighteen months he had been hospitalized twice due to similar symptoms, both times with spontaneous remission. The operative finding was a large multilobular vascular tumour which on pathological examination was a haemangiopericytoma, with no degree of malignancy. The tumour was removed in toto.
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PMID:[Intraabdominal hemangiopericytoma. Diagnosed during surgery for suspected acute appendicitis]. 1047 68

The evaluation of right lower quadrant (RLQ) abdominal pain in pediatric patients with malignancy can be difficult. However, since the mortality rate from peritoneal infections in these patients is very high, the differential diagnosis of RLQ peritoneal irritation, mainly of acute appendicitis (AA) versus neutropenic enterocolitis (NE), is crucial. Three cases of pediatric patients with malignancy demonstrating these difficulties are represented to enlighten this problem. The first patient died of multiorgan failure after operation for perforated appendicitis without generalized peritonitis. The second had a severe life-threatening postoperative complication because of delayed diagnosis of acute appendicitis. The third patient with malignant pelvic spread, underwent an unnecessary abdominal exploration for suspected AA. In all these cases and probably in many others, the clinical outcome could have been different if a previous incidental appendectomy had been performed during the primary abdominal operation. Incidental appendectomy in oncologic patients is recommended to facilitate the differential diagnosis of RLQ pain and to exclude the diagnosis of AA.
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PMID:A plea for incidental appendectomy in pediatric patients with malignancy. 1050 19

There is no clear scientific evidence for a clinically relevant chronic form of appendicitis in the absence of acute flares. Lacking typical symptoms of acute appendicitis or corresponding imaging findings, no indication is given for appendectomy from the internal medicine point of view. By contrast, chronic or recurrent right lower quadrant pain is often of functional origin and may be part of the Irritable Bowel Syndrome or the Functional Abdominal Pain Syndrome. These syndromes are linked to a higher rate of appendectomies in the medical history. The Irritable Bowel Syndrome may be diagnosed based on clinical symptoms alone. But in doubt and in considering malignancy, the indication for diagnostic imaging is given, after ultrasound particularly by colonoscopy. For positively diagnosing these functional syndromes, the typical clinical presentation, extraintestinal pain syndromes, and psychic factors should be evaluated. The visceral hypersensitivity is the predominant pathophysiologic finding and measured by rectal distention stimuli. Medical treatment comprises relaxatives of smooth muscle and low dose antidepressants as modulators of visceral perception. These are supplemented by the psychosocial management.
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PMID:[Chronic appendicitis. Recurrent abdominal pain in the right lower quadrant from the viewpoint of the internist]. 1067 96


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