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

Polycythemia vera (PV) is a rare disease in children. A 9-year-old male was diagnosed following laboratory results acquired because of an acute appendicitis. Regular phlebotomy was performed for over 2 years followed by alpha-interferon treatment. At the age of 12 years, HLA-matched unrelated stem cell transplantation including T-cell depletion was done. The conditioning regimen consisted of busulfan, cyclophosphamide, and ATG. Chimerism was monitored during the whole post-transplant period. A single dose of donor T-lymphocytes was given at month 3. One year after transplantation, chimerism was complete. The patient is in complete remission and shows no signs of transplant-related morbidity at month 78.
Pediatr Blood Cancer 2008 Jan
PMID:Stem cell transplantation for polycythemia vera. 1672 11

Diverticular disease of the right colon is not common, especially in western countries. It occurs in two different clinical forms, known as the "usual" and "hidden" variants. The diagnosis is not always easy, especially in the latter variant, because sometimes barium enema and CT scan are unable to distinguish this form from cancer. The final diagnosis is only intraoperative. In our experience, from 1994 to 2004, we observed 4 cases of complicated right-sided diverticulitis. Three of these patients had symptoms mimicking acute appendicitis, such as fever and abdominal pain. Only 2 of them underwent surgical treatment consisting of a right standard hemicolectomy. The 4th patient had no inflammatory symptoms, but had a history of right-sided abdominal pain and diarrhoea. Laboratory data showed only hypochromic anaemia. Barium enema and CT scan highlighted a vegetating mass in the ascending colon causing irregular severe stenosis of the lumen and hyperdensity of mesocolic fatty tissue. Surgical treatment consisted in a right hemicolectomy. Macroscopically, the mass involved the caecum and ascending colon. Enlarged lymph-nodes were present in the thickness of the mesocolon, but not in other districts. Histological examination revealed diffuse diverticular disease complicated by perforation of many diverticula into the mesocolon.
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PMID:Diverticular disease of right colon. Clinical variants and personal experience. 1673 70

This is the first report in the literature of a non-seminomatous metastasis from an occult testicular primary that presented as an acute appendicitis. The report highlights the necessity of testicular re-imaging in cases of occult malignancy and reviews the association of chromosome 12 with embryonal germ cell tumours.
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PMID:Non-seminomatous testicular metastasis mimicking acute appendicitis. 1911 Aug 30

Primary appendiceal cancer is a rare neoplasm. We analyzed the clinicopathologic characteristics and clinical outcomes of patients with primary appendiceal cancer treated at Buddhist Tzu Chi General Hospital in Eastern Taiwan. We reviewed the medical records of patients who had appendectomy at our hospital over a 10-year period and studied those who had histologically proven malignant appendiceal neoplasms. We treated eight such patients: seven males and one female. Their median age was 66 years (range, 59-78 years). There were three mucinous adenocarcinomas, two colonic type adenocarcinomas, and three adenocarcinoids. No patient was diagnosed correctly before surgery, and five (62.5%) had a preoperative diagnosis of acute appendicitis. Operative procedures included right hemicolectomy or partial colectomy in four, debulking and right hemicolectomy in three, and appendectomy only in one. With a mean follow-up of 64 months (range, 3-132), patients with adenocarcinoid lesions had better prognosis than those with adenocarcinomas. The important prognostic factors of primary appendiceal cancer included histologic subtypes and the extent of dissemination. In our series, palliative resection for disseminated lesions with or without additional chemotherapy resulted in long-term survival.
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PMID:Primary appendiceal malignancy: a clinicopathologic study. 1711 23

Primary adenocarcinoma of the appendix is a rare malignancy that constitutes less than 0.5% of all gastrointestinal neoplasms. Usually the diagnosis is made only after histological examination of surgically removed inflamed appendix. Alternatively represent an unexpected finding, confirmed by frozen section, during surgery performed for acute appendicitis or other non appendiceal pathologies. Natural history is strongly influenced by anatomic peculiarities of the appendix that predispose to early spread and perforation. Frequently is associated with synchronous and metachronous colorectal or extraintestinal cancers. The correct management is the right hemicolectomy as a primary procedure in the case of preoperatively or intraoperatively diagnosis or as secondary procedure, after two-three weeks from appendectomy, when the microscopic examination of specimen reveals the presence of adenocarcinoma. Right hemicolectomy is the best treatment for all histologic types (colonic, mucinous, adenocarcinoid), in presence of perforation and even in Dukes A tumors. A careful intraoperative search for synchronous lesions and a life-long program of surveillance for the detection of early stage metachronous carcinomas are recommended. The Authors report a case of primary adenocarcinoma of the appendix occurred in a 78 year-old female patient, diagnosed incidentally during surgery performed for ileus from suspected cecal neoplasm.
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PMID:[Adenocarcinoma of the appendix. A case report and review of the literature]. 1741 3

Although 3 retrospective studies from the Netherlands conclude that interval appendectomy should only be performed when indicated, i.e. when patients present with recurrent acute appendicitis or persistent pain, there is still no consensus in the literature regarding the management of these patients. This is probably due to the lack of sound studies needed to change the standard treatment and because surgeons prefer to adhere to the traditional strategy of interval appendectomy, although it is based on even less valid arguments. The risk of recurrent appendicitis is low, especially in adult patients. In this setting, the disease is generally less severe, and performing interval appendectomy only as indicated does not increase the risk ofcomplications. In contrast, routine interval appendectomy is associated with increased morbidity, longer hospital stays and greater costs. Colon malignancy, however, should be ruled out in patients over 40 years. It is still unclear whether the conservative strategy should also be preferred for paediatric patients, who may have a higher risk of recurrence. Faster and better diagnosis may further reduce the incidence ofappendiceal mass or abscess.
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PMID:[Interval appendectomy as routine therapy or only as indicated: the controversy continues]. 1762 67

Neutropenic enterocolitis (NE) and acute appendicitis are life-threatening conditions that develop in children with severe or prolonged neutropenia secondary to acute leukemia and lymphoma. The medical records of 118 patients who were treated for acute lymphoblastic leukemia (69 patients), acute myelogenous leukemia (22 patients), or aplastic anemia (27 patients) between 1997 and 2006 in our hospital pediatric hematology department were examined retrospectively. NE was diagnosed in 11 patients (age range, 2.5-16 years) on the basis of clinical and laboratory features. Two of these 11 patients had appendicitis in addition to NE. Conservative treatment was favored for all patients, but 1 patient with acute appendicitis underwent surgery. Neutropenic patients with a hematologic malignancy and abdominal pain should receive their diagnoses immediately and undergo treatment. NE and acute appendicitis should always be considered in the differential diagnosis of abdominal pain. Conservative treatment must be chosen initially for patients with NE, and these patients should be evaluated carefully for surgery. The criteria for the surgical process are the same as those for immunocompetent children. In addition, the close monitoring of hematologic factors is necessary.
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PMID:Neutropenic enterocolitis in children with acute leukemia or aplastic anemia. 1805 46

Ovarian vein thrombosis (OVT) is a rare cause of abdominal pain that may mimic a surgical abdomen. The differential diagnosis of OVT includes acute appendicitis, endometritis, pelvic inflammatory disease, pyelonephritis, nephrolithiasis, tubo-ovarian abscess, and ovarian torsion. The complications of OVT, including sepsis and pulmonary embolism, are significant. Diagnosis relies on a careful examination of the radiographic findings. This diagnosis should be considered not only in postpartum patients but also in women with pelvic inflammatory disease, recent abdominal surgery, malignancy, or known hypercoagulable state. In this report we present a case of OVT in a 29-year-old woman presenting with 3 days of sharp left-sided abdominal pain, nausea, and vomiting after bilateral salpingectomy. We then discuss the epidemiology, pathophysiology, and clinical management of OVT.
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PMID:Ovarian vein thrombosis: a rare cause of abdominal pain outside the peripartum period. 1819 26

Acute appendicitis in the immunosuppressed patients are often difficult to diagnose and are associated with increased morbidity and mortality. Recent debates on primary appendicitis and typhlitis-associated appendicitis have contributed to the diagnostic and therapeutic dilemma. We retrospectively reviewed all our immunosuppressed patients with appendicitis. The most frequent presenting symptom was fever followed by non-specific intermittent abdominal pain. The median delay in diagnosis was 4 days. CT scan was useful in making the diagnosis, but the presence of adjacent bowel thickening has contributed to the dilemma in diagnosis and treatment.
Pediatr Blood Cancer 2008 Jun
PMID:Appendicitis in immunosuppressed children: Still a diagnostic and therapeutic dilemma? 1830 78

The importance of prevention in late hematogenous infection is well understood but, because responsibility lies with general practitioners and other specialists, the orthopedic surgeon is usually not much interested. In both our and other countries, discussions are taking place on whether and to what extent antibiotic prevention should be carried out. Antibiotic prophylaxis of hematogenous infection is not indicated for all patients with joint arthroplasty, but only for a limited, defined group of patients at high risk. In these, however, the present state of knowledge suggests that prevention is necessary. A preventive treatment of late hematogenous infection is used for a procedure or a disease associated with risks in all the patients involved within two years of prosthetic joint implantation and, after this period, only in immunosuppressed patients. Surgery on the urogenital tract associated with the risk of bacteremia includes prostate gland surgery, operations for urinary bladder tumors, nephrolithotomy, extracorporeal lithotripsy and prostate biopsy. Certain conditions, such as urinary catheter presence, intermittent catheterization, urethral stent presence, urine retention and a history of urinary tract infection or prostate inflammation, pose an increased risk of bacterial colonization for the urogenital system. Dental procedures associated with a risk of bacteremia include tooth extraction, surgery on the parodontium, surgical extraction of an impacted tooth, dental implant treatment, procedures in a tooth's apical region, initial application of an orthodontic apparatus, intraligamentous blocks and also cleaning teeth and implants expected to bleed. Gynecological surgery with a risk of bacteremia are abdominal, vaginal and laparoscopic hysterectomies, surgery for cancer contaminated with vaginal bacteria, reconstruction surgery, operations on the pelvic floor for defects associated with urinary incontinence and use of xenotransplants. In obstetrics, a cesarean section carries some risks. In general surgery, the preventive administration of antibiotics is indicated, apart from situations always requiring antibiotic therapy, also for advanced forms of acute appendicitis, perirectal abscess, invasive endoscopy procedures on the colon, soft tissue phlegmona or abscess, surgical treatment of venous ulceration and pressure sores, and limb amputation. When inserting any piercing in patients with joint replacement at risk, it is recommended to do it with antibiotic administration; also, it is necessary to responsibly treat any inflammatory complication. The system of prevention for the late hematogenous infections of prosthetic joints is not developed as thoroughly as, for instance, it is in cardiology for patients with valve reconstruction. Because of the reasons given above, it is advisable to set up unambiguous guidelines for the prevention of late hematogenous infection in patients with joint replacement.
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PMID:[Late hematogenous infection of prosthetic joint]. 1845 11


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