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

The management of acute appendicitis in the febrile neutropenic patient after intensive chemotherapy is controversial. We report our single-center-experience of 5 children diagnosed with appendicitis during febrile neutropenia after chemotherapy for acute leukemia or lymphoma. All patients presented with an isolated appendicitis without signs of overt mucositis or more diffuse enterocolitis. The clinical diagnosis was confirmed by ultrasonography. Perforation with retrocecal abscess was present in 1 patient. Administration of combination antimicrobial regimens including meropenem resulted in complete resolution in all patients. Our observations indicate that acute appendicitis in clinically stable neutropenic cancer patients can be managed conservatively without surgery.
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PMID:Conservative management of acute appendicitis in children with hematologic malignancies during chemotherapy-induced neutropenia. 1852 66

We report a diabetic renal transplant recipient who presented with fever and right lower quadrant abdominal pain. Acute appendicitis was considered initially and she underwent emergent appendectomy. However, persistent symptoms postoperatively made us perform an imaging study to identify the problems. Abdominal and pelvic computed tomography disclosed several focal wedge-shaped lesions of low attenuation in the renal allograft. Acute lobar nephronia was successfully managed with parenteral antibiotics. The patient recovered without any sequela. A renal allograft in the right iliac fossa complicates the diagnosis among acute renal infection, malignancy, acute rejection, and even acute appendicitis. Biopsy of the renal allograft is sometimes needed due to clinically ambiguous imaging results. In this report, we not only detail the clinical course of such a rare case, but also review the previous 3 cases of acute lobar nephronia in renal allografts in the literature.
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PMID:Acute lobar nephronia in a renal allograft: a case report and literature review. 1858 82

We determined the HIV-1 RNA and Gag p24 protein expression in gastrointestinal tract-associated lymphoid tissue (GALT), deep lymph nodes (LNs), and inflammatory lesions, acquired during surgery on HIV-infected patients. Surgically excised gastrointestinal tract specimens, LNs, and cervices removed from HIV-1-infected patients for various clinical conditions were studied by immunohistochemistry (IHC) for Gag p24 HIV protein and in situ hybridization (ISH) for HIV-specific RNA. Fragments of some specimens were also submitted in glutaraldehyde for TEM analysis. Germinal centers (GC) in the GALT had at least as much HIV RNA and p24 protein deposited on their follicular dendritic cell (FDC) networks as did GC in LNs draining or associated with areas of inflammation or ulceration. The level of viral expression in the deep LNs, e.g., mesenteric and retroperitoneal, was at least equivalent to that seen in superficial LNs, i.e., inguinal, axillary, and cervical, and tonsils and adenoids. HIV expressing T and B lymphocytes and macrophages were seen in GALT and LNs. Virus-expressing mononuclear cells (MNC) were also seen in inflammatory lesions such as gastrointestinal ulcers and acute appendicitis. Abundant virus was seen in the cervix of patients with and without cancer and in LNs of patients with metastatic cancer. Individual and clusters of mature HIV particles were identified by TEM in LN GC and in GALT. Gastrointestinal tract lymphoid tissue, inflammatory lesions, and deep LNs showed levels of HIV RNA and Gag p24 protein expression in the range seen in superficial LNs.
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PMID:HIV expression in surgical specimens. 1867 77

Results of treatment of 2308 patients, suffering nonincarcerated hernia of abdominal wall of various localization, were analyzed. In 24 (1.1%) of them different pathologic changes of hernial sac were noted and in 17 (0.7%)--the diseases of organs, localized in hernial sac: an acute appendicitis, ileus, trauma, malignant tumor and others. The course of majority of the above-mentioned diseases was masked by incarcerated hernia signs, demanding the urgent operation performance. The operative intervention volume depended on the character of the organ pathological changes, localized in hernial sac, it was directed on the main disease elimination and on the abdominal wall defect closure.
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PMID:[Pathologic changes of hernial sac and its content]. 1868 Sep 97

A 17-year-old boy presented with an atypical manifestation of acute appendicitis. The clinical aspect, radiological investigations and peroperative aspect of the appendix were not conclusive but nevertheless a neuroendocrine tumour (carcinoid tumour) of the appendix was suspected. After ileocaecal resection and resection of pathological lymph nodes, histopathological evaluation revealed the diagnosis: a periappendicular mass without any sign of malignancy. In retrospect, ileocaecal resection was performed for a benign disease. This case illustrates that an unusual presentation of a common disease occurs more frequently than a typical presentation of a rare disease.
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PMID:[An unusual presentation of a periappendicular infiltrate]. 1885 31

Acute appendicitis is the most common acute abdominal condition that requires surgical intervention in childhood. From the diagnostic performance perspective, computed tomography (CT) has a significantly higher sensitivity than does ultrasound (US) for diagnosing appendicitis in children; from the safety perspective, however, one should consider the radiation associated with CT, especially in children. There is strong evidence supporting improved patient outcomes in children with suspected acute appendicitis who undergo CT scanning. Nevertheless, we should keep in mind that for a single abdominal CT study in a 5-year-old child, the lifetime risk of radiation-induced cancer would be 26.1 per 100,000 in female and 20.4 per 100,000 in male patients, based on probabilistic models designed with data from atomic bomb survivors. An integrated clinical-imaging approach, applying clinical scores that are able to predict which children with acute abdominal pain do or do not have a high probability of presenting with appendicitis may improve the effectiveness of the imaging diagnosis of appendicitis at the hospital level. Such an approach could avoid exposure of children who at low risk for appendicitis to unnecessary diagnostic tests and eventually, to radiation.
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PMID:Optimizing the role of imaging in appendicitis. 1930 74

Cysts of the omentum are rare and most frequently discovered in children. These cysts may cause abdominal distension, pain, or vomiting. Omental cysts with right lower quadrant pain are found even more rarely in adults. We describe a 44-year-old male who had a 2-day history of abdominal pain localized in the right lower quadrant. Before surgery, acute appendicitis with intra-abdominal abscess was suspected, but during the operation, an infected cyst of the omentum, adjacent and adherent to the redundant transverse colon, was found to have been causing these symptoms. Despite the fact that cysts of the omentum have been reported rarely, the operator should be aware that the cyst is a benign entity and the surgical strategy should be different from that for malignancy. We should keep the possibility of omental cyst in mind to avoid unnecessary bowel resection and potentially harmful inappropriate treatment.
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PMID:Inflammatory omental cyst adjacent to the transverse colon mimicking appendicitis in an adult patient. 2004 Apr 64

The current treatment for acute appendicitis is an appendectomy. Several studies have, however, assessed the efficacy of an antibiotic for treating acute appendicitis that is either uncomplicated or complicated by local peritonitis. A meta-analysis in 2007 that collected the results of 44 prospective studies showed that antibiotics were efficacious in 92.8% of cases of appendicitis complicated by local peritonitis, with percutaneous drainage of an abscess when necessary. No predictive factor for failure was identified. The failure of antibiotic treatment did not increase morbidity. Over time and on the whole, the recurrence rate was only 8.9%. The risk of cancer of the appendix (1.5%) nonetheless led to the recommendation of an interval appendectomy for adults. Four randomized controlled trials have compared antibiotic treatment with an appendectomy for the treatment of uncomplicated acute appendicitis. The efficacy of the antibiotic treatment ranged from 86 to 100% and the recurrence rate from 10.4 to 35%. These studies have had various methodological impediments; however, too few patients were included (40 and 80 patients), or only a clinical diagnosis was made before inclusion, or important protocol violations occurred, in particular for almost half the patient in the antibiotic therapy group in the 2009 study. These problems prevent us from relying on these authors' findings. Antibiotics have a role in the initial treatment of acute appendicitis complicated by local peritonitis. In uncomplicated acute appendicitis, the methodological inadequacy of the currently available randomized trials makes it impossible to reach a definitive conclusion about the efficacy of antibiotics.
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PMID:[Can acute appendicitis be treated by antibiotics and in what conditions?]. 1984 94

A 33-year-old man, who underwent ileo-cecal resection and sigmoidectomy for concomitant cecal cancer and sigmoid colon cancer which was diagnosed during the emergent operation for the perforated acute appendicitis, suffered simultaneous multiple hepatic metastases. Postoperative hepatic aerial infusion chemotherapy with 5-FU was done (total dose 63 g), and the metastases were successfully disappeared (CR). Although 16-month passed from the operation, locoregional recurrence at the colorectal anastomosis and peritoneal dissemination were occurred. Aggressive resections of the recurrent sites (anterior resection of the rectum, ileum, ascending colon and other recurrent sites) and successive systemic administration of FOLFOX4(9-course), FOLFIRI (20-course) and capecitabine (15-course) were achieved. The patient survived for 4.5 years after the initial treatment.
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PMID:[The colon cancer patient with multiple hepatic metastases and peritoneal disseminations was treated by hepatic arterial infusion chemotherapy and resection of the metastatic peritoneal dissemination with successive systemic chemotherapy--a case report of the long term survivor]. 2003 26

A broad spectrum of colonic complications can occur in patients with colon cancer. Clinically, some of these complications can obscure the presence of underlying malignancies in the colon and these complications may require emergency surgical management. The complications of the colon that can be associated with colon cancer include obstruction, perforation, abscess formation, acute appendicitis, ischemic colitis and intussusception. Although the majority of these complications only rarely occur, familiarity with the various manifestations of colon cancer complications will facilitate making an accurate diagnosis and administering prompt management in these situations. The purpose of this pictorial essay is to review the CT appearance of the colonic complications associated with colon cancer.
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PMID:CT findings of colonic complications associated with colon cancer. 2019 Oct 69


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