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

The purpose of this study was to determine the etiology of elevated alanine aminotransferase (ALT) in a population of asymptomatic volunteer blood donors. Subjects with an ALT value > 2.25 sd above norm (> 55 IU/liter) from the donated unit, were prospectively evaluated over a six-week interval. The subjects consisted of blood donors (78% male, 22% female) beginning basic military training at Lackland Air Force Base. Of 44,160 individuals screened, 19,877 (45%) voluntarily donated blood, 99 (0.5%) of which had confirmed ALT elevation. Of these (90 male/9 female), an associated condition or explanation was made in 12%: four with acute hepatitis B, four positive for anti-HCV, two with autoimmune disease, one with cholelithiasis and one associated with acute appendicitis. In 87 the ALT elevation could not be explained using available testing methods but may represent individual variation from a non-Gaussian distribution, be of nonhepatic origin (muscle), or of hepatic disease not detected by the diagnostic algorithm used. To increase the diagnostic yield, it is suggested that at least two elevated ALT values be established in this population over a period of time (yet undefined), before an extensive hepatic investigation is pursued.
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PMID:Serum alanine aminotransferase (ALT) elevation in asymptomatic US Air Force basic trainee blood donors. 826 13

We reviewed the emergency US exams carried out in the Radiology Department of the Sesto S. Giovanni Hospital on patients referred from the First Aid, Surgery and Medicine Depts in 1994. 202 of 8,400 US exams (2.7%) were emergencies in patients of both sexes aged 15 to 83 years. The exams were carried out in the daytime by 4 radiologists with different (longer/shorter) experience. The results were arranged in tables showing the referring department, the number of exams according to the anatomical district, the number of negative exams (122 cases) and of the exams where the clinical suspicion was confirmed (80 cases), as well as the frequency of the different conditions diagnosed. The conditions usually involved the abdominal organs and particularly the bile ducts (48 cases), showing gallstones which were quickly operated on. Renal colics were the second most frequent finding (10 cases). The results of many precautionary exams were poorly significant. Considering the numerous indications of emergency US, currently including also acute appendicitis and soft periskeletal tissue traumas, we conclude that more operators and technically adequate equipment are needed.
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PMID:[Emergency ultrasonography]. 903 55

Between January 1985 and September 1994, 21 patients with psychiatric disorders underwent various forms of surgery at our hospital. There were 12 men and 9 women with an average age of 57.6 years. The coexisting psychiatric disorders were schizophrenia in 15 patients, depression in 2, dementia in 2, mental retardation with epilepsy in 1, and Parkinson's disease in 1. All the patients had been receiving neuroleptic medications for a long period. The indications for surgery were: cholelithiasis in 6 patients, acute appendicitis in 4, perforation of the small intestine in 3, incarceration of an inguinal hernia in 2, and esophageal cancer, stomach cancer, bleeding from a gastric ulcer, perforation of a duodenal ulcer, strangulating ileus, and burns in 1 patient each, respectively. All of the patients who underwent elective surgery were given epidural anesthesia with or without general anesthesia. Antipsychotic medications were given until just prior to surgery and recommenced concurrent with the first meal. Abnormal behavior was observed in 11 patients (52.4%) postoperatively, but all the patients were discharged in accordance with recovery from their surgical disorder. Intra- and postoperative hypotension resistant to intravenous catecholamine administration was recognized in 9 patients (42.9%), and this peculiar complication should be borne in mind when patients with psychiatric disorders require surgical management.
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PMID:Surgical treatment of patients with psychiatric disorders: a review of 21 patients. 913 Mar 38

Our initial experience over the last 3 years with laparoscopic and thoracoscopic surgery in children and adolescents is reported. Between September 1992 and August 1995, a total of 215 laparoscopic and thoracoscopic procedures were performed: 32 appendectomies for acute appendicitis, 10 cholecystectomies for symptomatic gallstones, 11 procedures for adnexal pathology, 6 laparoscopies in children with nonpalpable testes, 3 diagnostic laparoscopies, and 153 thoracoscopic sympathectomies in children suffering from primary palmar hyperhidrosis. The post-operative course was uneventful in all cases. In 2 children with acute appendicitis we converted to the open technique due to technical difficulties. We are encouraged by the results of our initial experience. There is no doubt that laparoscopic cholecystectomy, laparoscopic surgery of adnexal pathology, and thoracoscopic sympathectomy, because of their numerous benefits - shorter operative time, hospitalization, and convalescence as well as less postoperative pain and improved cosmetic results - are replacing the open techniques. We are not convinced as yet of the advantages of laparoscopic appendectomy in children; we are presently performing both laparoscopic and conventional techniques and studying the various parameters in order to reach a more definite conclusion. Various other endoscopic surgical procedures will be carefully considered in the near future.
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PMID:Laparoscopic and thoracoscopic surgery in children and adolescents: a 3-year experience. 988 Jul 29

Situs inversus totalis is an uncommon anatomic anomaly that complicates diagnosis and management of acute abdominal pain. Expedient diagnosis of common intraperitoneal disease processes such as biliary colic, acute appendicitis and diverticulitis is often delayed as a result of seemingly incongruous physical findings. We present the case of a young woman with prior emergency room visits for complaints of a vague left upper quadrant abdominal pain. An ultrasound performed on her third presentation revealed visceral situs inversus with cholelithiasis and dilated intra- and extrahepatic biliary ducts. Standard laparoscopic cholecystectomy and cholangiography with a mirror-image surgical approach was performed successfully and without complication.
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PMID:Laparoscopic cholecystectomy and appendectomy in situs inversus totalis. 1098 5

This is a review of the epidemiological, diagnostic and therapeutic aspects of acute abdominal conditions during pregnancy. We emphasize the recent changes in surgical criteria that have appeared since the advent of laparoscopic surgery. The incidence of acute appendicitis during pregnancy is 1 in every 1,500 while approximately 4.5% of pregnant women have asymptomatic cholelithiasis and 0.05% acute cholecystitis. Up to 40% of these patients will require surgery during gestation and it is well known that abdominal interventions in this period carry out a higher risk of miscarriage or premature labor. We analyze the most common causes of acute abdomen during pregnancy as well as the special considerations of conservative treatment, open surgery and laparoscopic surgery. We also review the technical aspects of laparoscopic procedures and the safety guidelines by the Society of American Gastrointestinal Endoscopic Surgeons. It is concluded that the laparoscopic approach is safe and effective in the diagnosis and treatment of acute abdominal pathology during pregnancy. The advantages over conventional open surgery have made many surgeons and gynecologists change their criteria in favor of laparoscopy and this is now often their first choice of treatment.
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PMID:[Analysis of the increasing role of laparoscopy in the management of acute abdomen in pregnancy]. 1182

Perforation of the gallbladder with resultant spillage of gallstones is not an uncommon occurrence. Spillage is reported to occur in 6% to 40% of laparoscopic cholecystectomies. Although not generally considered a significant problem, retained gallstones may cause serious complications years after the operation, with a clinical presentation that often is confusing. We report two cases of unusual complications from spilled gallstones. The first patient presented with clinical and radiologic findings of acute appendicitis 8 years after the laparoscopic cholecystectomy. The second patient presented with spontaneous erosion of spilled gallstones through the back 2 years and 9 months after the laparoscopic cholecystectomy. The literature is reviewed, and the management of spilled gallstones is discussed briefly. Although the complication rate is low, every effort should be made to retrieve spilled gallstones, and the event should be recorded in detail in the operative record. Obligatory conversion to an open procedure is not necessary.
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PMID:Unusual presentations of spilled gallstones. 1280 56

This study was designed to measure the levels of serum and saliva ghrelin concentrations before and after surgery in an attempt to clarify whether this hormone plays any significant roles in acute appendicitis and cholelithiasis patients when compared with healthy controls. Samples were obtained from 20 patients with appendicitis, 10 patients with cholelithiasis before and after operation, and 16 healthy controls. The levels of ghrelin (acylated) were measured by means of a RIA assay. The results revealed that preoperative levels of ghrelin in saliva and serum were significantly decreased with respect to post-op in patients undergoing appendectomy, and control levels. This was also the case when the preoperative ghrelin concentrations in patients with appendicitis were compared with those having choelithiasis. Taken together, decreased ghrelin concentration in preoperative appendicitis might be a causative factor for the "loss of appetite" observed in an acute inflammatory condition such as acute appendicitis. However, further studies are necessary to reveal the exact mechanisms behind this observation.
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PMID:Changes in appetite hormone (ghrelin) levels of saliva and serum in acute appendicitis cases before and after operation. 1883 96

To determine the relative frequencies of gastrointestinal diseases (GI) in patients admitted to Samtah General Hospital, Gizan, the records of 2,442 adults admitted to the medical and surgical services for gastrointestinal diseases during the period 1413 to 1416 were analyzed retrospectively. 1,028 patients had acute appendicitis. The remaining 1,414 patients were admitted for various other GI diseases. In these 1,414 patients the commonest diseases were gastrointestinal infections (36.4%), peptic ulcer disease (19%), gall bladder disease (18.5%), viral hepatitis and its sequelae (20.7%). Despite the high prevalence of cholelithiasis, acute pancreatitis was uncommon (0.1 %). Inflammatory bowel disease was rare. There was no gender - related difference in the prevalence of gastrointestinal infections, peptic ulcer disease and carcinoma of the stomach. Males were significantly more afflicted than females with viral hepatitis (p< 0.0001), cirrhosis of the liver (p< 0.0001), hepatocellular carcinoma (p< 0.0005), variceal bleeding (p< 0.0005), and peptic ulcer bleeding (p< 0.005). As a large proportion of our patients had preventable diseases, it is expected that immunization and other public health measures will reduce the frequency of these diseases in the future.
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PMID:Pattern of gastrointestinal diseases in adult patients admitted to Samtah General Hospital, Gizan region, Saudi Arabia. 1986 48

A middle-aged woman was admitted with recurrent episodes of ill-defined right-sided abdominal pain, more prominent in the right upper quadrant. Surgical history revealed a laparoscopic cholecystectomy, 1 month prior, for gallstones that were thought to be the cause of her symptoms. However, she continued to experience similar pain with exacerbation leading to readmission. Blood tests revealed increased inflammatory markers and an ultrasound scan showed a tubular hypoechoic structure between her right kidney and liver corresponding to the area of maximal tenderness. A diagnostic laparoscopy was performed and a subhepatic inflammatory mass of appendicular origin was found. This required mobilisation of the right colon and appendicectomy. The patient made an uneventful recovery after being readmitted for an ileus treated conservatively. Histology revealed acute appendicitis with mucosal ulceration.
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PMID:Subhepatic appendicitis: a diagnostic dilemma. 2360 43


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