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

Acute appendicitis, the most common cause of abdominal surgical emergency, shows a different pathogenesis, clinical course and outcome in the elderly. Age-specific factors are effective on preoperative clinical diagnosis and on the stage of this infectious disease. We aimed to present our experience with a series of elderly patients with appendicitis who were subjected to appendectomy. Operative and hospital records of patients with appendicitis were retrospectively reviewed. Patients who were 50 years of age or older were the main constituents of the study. Demographic features, preoperative clinical diagnosis, abdominal interventions, and postoperative morbidity and mortality were analysed as the main criteria. A total of 109 older patients have constituted 4.3% of our appendectomy cases. Besides right lower quadrant transversal incisions, surgery was performed via vertical incisions in 28.4% of cases with a diagnosis of acute abdomen. In the elderly, the perforation rate was significantly higher than in paediatric and adult patients (P<0.001). The proportion of the elderly among perforated cases was significantly increased when compared with non-perforated cases (12.9 versus 2.9%; P<0.001). Postoperative morbidity was noted in 35.8% of elderly patients, in 73.8% of perforated, and in 11.9% of non-perforated cases (P<0.001). The mortality rate was 5.5% in the elderly group, 11.9% in patients with perforated, and 1.5% in patients with non-perforated appendicitis. No mortality was noted in patients younger than 50 years. The precise diagnosis of appendicitis is relatively low in the elderly. Despite the uncommon occurrence of appendicitis, the perforation rate is still unfavourable. Postoperative morbidity and mortality is unacceptably high. Advancing age adversely affects clinical diagnosis, the stage of disease and the outcome of patients. Perforated appendicitis and septic progression is the main cause of undesirable outcomes.
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PMID:Age-related clinical features in older patients with acute appendicitis. 1297 95

HIV infection is a very actual disease widespread all over the world (40 million people), including up to 10 thousand Romanian, are infected with HIV; there are 950 HIV-infected patients in Oltenia, 450 of them are in our county (Dolj area), 80% of the HIV-infected persons are children. The authors are studying a group of 17 cases of HIV-infected children with surgical problems (Acute appendicitis, acute cholecystitis, pulmonary and kidney abscess, lymphadenophlegmons, abdominal tumours), which have been transferred to our department from the Infectious Diseases Clinic, between 1995-2004. The medical records of all patients were reviewed: strategies of management, particularity of antiretroviral therapy of children, and also strategies of prevention the perioperative HIV transmission. The most frequent cases were the lymphadenophleg mons (40%) and chronic abdominal pain (25%). The acute abdominal pathology consisted in 2 cases of acute appendicitis and 1 case of acute cholecystitis, which were successfully treated. The HIV infection remains in actuality, because there is not an efficient antiretroviral therapy. Surgeons planning treatment must consider the risks of the patient against the potential benefits of surgery.
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PMID:[Surgical management of clinical problems in children with HIV infection]. 1556 May 57

This study was conducted to define the value of procalcitonin (PCT) levels in the differential diagnosis of abdominal familial Mediterranean fever (FMF) attacks from acute appendicitis. From October 2006 to January 2007, 28 FMF (12 males, 16 females) patients with acute abdominal attacks and 34 patients (18 males) with acute abdomen who underwent operation with the clinical diagnosis of acute appendicitis were consecutively enrolled in this study. FMF patients with concurrent infectious diseases were excluded. PCT values were measured by an immunofluorescent method using the B.R.A.H.M.S. PCT kit (B.R.A.H.M.S. Diagnostica, Berlin, Germany). Erythrocyte sedimentation rate (ESR), C-reactive proteins (CRP) and leucocyte levels were also noted. Mean disease duration in FMF patients was 9.6 +/- 8.1 years (range 2-33 years) and all were on colchicine therapy with a mean colchicine dosage of 1.2 +/- 0.4 mg/day. Among the operated patients, 5 were excluded: 3 patients had normal findings and 2 had intestinal perforation (PCT levels were 2.69 and 4.93 ng/ml, respectively) at operative and pathologic evaluation. There were no significant differences between the two groups with respect to gender and age (p was not significant (NS) for all). Acute phase reactants and PCT levels were increased in patients with FMF compared to patients with acute appendicitis (0.529[0.12 +/- 0.96] vs 0.095 [0.01-0.80] p < 0.001, respectively). PCT levels higher than 0.5 ng/ml were found in 11% (3/28) of FMF patients compared to 62% (18/29) of acute appendicitis patients (p < 0.001). Our results suggest that PCT could be a useful test in the differentiation of abdominal FMF attacks from acute appendicitis, though it should not supplant more conventional investigations.
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PMID:Accurate diagnosis of acute abdomen in FMF and acute appendicitis patients: how can we use procalcitonin? 1903 Oct 94

Schistosomiasis is a major parasitic infection of tropical areas. We present a 26-year-old male immigrant from Egypt with acute abdomen due to schistosomial infection, mimicking symptoms of acute appendicitis, with histopathological detection and representation of schistosomial eggs in the unusual area of the greater omentum. This is a rare case with findings of intra-peritoneal schistosoma ova. We review the pertinent literature and indicate the need for a new approach to infectious diseases with unusual clinical presentation, due to pathogens coming from distal geographical regions, in which surgeons must keep a high index of suspicion.
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PMID:Schistosomal peritonitis: a rare cause of acute abdomen. 1913 20

Although the involvement of common childhood infections in the aetiology of acute appendicitis has long been conjectured, supporting evidence is largely restricted to a disparate set of clinical case reports. A systematic population-based analysis of the implied comorbid associations is lacking in the literature. Drawing on a classic epidemiological dataset, assembled by the School Epidemics Committee of the United Kingdom's Medical Research Council (MRC) in the 1930s, this paper presents a historical analysis of the association between termly outbreaks of each of six common childhood infections (chickenpox, measles, mumps, rubella, scarlet fever and whooping cough) and operated cases of acute appendicitis in 27 English public boarding schools. When controlled for the potential confounding effects of school, year and season, multivariate negative binomial regression revealed a positive association between the level of appendicitis activity and the recorded rate of mumps (beta=0.15, 95% CI 0.07-0.24, P<0.001). Non-significant associations were identified between appendicitis and the other sample infectious diseases. Subject to data caveats, our findings suggest that further studies are required to determine whether the comorbid association between mumps and appendicitis is causal.
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PMID:Common acute childhood infections and appendicitis: a historical study of statistical association in 27 English public boarding schools, 1930-1934. 2000 16

Actinomycosis is an uncommon chronic infectious disease. Common sites of involvement include the cervicofacial, thoracic and abdominopelvic regions. In abdominopelvic actinomycosis, the ileocecal region, including the appendix, is the most commonly involved site. In some reports, limited appendiceal actinomycosis has revealed a thickened appendiceal wall with peri-appendiceal inflammation as acute appendicitis or perforated appendicitis. We experienced pathologically confirmed intraluminal limited appendiceal actinomycosis without peri-appendiceal infiltration. Here, we report the computed tomography and ultrasound findings.
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PMID:Actinomycosis of the appendix mimicking appendiceal tumor: a case report. 2008 89

Acute appendicitis is uncommon after renal transplant. Infection with Candida albicans can produce serious complications by compromising the vascular anastomosis. In such cases, the origin of Candida albicans is often in the gastrointestinal system. Here, we report 2 uncommon complications that occurred in the same patient. A 27-year-old female renal transplant patient with appendicitis presented to our institution with acute graft failure. The patient was treated with an appendectomy and a transplant nephrectomy. Subsequently, the patient had a mycotic pseudoaneurysm rupture of the external iliac artery secondary to Candida albicans infection that originated possibly in the gastrointestinal system. This complication was further treated with a cross-femoral bypass. The occurrence of these 2 complications together is rare.
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PMID:Spontaneous mycotic external iliac artery aneurysm rupture after perforated acute appendicitis in a renal allograft recipient. 2164 72

Acute appendicitis is a very rare complication of varicella, and is rarely reported in studies of complications of varicella or appendicitis. This report describes three cases of acute appendicitis in the course of varicella, diagnosed in Clinical Department of Infectious Diseases at Split University Hospital, Croatia between 1998 and 2010. Varicella was diagnosed clinically, and in two cases confirmed by positive serological tests for varicella-zoster virus (VZV). In addition to routine histopathological examination, testing for viral antigens or DNA in the appendix, omentum and peripheral blood by genetic and immunohistochemistry methods may be important to confirm whether VZV and appendicitis are etiopathogenetically connected.
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PMID:Acute appendicitis, a rare complication of varicella: a report of three cases. 2204 82

The fourth, fifth and sixth Millennium Development Goals relate directly to improving global healthcare and health outcomes. The focus is to improve global health outcomes by reducing maternal and childhood mortality and the burden of infectious diseases such as HIV/AIDS, tuberculosis and malaria. Specific targets and time frames have been set for these diseases. There is, however, no specific mention of surgically treated diseases in these goals, reflecting a bias that is slowly changing with emerging consensus that surgical care is an integral part of primary healthcare systems in the developing world. The disparities between the developed and developing world in terms of wealth and social indicators are reflected in disparities in access to surgical care. Health administrators must develop plans and strategies to reduce these disparities. However, any strategic plan that addresses deficits in healthcare must have a system of metrics, which benchmark the current quality of care so that specific improvement targets may be set.This concept paper outlines the role of surgical services in a primary healthcare system, highlights the ongoing disparities in access to surgical care and outcomes of surgical care, discusses the importance of a systems-based approach to healthcare and quality improvement, and reviews the current state of surgical care at district hospitals in South Africa. Finally, it proposes that the results from a recently published study on acute appendicitis, as well as data from a number of other common surgical conditions, can provide measurable outcomes across a healthcare system and so act as an indicator for judging improvements in surgical care. This would provide a framework for the introduction of collection of these outcomes as a routine epidemiological health policy tool.
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PMID:A concept paper: using the outcomes of common surgical conditions as quality metrics to benchmark district surgical services in South Africa as part of a systematic quality improvement programme. 2394 51

The authors present three cases of abdominal actinomycosis that were initially diagnosed as acute appendicitis, an abscess in the left groin and pelvic tumour, probably of gynaecological origin. Definitive diagnosis of abdominal actinomycosis was established as late as postoperatively. Abdominal actinomycosis is a chronic, infectious disease characterized most frequently by non-specific symptoms such as abdominal pain, fever, vomiting, bowel obstruction, weight loss, sometimes palpable resistance, and leukocytosis [1-9]. Diagnosis may be difficult and needs to be taken into account, especially in patients with risk factors.
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PMID:[Abdominal actinomycosis - 3 case reports and literature overview]. 2396 30


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