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

In cases of clinical suspicion of an acute appendicitis sonography uncovers another disease as the real cause of the symptoms in about one-quarter of such cases. Bacterial ileocaecitis is most frequently diagnosed (11.6% of N = 786). In special bacteriological stool cultures, Yersinia enterocolitica and Campylobacter jejuni were identified, whereas Salmonella enteritidis was a rarer finding. The typical sonographic manifestation of bacterial ileocaecitis compared against Crohn's disease of the ileocaecal region is described. These two diseases can be differentiated against each other by means of sonography; likewise, it is also possible to distinguish them from appendicitis. Since stool cultures--which are not always prepared if diarrhoea is only mild or completely absent--are received relatively late in acute cases, knowledge of the sonographic manifestation of bacterial ileo caecitis can help save many an unnecessary laparotomy.
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PMID:[Bacterial ileocecitis: a "new" disease]. 179 86

Ultrasonography with graded compression was performed in 525 patients with clinical signs of acute appendicitis. Of 207 patients with surgically proven appendicitis the inflamed appendix (diameter greater than or equal to 6 mm) had been visualized sonographically in 177 (86 per cent). The score for non-perforated appendicitis (91 per cent) was higher than for perforated appendicitis (55 per cent). Twenty-four patients in whom an inflamed appendix was seen on ultrasonography did not undergo surgery because of rapidly subsiding symptoms ('abortive appendicitis'). Four of these 24 developed recurrent appendicitis warranting surgery. Two underwent elective appendectomy and 18 have remained symptom-free. Of 155 patients with a subsequently confirmed alternative condition, ultrasonography made the correct diagnosis in 140: bacterial ileocaecitis (69), mesenteric lymphadenitis (eight), gynaecological conditions (34), urological conditions (eight), caecal diverticulitis (six), perforated peptic ulcer (six), Crohn's disease (two) and miscellaneous conditions (seven). Of 139 patients in whom no definite diagnosis was made ultrasonography showed no abnormalities in 138. In four patients a false positive sonographic diagnosis of appendicitis was made and in two patients with appendicitis an alternative condition was incorrectly diagnosed. During the last 3 years of the study the negative appendicectomy rate was 7 per cent and delay beyond 6 h after admission occurred in only 2 per cent of patients with surgically proven appendicitis. When used to complement the clinical diagnosis ultrasonography improves the diagnostic accuracy and patient management in those suspected of having acute appendicitis.
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PMID:Ultrasonography in the diagnosis of acute appendicitis. 202 47

Two patients with Crohn's disease confined to the appendix are described. The condition may present as acute appendicitis or appendiceal infiltrate. Therapy of either manifestation includes appendectomy. Concurrent Crohn's disease elsewhere in the gastrointestinal tract may be found in 25 per cent of the patients. A recurrence rate of 10 to 15 per cent in the remaining patients justifies a follow-up of some three years.
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PMID:Crohn's disease of the appendix. 202 9

The authors sent a questionnaire containing a series of questions dealing with acute manifestations of Crohn's disease, to eminent surgeons of different surgical schools. Results are interesting because differences are quite evident. In terminal ileitis mimicking acute appendicitis, 75% of surgeons perform an appendectomy. In the case of on acute intestinal obstruction, resection of the diseased bowel with primary anastomosis is preferred. In case of free perforation of the lesion, abdominal and massive hemorrhage, answers need to be analyzed in details.
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PMID:[Treatment of Crohn's disease in the acute phase]. 203 84

Among 2,443 patients who underwent operation for acute appendicitis in a period of 9 years 19 had Crohn's disease. The specific features of the clinical picture and the morphological changes are described. The diagnosis and surgical tactics in Crohn's disease are discussed. It is emphasized that alertness in relation to this disease in emergency surgery is necessary because of the danger of the development of grave complications. Recommendations with regard to the treatment of patients in the postoperative period are given.
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PMID:[Crohn disease]. 207 48

Although the primary role of the specialist in internal medicine in treatment of Crohn's disease is generally accepted, frequently the surgeon is the first person to take action. In patients with hitherto not diagnosed Crohn's disease he performs laparotomy because of suspected acute appendicitis or on account of surgical complications, most frequently ileus, which may be a very early manifestation of the disease. In a group of 40 patients with Crohn's disease and treatment ileitis the author gives an account of surgical indications, affections of different portions of the gastrointestinal tract and surgical operations.
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PMID:[Surgical complications in Crohn's disease]. 208 51

A rare case of Crohn's disease limited to the appendix is reported in an 18 years old adolescent, hospitalised as having acute appendicitis. Appendectomy was performed. There were no postoperative complication and no recurrence after 3 years follow-up. Surgical indications are discussed and literature reviewed.
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PMID:[Crohn's disease limited to the appendix. Apropos of a case]. 209 47

Incidental appendectomy is contraindicated in patients whose conditions are unstable, patients previously diagnosed with Crohn's disease, patients with an inaccessible appendix, patients undergoing radiation treatment, patients who are pathologically or iatrogenically immunosuppressed and patients with vascular grafts or other foreign material. In patients ten to 30 years of age--the age group associated with a higher incidence of acute appendicitis--who are otherwise healthy, incidental appendectomy is effective in preventing morbidity and death associated with acute appendicitis. In patients 30 to 50 years of age, incidental appendectomy should be left to the discretion of the surgeon. In this age group, the physician should give special consideration to the gender of the patient and the desire for future childbirth. In patients more than 50 years of age, the incidence of acute appendicitis decreases and the risk associated with operation and prolonged anesthesia is such that an incidental appendectomy is not beneficial. In mentally handicapped patients less than 50 years of age and who are physically healthy, incidental appendectomy should be performed. An inversion technique should be used in all instances of incidental appendectomy. In otherwise clean cases in which incidental appendectomy is anticipated, prophylactic antibiotics may be of value. Patients undergoing procedures that may compromise access to the appendix in the future should undergo incidental appendectomy.
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PMID:Guidelines for therapeutic decision in incidental appendectomy. 219 15

During a 4-month period, high-resolution ultrasonography (US) was used to prospectively evaluate 70 children with clinically suspected acute appendicitis. Thirty-five US scans showed a noncompressible appendix with maximal outer diameters greater than 6 mm. This finding was considered positive for the diagnosis of acute appendicitis. Thirty-one of these 35 patients had acute appendicitis documented by surgical and pathologic findings. The remaining four patients were observed, and their symptoms resolved. Thirty-five patients had US scans considered negative for appendicitis. Seventeen of these patients had US findings positive for other conditions including mesenteric adenitis, ileitis, intussusception, Crohn disease, and Burkitt lymphoma. In this series US enabled diagnosis of acute appendicitis with a sensitivity of 94%, a specificity of 89%, and a predictive accuracy of 91%. Diagnosis of acute appendicitis can be made with US with the same accuracy in children as has been previously reported in series of adult patients. The use of US in clinically ambiguous cases may allow earlier diagnosis, prevention of perforation, and decreased complications in the pediatric patient with acute appendicitis.
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PMID:Acute appendicitis in children: evaluation with US. 219 94

Actinomycosis is a rare infection which can attack most parts of the body, even in normal individuals. In the gastrointestinal tract it may imitate acute appendicitis, Crohn's disease or tumors. We present a young soldier with appendiceal involvement who was mistakenly operated on. Because of its very good response to antibiotics, this infection should be recognized early and treated, to prevent prolonged, unnecessary suffering.
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PMID:[Actinomycosis imitating acute appendicitis]. 234 25


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