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

Crohn's disease limited to the appendix is uncommon. The disease may mimic acute appendicitis with fever, leukocytosis, right lower quadrant pain, and occasionally a palpable mass. When Crohn's disease affects the appendix, it typically has a longer clinical period in which the patient has symptoms than do most cases of acute appendicitis. The most common preoperative diagnoses are acute appendicitis and appendiceal abscess. A review of the literature is presented along with our experience in three additional cases of Crohn's disease limited to the appendix. We suggest that Crohn's disease be included in the preoperative differential diagnosis and that extensive intraoperative examination of the gastrointestinal tract be made in any case of suspected appendicitis that has had a protracted preoperative course.
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PMID:Crohn's disease of the appendix. 240 47

The ranking of sonography in the diagnosis of acute appendicitis and its complications was examined in 208 patients in a prospective study. With a prevalence of the disease of 31.25% the sensitivity of sonography was 91.5, and the specificity more than 96% with a low negative laparotomy rate of 12.9%. Since due to increasing experience in the techniques of examination and also due to technological improvements the normal appendix or concomitant appendicitis in enteritic disease patterns become visualisable, the sonographically determined appendix pattern is an important parameter. Sonography contributes to a reduction of the negative laparotomy rate due to the identification of differential diagnostically important diseases including lymphadenitis mesenterialis and Crohn's disease of the terminal ileum. At the same time, this method safely identifies perityphlitic abscesses and perforations of the appendix.
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PMID:[Ultrasonic diagnosis of acute appendicitis]. 267 22

Thirteen cases of Crohn's disease confined to the vermiform appendix were seen during a 12-year period. They constituted 16.9% of patients with primary resection of the bowel for Crohn's disease in the same period, but only 0.4% of the cases of acute appendicitis. In 10 of the 13 cases there was marked fibrous thickening of the appendiceal wall, and in 11 there were epithelioid cell granulomas. Appendectomy was performed in all cases. None had postoperative fistula or later manifestations of the disease within the observation time averaging 6.3 years. The recurrence rate was previously believed to approach that of recurrence after resection in other parts of the intestines. Collective review of this and three other relatively large case series gave an estimated recurrence rate of 3.5%. We conclude that in Crohn's disease initially confined to the appendix the course appears to be indolent.
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PMID:Crohn's disease limited to the vermiform appendix. 367 53

In the diagnosis of intra-abdominal disease, absence of gas or fecal shadows from the right iliac fossa is an important but nonspecific finding on plain roentgenograms. We found the empty right iliac fossa most commonly associated with acute appendicitis, Crohn's disease, and carcinoma of the cecum. Retrospective analysis of 137 confirmed cases of disease in the right lower quadrant yielded 21 (15.4%) with an empty right iliac fossa. In an additional 21 cases, an empty right iliac fossa was prospectively identified, and 13 of these patients (61.9%) had confirmed disease in a particular area.
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PMID:Empty right iliac fossa. 402 89

Complications after ineffective medical management are indications for surgical treatment in Crohn's disease and ulcerative colitis. Immediate intervention is necessary in perforation, bleeding and intestinal obstruction, but abscess, fistulation, chronic bowel obstruction and an inflammatory tumor need also surgery without longer delay. Acute ileitis terminalis imitating acute appendicitis is an exceptional case of Crohn's disease. Local recurrence, severe abdominal pain, diarrhoea, retardation of growth and development, and risk of malignant change may be reasons for elective surgery. As development of recurrence after operation is frequent and the results of colectomy and proctocolectomy with ileostomy are not always satisfactory some caution to surgery in ulcerative colitis and Crohn's disease in childhood is advisable.
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PMID:[Surgical indications in Crohn's disease and ulcerative colitis in childhood]. 660 Dec 4

Ultrasonographic findings in patients with diseases of the appendix, including acute appendicitis, suspected appendiceal abscess, and palpable right-lower-quadrant abdominal mass, are described. An appendiceal abscess may manifest as a cystic mass, a mixed solid and cystic mass, or a hypoechoic solid mass. An appendiceal calculus within an abscess can be recognized as a hyperechoic structure with acoustic shadowing. On ultrasonography, acute appendicitis in female patients may mimic tubo-ovarian disease. Ultrasonographic features of isolated Crohn's disease of the appendix and mucocele of the appendix are also described.
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PMID:Ultrasonographic findings in diseases of the appendix. 684 59

A study comparing the symptoms and signs of patients with acute Crohn's disease and those with acute appendicitis and intestinal obstruction is reported and a preliminary evaluation of computer-assisted diagnosis in this problem is given. There are significant differences between the three conditions. However, the accuracy of computer-assisted diagnosis in Crohn's disease is reduced by the high false positive rate of diagnosis in both appendicitis and intestinal obstruction. Computer accuracy in Crohn's disease may increase when further information is available to extend the data base.
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PMID:Computer-assisted diagnosis of acute Crohn's diseases. 699 11

Sixty-six young patients (average age, 17.2 years) underwent intestinal operations for Crohn's disease during a 14-year period at the UCLA Hospital. Nine had undergone previous appendectomy for suspected appendicitis, and in seven subsequent enteric fistulae and/or obstruction involving the cecum developed. None of the appendices were acutely inflamed. During the same period, a total of 125 children with Crohn's disease underwent medical or surgical care, and in none did acute appendicitis develop. Of the 66 patients under 22 years old who required intestinal resection, 60 had removal of the cecum. In a child with ileal Crohn's disease, rarely should a normal appendix be removed because of the high likelihood of complications and the low incidence of subsequent appendicitis.
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PMID:Management of the appendix in young patients with Crohn's disease. 705 21

A case of acute segmental inflammation of the terminal ileum in a female patient, who presented with signs and symptoms of acute appendicitis is reported. She had an associated bilateral pulmonary tuberculosis. The role of Mycobacterium tuberculosis in the etiology of the segmental ileal disease, and the relationship of the acute disease of the ileum to Crohn's disease is discussed. Henoch's purpura whose intestinal manifestations may mimic acute regional ileitis is discussed in the differential diagnosis.
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PMID:Acute regional ileitis with concomitant pulmonary tuberculosis. 716 Oct 2

A case of small-bowel obstruction occurred secondary to an uncommon parasitic disease, anisakiasis. Intestinal obstruction is a rare manifestation of this disease. Anisakiasis may be seen initially with nausea and vomiting or may mimic acute appendicitis or Crohn's disease. The predisposing factor in all cases is the ingestion of raw fish, and the disease is preventable by cooking fish at greater than 60 degrees C for a short time or by freezing at less than -20 degrees C for more than 24 hours. Anisakiasis should be considered in the differential diagnosis of small-bowel obstruction in patients whose diet includes raw fish.
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PMID:Anisakiasis: nematode infestation producing small-bowel obstruction. 720 Jul 65


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