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

An infection with Yersinia strains may develop with the picture of acute appendicitis. Laparotomy will then not reveal an acutely inflamed appendix, but will often show mesenteric lymphadenitis or acute terminal ileitis. These conditions have been observed in four patients. The differential diagnostic possibilities are discussed. It is pointed out that acute terminal ileitis is practically never transformed into chronic terminal ileitis (Crohn's disease).
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PMID:Yersiniosis as a surgical disease. 736 78

A case of isolated Crohn's disease involving the appendix and, indeed, presenting as acute appendicitis is described and related to 12 analogous cases reported in the literature. Crohn's disease of the appendix is exclusively diagnosed by histopathological evidence. According to published data isolated Crohn's disease of the appendix would not seem to predispose towards the formation of fistulae after appendectomy. Subsequent evidence of Crohn's disease in other sites is similar in frequency to cases with primary Crohn's disease in other parts of the intestinal tract.
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PMID:[Isolated Crohn's disease of the appendix]. 746 61

Due to controversial evaluation of the contribution of clinical signs for the diagnosing of non-specific inflammatory bowel disease, as well as due to the lack of similar data, we tried to find our own answer to the question as to whether the clinical signs of ulcerative colitis (UC) and Crohn's disease (MC) are helpful, unhelpful, or even confusing for the diagnosis. A group of patients with MC and UC was analyzed from this aspect. Individuals in their twenties and thirties prevailed in the sample, mostly intellectual workers, the number of males and females was equal. Our attempt to analyze all the available diagnostic methods originated in an observation that a long period of health problems precedes the diagnosis of MC, namely 1.5 y in males and as long as 4 y in females. Other striking information was that surgery represented the initial treatment in 66% of cases and the correct diagnosis was made peroperatively only in 56% of cases. We compared our results with those of the OMGE study, one of the largest projects which evaluated positively the contribution of clinical signs to the diagnosing of MC and UC. We found that the main signs of CU have not changed in the last century, and some additional signs occur rather due to complications than due to the disease per se. Frequency of pain increased by 25% in our patients, and approximately 1/3 of it represented intermittent pain caused by tenesms. Pain in MC must be properly analyzed in order to discriminate acute appendicitis. Other indicators did not differ from the OMGE study. In accordance with its results, we confirmed the importance of correct evaluation of clinical signs for the diagnosis and differential diagnosis of UC and MC. The number of diagnostic methods still increases. Their validity must be continuously re-evaluated, however the clinical examination in the dynamic process stays to be of crucial value.
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PMID:[What is the value of clinical symptoms in the diagnosis of nonspecific inflammatory bowel disease?]. 763 12

Crohn's disease of the appendix is an uncommon process that is more frequent in young people. The most common preoperative diagnosis is acute appendicitis. At exploratory laparotomy the appendix is enlarged and malignancy may be suspected. The differential diagnosis may be difficult. Serologic tests and cultures should be performed to exclude Yersinia infections. Appendicectomy is a safe procedure when the disease is limited to the appendix. The postoperative course is usually uncomplicated with a low rate of complications and recurrence. Although it may be a different process than Crohn's disease and the recurrence rate is low, it is suggested that all the patients should be followed-up so that recurrences may be recognized and treated as early as possible. A new case is presented after two years of follow-up without recurrence.
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PMID:[Appendiceal Crohn's disease]. 779 43

Interleukin-8 (IL-8) is a potent cytokine for recruitment and activation of neutrophils. To visualize its distribution in the intestinal mucosa and to understand better its possible role in the induction and promotion of inflammatory bowel disease, expression of the IL-8 gene was analyzed in resected bowel segments of 14 patients with active Crohn's disease or ulcerative colitis. In situ hybridization with IL-8 anti-sense RNA probes revealed strong and specific signals in the histologically affected mucosa. The number of cells expressing IL-8 gene correlated with the histological grade of active inflammation. In accordance with the characteristic histological signs of active disease, IL-8-expressing cells were diffusely distributed over the entire affected mucosa in patients with ulcerative colitis, whereas in patients with Crohn's disease, IL-8-expressing cells showed a focal distribution pattern. Cells expressing IL-8 were mainly located at the base of ulcers, in inflammatory exudates on mucosal surfaces, in crypt abscesses, and at the border of fistulae. Analysis of semi-serial sections pointed to macrophages, neutrophils, and epithelial cells as possible sources of this cytokine in active inflammatory bowel disease. We consistently failed to detect IL-8 messenger RNA in the mucosa of uninvolved bowel segments and in normal-appearing control mucosa of patients with colon cancer. In contrast, tissue specimens from two patients with acute appendicitis displayed IL-8-expressing cells in the mucosa. These results support the notion that IL-8 plays and important but nonspecific role in the pathogenesis of inflammatory bowel disease and that the production of IL-8 messenger RNA is restricted to areas with histological signs of inflammatory activity and mucosal destruction.
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PMID:Expression of interleukin-8 gene in inflammatory bowel disease is related to the histological grade of active inflammation. 817 48

The results of treatment of 28 patients with "appendicitis-like" form of the Crohn's disease are summarized. Diagnosis before the operation was supposed in 6 patients. Operated on were 25 patients. All of them underwent appendectomy. Differential diagnosis of acute appendicitis and Crohn's disease in difficult, of main importance are the data of clinical investigation. In diagnosis verification by the data of histologic conclusion, the performance of postoperative specific antiinflammatory therapy is mandatory. Danger of appendectomy under such conditions is exaggerated. The result of treatment at the period of from 3 to 20 years was studied in 22 patients operated on. Performance of postoperative treatment contributed to abatement of the disease, achievement of a satisfactory long-term result in all the patients.
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PMID:[Crohn's disease in emergency surgery]. 827 81

An acute disorder of the lower abdomen requires early clarification, whether or not it is of gynaecological or surgical origin. With non-gynaecological affections, beside diverticulitis, Crohn's disease, perforations, bowel obstructions, yersiniosis, vascular diseases (acute embolism, thrombosis or dissection), urological disorders or hernias, acute appendicitis has firstly to be considered. The systematic use of the different diagnostic instruments is discussed.
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PMID:[Acute disease of the pelvis: differentiation between gynecologic and surgical cause]. 829 39

Idiopathic granulomatous appendicitis has been categorized as primary Crohn's disease of the appendix based on its pathologic features, although the clinical course of this condition simulates acute appendicitis. In this study we report the clinical and pathologic features of 10 cases of idiopathic granulomatous appendicitis and compare the histopathology to 14 appendices inflamed by Crohn's disease. The patients comprised six women and four men with an age range of 15 to 48 years (mean, 29 years). Six patients had acute onset of right lower quadrant abdominal pain while in three patients the presentation was subacute; one patient was asymptomatic. Focal neutrophilic infiltration of crypts with crypt abscesses, mucosal erosion and ulceration, fissures, transmural lymphoid aggregates, and mural fibrosis were comparable in idiopathic granulomatous appendicitis and Crohn's disease affecting the appendix. Fistulization occurred more commonly in Crohn's disease. Idiopathic granulomatous appendicitis contained 19.7 granulomas per tissue section (range, 2.75 to 71.0) compared with 0.3 granulomas per tissue section (range, 0 to 3.0) for appendices affected by Crohn's disease. No patient with granulomatous appendicitis treated by simple appendectomy had recurrence of disease at mean follow-up of 4.5 years. Our morphologic data support the clinical contention that idiopathic granulomatous appendicitis is nosologically distinct from Crohn's disease. Ironically, the presence of numerous granulomas is the histopathologic feature distinguishing idiopathic granulomatous appendicitis from Crohn's disease.
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PMID:Idiopathic granulomatous appendicitis, or Crohn's disease of the appendix revisited. 850 37

Gastrointestinal carcinoids are infrequent but at the same time hardly rare tumours. They are often chance findings but, as is clearly reported in the literature, their potential malignancy should not be overlooked. They are most commonly localised in the appendix. The authors describe two case reports of carcinoid tumours of the appendix, one of which was diagnosed during left hemicolectomy due to Crohn's disease and the other during acute appendicitis. Prognostic and therapeutic problems are discussed in the light of the most recent literature.
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PMID:[Carcinoid tumors of the appendix. Review of the literature and two case reports]. 850 40

Crohn's disease limited to the appendix is uncommon. When Crohn's disease affects the appendix it typically has a longer clinical course than most cases of acute appendicitis. The diagnosis is histological. Appendiceal Crohn's disease has a benign course after surgery, and that's why some authors believe that it could be a different entity which should be better addressed to as "Idiopathic Granulomatosus Appendicitis". We present three new cases of Crohn's disease limited to the appendix.
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PMID:[Idiopathic granulomatous appendicitis or Crohn's disease confined to the appendix?]. 856 96


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