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

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

We report a case of acute appendicitis in a 36-year-old patient with recurrent abdominal pain diagnosed seven years previously as abdominal epilepsy. Prior to his reported presentation, he successfully managed his pain at home by self-administration of phenobarbital, but on three previous occasions the patient required emergency-department treatment for severe pain. Our patient had been symptom free for several months prior to this presentation. This case raises several important questions regarding the approach to the diagnosis of acute appendicitis in the emergency department. The case illustrates the relative value of clinical and paraclinical data in establishing the diagnosis. We evaluate accepted clinical and paraclinical data used to diagnose acute appendicitis and advocate using likelihood ratios to increase diagnostic accuracy.
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PMID:Use of clinical and paraclinical data to diagnose appendicitis in a patient with abdominal epilepsy. 2124 80