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

During a two-year period, major operations were performed on 874 males and 649 females at the first-aid section of a major hospital. Acute appendicitis was the most common intraoperative diagnosis (45.63%), followed by intestinal obstruction (21%), gastroduodenal perforation (6.83%), abdominal injury (5.98%), angiosurgical emergency situations (5.19%, including amputation for gangrene), gynaecological emergency situations (3.74%), acute cholecystitis (3.35%), haematemesis (1.44%), acute pancreatitis (1.31%), and various other diseases. Further surgery as a result of complications was required in 2.63%. Mortality (1 year only) was 7.42%. The results achieved and the tactical criteria employed are discussed.
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PMID:[Epidemiological study of emergency surgical pathology in the first aid department of a large hospital]. 30 23

The clinical details of 100 patients with proved acute appendicitis were compared with those of 100 patients with perforating or gangrenous appendicitis. Twenty features were found to be significantly different between the two groups. This information was incorporated into a computer data base and used in the differential diagnosis of abdominal pain. A program written to predict the probability that gangrene or perforation was present in patients with appendicitis gave a diagnostic accuracy over 91%. A clinical scoring index, which accurately predicted the state of the appendix in 88% of patients, was constructed from the significant differences between the two groups. When clinical scoring or computer analysis predicts a high probability of perforation or gangrene in patients with appendicitis, surgery should be performed without delay.
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PMID:Computer-aided prediction of gangrenous and perforating appendicitis. 33 8

A 29-year-old female suffering from acute terminal ileitis was subjected to laparotomy undertaken on the tentative diagnosis of acute appendicitis. The appendix was found to be normal and was removed. The course was complicated with segmental gastro-intestinal gangrene with fatal outcome. The involvement of histotoxic clostridial infection as a causative factor is discussed.
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PMID:Acute segmental gastro-intestinal gangrene probably of clostridial origin. Report of a case. 96 23

This communication concerns the incidence of intra-abdominal surgery in 904 patients with acquired immunodeficiency syndrome who were admitted to the Cabrini Medical Center during a 3-year period from January 1985 to January 1988. It was found that 36, or 4.2%, of the patients underwent surgery, including 12 cholecystectomies, 7 splenectomies, 7 appendectomies, 6 laparotomies, and 6 other operations for miscellaneous conditions. It was pointed out that the high incidence of inflammatory involvement of the gallbladder, appendix, and intestines in AIDS patients was in all probability due to the nature of the blood supply to these organs. All receive blood from terminal arteries or vessels with few anastomoses, and therefore when vasculitis ensues it is often followed by gangrene or ulceration of mucosal surfaces. Surgical intervention was deemed advantageous for those patients with splenomegaly and accompanying pancytopenia, acute appendicitis, and lesions of the gastrointestinal tract, but not for those with cholecystitis. The high postoperative mortality rate, 22.2%, was attributed primarily to the immunodeficient state of the patients rather than to complications of their surgery.
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PMID:The incidence of intra-abdominal surgery in acquired immunodeficiency syndrome: a statistical review of 904 patients. 291 79

This is a prospective and randomized study of 100 patients with acute appendicitis who were less than 10 years old, in which four different antibiotic regimens commonly in use against gram-negative and anaerobic bacteria were compared in terms of postoperative septic complications. The antibiotics were begun immediately preoperatively and continued for five days. Ten percent of the patients developed infection complications, with 4% requiring further surgery. The best results were obtained with cefoxitin (4% of infection), metronidazole plus amikacin and latamoxef (8%), while the regimen of clindamycin plus amikacin was associated with the greatest number of complications (20%). On analyzing the main microbiologic findings of the study, we conclude that some sort of antibiotic treatment is indicated in all types of appendicitis, due to the occult presence of bacteria in the peritoneal cavity, even without clinical evidence of gangrene or perforation. Further, we emphasize the significance of Streptococcus faecalis as being responsible, along with Escherichia coli and Bacteroides fragilis, for serious postoperative complications.
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PMID:Study of appendicitis in children treated with four different antibiotic regimens. 331 64

Four cases are reported, in whom radiologically opaque appendiceal coproliths (appendicoliths) were recognised on plain abdominal radiographs. These were undertaken for diagnostic purposes, in patients with right-sided abdominal pain, in whom the diagnosis was not immediately apparent. The pathology, radiological features, and clinical significance of the phenomenon are discussed, and the association of appendicoliths with appendiceal perforation and gangrene is stressed. The fact that clinical signs and symptoms of acute appendicitis are often misleading and sometimes minimal, even in the presence of severe local peritoneal infection is of importance to physicians as well as surgeons.
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PMID:The radio-opaque appendicolith--its significance in clinical practice. 666 79

A reduction in wound infection after appendicectomy for acute appendicitis in children is described and attributed to the use of preoperative prophylactic antibiotics. In 118 consecutive children with appendicitis proven on histological examination there were three wound infections (2.5%) and only one of these was a serious wound abscess (0.8%). There was no postoperative abdominal abscess. Twenty-four of these children had appendicitis complicated by gangrene, perforation, peritonitis or abscess formation. This wound infection rate is compared with the author's previous unpublished rate of 8%, and a rate of 37% in a previously published series. It is comparable to the current wound infection rate for clean heriniorrhaphy procedures. The ideal is a single antibiotic effective against aerobic and anaerobic organisms with few side effects and little hypersensitivity. In early appendicitis, cefoxitin alone is likely to be effective, but in patients with complicated appendicitis, cefoxitin with metronidazole or lincomycin with an aminoglycoside are recommended.
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PMID:Appendicitis in childhood: reduction in wound infection with preoperative antibiotics. 695 52

One hundred and sixty nine cases of acute appendicitis were seen among 760 children aged to zero to 15 years treated for a variety of acute abdominal emergencies in the University of Calabar Teaching Hospital (UCTH), Calabar, during the period January 1982 to 1991. This condition ranks second among cases of acute abdominal emergencies in this group of patients. Those aged 13 to 15 years formed the majority (59 pc) of the children undergoing appendicectomy. As is the experience of other authors, appendicitis is rare under the age of three years. A female preponderance is observed in our study with a male: female ratio of 1:1,6 in contrast to reports elsewhere. The reason for this reversal is not clear. Parasitic infestation due to Ascaris lumbricoides involved 3 pc of our cases. This may be of significance in the aetiology of this disease. Despite the long delay in surgical intervention, no death was reported. Complications such as gangrene and perforation with peritonitis were recorded in only 8 pc of the patients. This favourable outcome despite a delay in initiating treatment may be related to self-medication with antimicrobials before reporting to the hospital.
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PMID:Appendicitis in south eastern Nigerian children. 778 78

The early diagnosis of acute appendicitis before progression to gangrene or abscess formation is recognized as important to minimize morbidity from this common disease process. As our population ages, the challenge for expedient diagnosis and intervention in older age groups will become more significant. Prompted by recent unexpected complications occurring in elderly patients, we reviewed 100 consecutive admissions with the diagnosis of appendicitis to a tertiary Veterans Administration hospital. All patients were males and were arbitrarily divided into three age groups: less than 50, 50-70, and greater than 70 years of age. There were no patients less than 20 years old. Operative findings were classified as simple acute appendicitis, ruptured or perforated appendicitis, appendicitis associated with intra-abdominal abscess, and finally other when the operative diagnosis differed from appendicitis. Of the 37 patients less than 50 years of age, 28 were found to have simple acute appendicitis, making this by far the most common finding in this age group (P < 0.05). Only two of the 18 patients aged 50-70 with appendicitis demonstrated simple acute appendicitis, with the remainder having progressed to perforation or abscess formation (P < 0.05). Patients greater than 70 years of age were significantly more likely than any other age group to manifest appendicitis associated with intra-abdominal abscess (10 of 19, P < 0.05). Eight patients died in this series, six of whom were more than 70 years of age. In most cases, mortality was directly attributable to infectious complications of perforated appendicitis. There were no deaths in the under 50 age group.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Increased morbidity of appendicitis with advancing age. 783 80

A prospective study on the management of severe acute appendicitis with gangrene and perforation was carried out using protocols that included schematized treatment. The schemes emphasized adequate preoperative treatment, meticulous operative technique of peritoneal toileting, generous use of appropriate antibiotics in combinations, and early graded patient's ambulation in the postoperative period. The average hospital stay was seven days, wound infection was of mild degree and less than 1%, and there was a low morbidity. Follow-up has shown no serious complications.
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PMID:Management of peritonitis in perforated appendicitis in children. 792 55


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