Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085693 (acute appendicitis)
 3,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Yersinia enterocolitica was isolated from the feces of 29 patients over a three-year period following the introduction of a selective culture medium. Y. enterocolitica was the third most common enteric pathogen after Campylobacter jejuni and Salmonella in this series of 3795 specimens from a predominantly adult population. The isolation rate of Y. enterocolitica was 0.9% and this represented 15.8% of positive cultures. The usual symptoms of Yersinia infection were diarrhea (93%) and abdominal pain (72%), often associated with tenderness in the right iliac fossa and fever. Fourteen patients required admission to hospital and four came to surgery for possible appendicitis. Acute terminal ileitis and mesenteric lymphadenitis were noted in each case. Two patients who were HLA-B27 positive had a reactive arthritis as their dominant complaint. In conclusion, Y. enterocolitica has emerged as a common cause of diarrhea in adults. It is an important cause of symptoms resembling those of acute appendicitis and is occasionally complicated by reactive arthritis.
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PMID:Clinical aspects of infection with Yersinia enterocolitica in adults. 330 48

Human enteric infection with Yersinia enterocolitica or Yersinia pseudotuberculosis may masquerade clinically as acute appendicitis but it is unusual for the appendix to be histologically inflamed. We report a case of Yersinia pseudotuberculosis infection in which acute appendicitis was present in the absence of terminal ileitis.
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PMID:Yersinia pseudotuberculosis with inflammation of the appendix: a case report. 330 14

One hundred seventy consecutive patients with clinical suggestion of acute appendicitis were studied by ultrasound (US) with the examiner using the graded compression technique. In 14 patients, the only US findings consisted of enlarged mesenteric lymph nodes in combination with mural thickening of the terminal ileum. This was consistent with the findings at surgery in four patients and with the results of barium studies in seven patients. In nine of 14 patients, stool cultures were performed, eight of which were positive for Yersinia enterocolitica. None of these 14 patients finally proved to have appendicitis. In a patient with acute pain in the right lower quadrant whose appendix cannot be visualized sonographically and whose US findings consist of enlarged mesenteric lymph nodes and mural thickening of the terminal ileum, the diagnosis is probably mesenteric adenitis and acute terminal ileitis. Appendectomy should be avoided in this condition.
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PMID:Mesenteric adenitis and acute terminal ileitis: US evaluation using graded compression. 353 38

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

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

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

High-resolution real-time ultrasound (US) with a 5 MHz transducer has proved to be an important method in the diagnosis of acute appendicitis. In a prospective study we examined 2074 unselected patients with suspected appendicitis to assess the diagnostic and epidemiological value of US. According to the clinical diagnosis females aged 10 to 30 represented the majority of suspected cases. Appendicitis was most often proved in male patients aged 15-30 years. The prevalence of acute appendicitis in childhood is lower (7%) than in elderly patients (33%). US enables the diagnosis of acute appendicitis with a sensitivity of 91%, a specificity of 98% and an overall accuracy of 97%. For differential diagnosis US demonstrates other diseases that mimic acute appendicitis. Thus it is possible to reduce the negative appendectomy rate particularly in children by revealing mesenteric lymphadenitis or terminal ileitis and in young women by directing attention to gynecological diseases.
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PMID:[Sonography of acute appendicitis. A 5-year prospective study of 2074 patients. 2]. 836 3

Background: During the past decade, very little has been published on the relationships between Yersinia enterocolitica, acute terminal ileitis (ATI), and Crohn's disease, possibly due to a decrease in Yersinia infections and, consequently, in ATI. Methods: Fifty-three patients admitted to Herlev University Hospital during the period 1976-1998 were diagnosed as having ATI while undergoing surgery for suspected acute appendicitis. The patients were followed up, and both Yersinia titers and the development of Crohn's disease were registered. Results: Forty-four patients (83%) were tested for Yersinia, 17 of whom (39%; 95% confidence limits, 24-55%) were positive. The incidence of yersiniosis in ATI decreased significantly during the observation period (P<0.05), whereas the incidence of ATI itself was unchanged. Thirteen of the 53 patients (25%; 95% confidence limits, 14-38%) had, in addition to ATI, an inflamed appendix. Three patients developed Crohn's disease during a median observation period of 13 years (cumulative risk 6.1%). None of them had yersiniosis. Conclusions: The incidence of ATI remained stable during the observation period, even though the number of Yersinia infections decreased. This may have been due to an increase in gastrointestinal infections caused by other enteric pathogens. In accordance with previous findings, ATI patients who developed Crohn's disease did not have yersiniosis. Thus, it is still of prognostic value to test patients with ATI for Yersinia and perhaps for other enteric pathogens as well.
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PMID:Acute terminal ileitis, yersiniosis, and Crohn's disease: a long-term follow-up study of the relationships. 1129 11

The purpose of our study is to emphasize the central role of ultrasound (US) in finding the cause of abdominal pain in children. Ultrasound of the lower abdomen quadrant should be considered in all cases in which the clinical signs and symptoms are not diagnostic of appendicitis. There is a wide range of clinical syndromes and diseases which can easily be diagnosed using a high resolution ultrasound with adjunct of color and power Doppler. The spectrum of abnormalities includes appendicitis, mesenteric lymphadenitis, infectious ileocecitis, Crohn's disease, intussusception, ovarian cysts, and encysted cerebrospinal fluid. One of the most common causes of acute abdominal pain in children is acute terminal ileitis (infectious ileocecitis) with mesenteric lymphadenitis. Ultrasound is the best tool to rapidly differentiate this disease from acute appendicitis, and prevent unnecessary laparotomy (Ref. 12).
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PMID:Infectious ileocecitis--appendicitis mimicking syndrome. 1620 35

Anisakidosis is the infestation of man by the larval stage of the parasite Anisakis simplex. A history of ingestion of raw or undercooked fish up to 48-72 hours before the onset is highly orientative. Based on the location of the lesions, various types of human anisakidosis have been identified: gastric, intestinal and luminal forms constitute the majority of cases and symptoms often mimic a variety of acute conditions such as gastritis, acute appendicitis, diverticulitis, or ileitis. We present a case of a young woman admitted to our department with acute abdominal pain. A history of raw fish ingestion was recorded. The patient was submitted to explorative laparoscopy in which an oedematous, thickened segment of ileum was observed. Therefore a small laparotomy was performed, followed by resection of the thickened ileum. The histological examination revealed transmural inflammation with marked infiltration of eosinophils. High levels of total IgE and Anisakis simplex-specific IgE were recorded. Anisakidosis is an underestimated cause of acute abdomen, and should be taken into consideration as a differential diagnosis in these conditions. Nevertheless, in most cases, the correct approach could prove difficult, because surgery may be necessary in these settings, allowing the diagnosis only by histological and parasitological investigation of the resected specimen.
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PMID:[Acute abdomen due to anisakidosis]. 1883 68


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