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

A prospective study of 444 consecutive patients diagnosed as having acute appendicitis was carried out in a district general hospital. The appendix was acutely inflamed, gangrenous, or perforated in 346 patients. Diagnostic error, 22% overall, was twice as common in females as in males. Organisms were isolated from the outer appendix wall in 117 patients, isolation increasing with the severity of inflammation. 12% of children under 11 had mesentric adenitis, 10% of all females had gynaecological lesions, and 14% of patients over 50 had acute diverticulitis. In only 6% of patients was no abnormality found at operation, and in every case the disorder was dealt with through the gridiron incision.
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PMID:Appendicitis and mimicking conditions. A prospective study. 5 Dec 35

The gross and microscopic pathologic changes in 70 cases of serologically proven enteric infections with Yersinia pseudotuberculosis are presented. The highest incidence was in young males, and the commonest infecting organism belonged to serologic O-group I. Clinically, the illness resembled acute appendicitis, but the most consistent finding at laparotomy was mesentric lymphadenitis. Surgical specimens examined included 69 mesenteric lymph nodes, 18 appendices, five terminal ileums, and two ascending colons. Histologically, four stages of the disease were identified, leading to the formation of characteristic granulomas with central necrosis and microabscess formation. Ulceration of the intestinal and appendicular mucosa may occur. The illness usually runs a benign course, and antibiotic treatment is rarely necessary. The pathogenesis and differential diagnosis are discussed with reference to the current literature.
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PMID:The histopathology of enteric infection with Yersinia pseudotuberculosis. 37 42

In 895 patients operated on for acute appendicitis we found Yersinia enterocolitica in 41 cases. Another two cases were detected in postoperative serological examinations. Lymphadenitis mesenterialis was present in 17 cases during operation. Once we detected a regional enteritis. Histological examination of the appendix revealed a purulent inflammation in 21 cases and a phlegmonous-gangrenous inflammation in 4 cases. The other 18 patients suffered from Oxyuriasis, coprostasis or scars of the appendix. For this reason it is impossible to exclude an acute appendicitis in patients with cultural or serological identification of Yersinia enterocolitica.
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PMID:[Yersinia enterocolitica in acute appendicitis, lymphadenitis mesenterialis and regional enteritis (author's transl)]. 96 Nov 57

A case of acute appendicitis in which an appendicolith was present is described. The diagnosis was made by plain abdominal radiography and ultrasound, and was confirmed at surgery. The plain abdominal film showed a lamellated, round calcification, projecting over the right iliac wing. Ultrasound revealed a tubular, hypoechogenic structure, containing an oval hyperechogenic area with acoustic shadow. The recent literature was reviewed, and the "graded compression" technique is described. A summary is given of the ultrasound findings of acute appendicitis, and of its most important differential diagnoses in childhood: mesenterial adenitis, and--less frequently--terminal ileitis.
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PMID:[Acute appendicitis, echographic findings]. 265 82

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

576 patients admitted for suspected acute appendicitis were prospectively assessed by sonography following physical examination. The collective comprised - as proven by operation - 156 patients with acute appendicitis, 178 patients with chronic appendicitis or mesenteric lymphadenitis, as proven by observation, 186 patients suffering from gastroenteritis. 56 patients suffered from other diseases and 21 of them required urgent surgery. Based on clinical symptoms, correct diagnosis had been made in 433 patients (75%): gastroenteritis n = 186, chronic appendicitis or lymphadenitis n = 111 and acute appendicitis n = 136 (87%). In 123 patients the diagnosis was false positive, in 20 patients false negative. Based on sonographic assessment, 537 patients (93%) were correctly diagnosed; thus, in 129 patients (83%) an inflamed appendix was confirmed, in 56 patients; diagnosis of unrelated entities requiring urgent surgery correct in 21 cases. In 12 patients with mesenteric lymphadenitis - as proven by operation-a false positive, in another 27 patients with acute appendicitis a false negative diagnosis was made. The combination of clinical assessment and sonographic diagnosis yielded a correct diagnosis in 97% (560/576) comprising 414 true negative and 146 true positive results (94%) in respect of acute appendicitis.
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PMID:[Ultrasound study of "acute appendicitis," an elective procedure or obligation in general surgery. A prospective study]. 331 23

Salmonella infection requiring surgical intervention is rare. A case of localized ileocecal lymphadenitis due to Salmonella newport is reported. A review of the literature demonstrates that this is one of a spectrum of conditions of tissue infection by Salmonella in the ileocecal region. The outlook is good, and no untoward effects have arisen from surgery so that awareness of this condition should not alter the operative approach to a patient with a clinical diagnosis of acute appendicitis.
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PMID:Salmonella ileocecal lymphadenitis masquerading as appendicitis. 370 57

Appendectomy was performed on 1,059 children at the University Clinic of Paediatric Surgery in Mainz from 1. 1. 1975 to 31. 6. 1983. For the retrospective examination of the indication for appendectomy histopathological and intraoperative findings were analysed and evaluated. Histologically five types of appendicitis were differentiated: 1. acute appendicitis (two forms: acute ulcero-phlegmonous appendicitis with or without perforation and acute superficial appendicitis), 2. chronic appendicitis, 3. lymphatic hyperplasia, 4. submucosal fibrosis, 5. rare diseases. In 618 cases (= 58.3%) acute appendicitis was diagnosed histologically. In another 203 cases (= 19.2%) intraoperative findings (e.g. Lymphadenitis mesenterialis, Meckel's diverticulum) were retrospectively collected; they caused symptoms similar to those of appendicitis. However, there remain retrospectively 22% of all appendectomised children with no indication for laparotomy. The statistical analysis of postoperative complications showed a significant dependance from the histopathological findings. The highest rate of complications was seen in cases with perforated (34%) or non-perforated (10%) ulcero-phlegmonous appendicitis. Children with acute superficial appendicitis had a complication-rate of 5%; those with lymphatic hyperplasia and submucosal fibrosis of 6% each. Relaparotomies were almost exclusively necessary in cases with acute appendicitis; septic and pulmonary complications were mostly seen either in infants with malformations or other perinatal risks, or in children with additional severe diseases. Therefore non-acute appendicitis justifies a wide indication for appendectomy because of a low complication-rate; this, however, is not valid for high-risk children (e.g. malformations). In these cases sonography might be useful for preoperative diagnosis.
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PMID:[Appendicitis in childhood]. 401 Jun 71

The Authors describe a rare case of Yersinia Enterocolitica (Y.E.) infection in a child affected by thalassemia. The onset of the disease was that of an acute enteritis with diarrhea, fever, vomiting and abdominal pain which subsequently evolved in a picture consistent with an acute appendicitis. Laparotomy was then performed and showed a marked suppurative mesenterial lymphadenitis with mild appendicular inflammation and Y.E. infection was suspected. Culture from lymphonodes confirmed the presence of Y.E. sensitive to tobramicin and CTM. The use of these chemiotherapic agents has been followed by a rapid clinical improvement. Our recent experience could suggest some practical considerations: 1) Culture of Y.E. should be routinely performed in all children affected by acute gastroenteritis and particularly in those, above 5 years of age, in which the infection can simulate acute appendicitis. 2) Special attention should be carried out in children affected by thalassemia who can easily present more serious disease often complicated by septicemia. 3) Therapy depends on the form and severity of the disease and should be always guided by in vitro sensitivity test because of the possibility of resistence of Y.E. against the most frequently used antibiotics in septicemia.
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PMID:[Yersinia enterocolitica infection in thalassemia. Report of one case (author's transl)]. 697 42

Agenesis of the appendix is an exceedingly rare abnormality. When it does occur it may represent part of a more generalized ileocaeco-appendicular abnormality or it may occur as a localized event. A case is presented of a 23 year old lady with features of acute appendicitis in whom exploration revealed absence of the appendix and ileo-caecal lymphadenitis. The diagnosis should not be made without thorough exploration including full mobilization of the caecal area. Pre-operative diagnosis is only possible with laparoscopy.
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PMID:Agenesis of the appendix--case report. 808 Aug 37


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