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

The study was done, to determine the factors for negative appendicectomies. This prospective descriptive study includes patients managed at four non teaching and a teaching hospital of Karachi from March 2006 to February 2008. One hundred and sixty eight patients underwent appendicectomy during the study period. Details of clinical presentations, investigations, operative findings and histopathology were entered and analyzed. Literature search was aimed to see the negative appendicectomy rate (NAR) in last ten years despite using diagnostic tools (clinical scoring, diagnostic imaging and laparoscopy). In this study a total number of 168 patients under went appendicectomy. Normal appendices were found in 31 patients (negative appendicectomy rate was 18.45%) and associated pathology was seen in 13 patients, an incidental finding of Meckel's diverticulum in 5 patients and no other pathology was seen in 13 patients. The different factors which we identified for negative appendicectomies in our practice were non teaching hospitals where diagnostic scoring system was difficult to apply, female gender, selective use of imaging modality, other pathologies presenting with pain in right lower quadrant (RLQ) and requiring surgical intervention, and non-availability of CT scan and laparoscopy. Despite many advances in diagnostic system, acute appendicitis is still a diagnostic dilemma at times. Although there is no substitute for clinical judgment but in sub groups of patients in whom the possibility of negative appendicectomy is high, diagnostic modalities should be used judiciously to decrease the negative exploration.
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PMID:Factors identified for negative appendicectomies. 1962 47

Over the last 20 years, the treatment of acute appendicitis has been transformed by the development of the laparoscopic approach. And yet the net value of this approach continues to be debated. Laparoscopic appendectomy is associated with a lower complication rate and a shorter period of disability in the general population. While operative costs are higher, the global cost of laparoscopic appendectomy is lower than for open appendectomy. There is a somewhat higher rate of abdominal abscess for the laparoscopic route. Laparoscopic appendectomy shows clear advantages in obese patients and in those with gangrenous or ruptured appendicitis. The laparoscopic approach is contra-indicated during pregnancy due to a higher incidence of miscarriage. Treatment of the appendiceal stump by ligature decreases the expense associated with the use of a surgical stapler. When Meckel's diverticulum is encountered during appendectomy, it should be removed in all pediatric patients; in adults, Meckel's diverticulectomy in adults should be performed only for clear-cut pathology. Surgeons continue to innovate and refine appendectomy techniques but many questions remain to be answered.
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PMID:[Surgical techniques of appendectomy for acute appendicitis]. 1984 93

Meckel's diverticulum (MD) is a congenital disorder that results from an incomplete obliteration of the vitelline duct. MD may give rise to bleeding, intestinal obstruction and inflammation; however its perforation by a foreign body is an extremely rare life-threatening complication. We report on a 52 years-old Brazilian Amazon man presenting symptoms and signs of acute abdomen with an initial suspicion of acute appendicitis. However, the right diagnosis was made only during exploratory laparotomy when the appendix was found to be normal, whereas MD was found to be inflamed and perforated by a chicken bone. The patient was treated successfully with resection of a segment of the ileum, including the perforated diverticulum, and had an uncomplicated postoperative course.
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PMID:Perforation of Meckel's diverticulum by a chicken bone mimicking acute appendicitis. Case report. 2010 74

Meckel's diverticulum is the most prevalent abnormality of the gastrointestinal tract seen in approximately 2% of the population. Diagnosing complicated diverticulum is difficult, for its capacity to mime multiple disorders such as appendicitis, ulcer disease, enterocolitis, Chron disease, sigmoid diverticulitis, cholecystitis, and it should be considered in all patients with unexplained chronic abdominal pain, nausea, vomiting, gastrointestinal bleeding, unexpected cause of intestinal obstruction or acute abdomen. Herewith we provide an illustrative presentation, emphasizing the difficulties in preoperative diagnosis of complicated Meckel's diverticulum and underlining the nonspecific nature of the subjective and objective findings. Both cases were admitted to our clinic with acute abdomen diagnoses--first case as a intestinal obstruction and in second case was acute appendicitis. Laparatomy ascertain that the cause of symptoms was the complicated Meckel's diverticulum.
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PMID:[Complicated Meckel's diverticulum in adult pathology]. 2018 76

Meckel's diverticulum (MD) is the most common congenital anomaly of the gastro-intestinal tract (approximately 2% of population), and arises from improper closure and absorption of the omphalomesenteric duct. Very few cases of Meckel's diverticulitis on the mesenteric side have been reported in the surgical literature, and no reported cases have been documented on preoperative imaging. We report a 65-year-old woman presenting symptoms and signs of acute abdomen with an initial suspicion of acute appendicitis. MDCT imaging revealed a mesenteric abscess in the right lower quadrant at the level of the distal ileum as a complication of Meckel's diverticulitis on the mesenteric side. The patient recovered after a diverticulectomy without the need for a small bowel resection. This case demonstrates that MDCT is a fast imaging technique that may be helpful in the emergency setting for the preoperative diagnosis of an unusual complicated MD on the mesenteric side.
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PMID:Perforated Meckel's diverticulitis on the mesenteric side: MDCT findings. 2147 4

Meckel diverticulum is the most common congenital anomaly of the small intestine that generally comes to attention due to a variety of complications, such as gastrointestinal tract bleeding, bowel obstruction or acute inflammation. These diverticula frequently are difficult to prospectively diagnose by imaging. Clinically, acute Meckel diverticulitis can be mistaken for acute appendicitis or Crohn disease. We present a 6-year-old boy with perforated acute Meckel diverticulitis that mimicked Crohn disease both clinically and by CT imaging and was definitively diagnosed using MR enterography.
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PMID:MR enterography of perforated acute Meckel diverticulitis. 2159 46

Incidental carcinoid tumor of the Meckel's diverticulum is an uncommon event. Herein, a case of a carcinoid tumor in Meckel's diverticulum that was incidentally found in a patient with acute appendicitis is presented. A 42-year-old Caucasian man presented with acute abdomen and clinical signs of acute appendicitis. A typical appendectomy was performed during which further abdominal exploration revealed a Meckel's diverticulum 60 cm proximal to the ileocecal valve, with an irregular and somewhat indurated serosal region on one side. A stapled diverticulectomy was performed. Pathology revealed an incidental carcinoid tumor measuring 1 cm within the Meckel's diverticulum. CT scan of the abdomen and 24-h urine 5-hydroxyindoleacetic acid results were normal. The patient had an uneventful recovery and was discharged at the 5th postoperative day. He is alive and without evidence of disease 23 months after the operation. Coexistence of acute appendicitis along with an incidental Meckel's diverticulum raises controversies in their surgical management. We discuss the issues in managing patients with two or more of these coexistent pathologies.
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PMID:Acute appendicitis and carcinoid tumor in Meckel's diverticulum. Three pathologies in one: a case report. 2188 58

Intussusception is commonly seen in infants. It is occasionally found in adults usually due to carcinomas, colonic diverticuli, polyps and rarely Meckel's diverticulum. An adult male presented with upper abdominal pain, nausea, anorexia and loose stools. The initial investigative workup was unremarkable and patient responded to treatment given for acute gastroenteritis. After 3 days, the pain recurred in right iliac fossa with rebound tenderness and leukocytosis. Surgery was performed with provisional diagnoses of acute appendicitis and/or acute Meckel's diverticulitis. Per-operative findings revealed invaginated Meckel's diverticulum causing non-obstructing intussusception.
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PMID:Invaginated Meckel's diverticulum: a rare cause of small intestine intussusception in adults. 2355 42

Meckel's diverticulum is a congenital disorder that results from an incomplete obliteration of the vitelline duct. Meckel's diverticulum may give rise to bleeding, intestinal obstruction and inflammation; however, its perforation by a foreign body is an extremely rare life-threatening complication. We report ona 37-year-old male presenting symptoms and signs of acute abdomen with an initial suspicion of acute appendicitis.However, the right diagnosis was made only during exploratory laparoscopy when the appendix was found to be normal,whereas Meckel's diverticulum was found to be inflamed and perforated by a chicken bone. The patient was treated successfully with laparoscopic resection of the diverticulum, and had an uncomplicated postoperative course.
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PMID:Perforation of Meckel's diverticulum by foreign body, a rare complication. 2379 Jul 94

Perforation of Meckel's diverticulum by a foreign body represents an unusual and serious clinical occurrence. We present a case of a 4-year-old male who was admitted with symptoms of abdominal pain in the right iliac fossa, raising the suspicion of acute appendicitis. Exploratory laparotomy disclosed normal appendix and perforation of Meckel's diverticulum caused by a wood splinter. Meckel's diverticulectomy was performed and the child had an uneventful postoperative course. Preoperative diagnosis of perforated Meckel's diverticulum remains a challenging issue. Diagnosis should be considered in the presence of a right lower quadrant abdominal pain or a positive history of ingestion of a sharp foreign body.
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PMID:Perforation of Meckel's diverticulum by a wood splinter in a 4-year-old child: a case report. 2397


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