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

Primary torsion of the omentum is an unusual cause of an acute abdomen and commonly mimics acute appendicitis. The following report of four obese children is supportive of obesity as a predisposing factor. The paucity of gastrointestinal symptoms, anorexia, nausea, vomiting, and the relatively long duration of symptoms, may increase the index of suspicion. In the majority of cases, the diagnosis is made intraoperatively by digital exploration through the muscle-splitting incision. The torsed omentum is easily delivered through the same incision, and excision results in complete recovery.
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PMID:Primary omental torsion in children. 766 14

In the absence of any pathological condition in the pelvis of children who present with acute abdomen, the observation of serosanguineous intraabdominal fluid should prompt the surgeon to investigate the omentum. A 6-year-old boy who was admitted with a clinical picture of acute appendicitis, and was later diagnosed during a laparotomy to have primary torsion of the omentum, is reported. Obesity, exercise, and the presence of a bifid omentum were confirmed to be the predisposing factors.
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PMID:Primary torsion of the omentum in a 6-year-old boy: report of a case. 1038 76

Idiopathic or spontaneous segmental infarction of the greater omentum (ISIGO) is a rare cause of acute right-sided abdominal pain. The symptoms simulate acute appendicitis in 66% of cases and cholecystitis in 22%. Progressive peritonitis usually dictates laparotomy, and an accurate diagnosis is rarely made before surgery. The etiology of the hemorrhagic necrosis is unknown, but predisposing factors such as anatomic variations in the blood supply to the right free omental end, obesity, trauma, overeating, coughing, and a sudden change in position may play a role in the pathogenesis. We present herein the case of a 37-year-old man in whom ISIGO, precipitated by obesity and overeating, was successfully diagnosed and treated by laparoscopy. Resection of the necrotic part of the greater omentum is the therapy of choice, and ensures fast recovery and pain control. Serohemorrhagic ascites is a common finding in ISIGO, and careful exploration of the whole abdominal cavity should be performed. The laparoscopic approach allows both exploration and surgical intervention.
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PMID:Idiopathic segmental infarction of the greater omentum successfully treated by laparoscopy: report of case. 1081 85

Acute appendicitis is one of the most common causes of acute abdomen. Prospective studies have shown the overall accuracy of the clinical diagnosis to be not more than 70-78% in suspected appendicitis, with a correspondingly high rate of 20-25% unnecessary laparotomies. High-resolution ultrasonography (US) is a readily available, radiation-free noninvasive diagnostic modality that enables visualization of the inflamed appendix and a variety of relevant diseases in the differential diagnostic work-up. Prospective studies have shown that the overall accuracy of US in acute appendicitis ranges between 86 and 87% (sensitivity 75-92%, specificity 92-100%), with positive and negative predictive values of 89-96%, respectively. In experienced hands, US has significantly improved the diagnostic accuracy in suspected appendicitis, while halving the negative laparotomy rate to 8-15%. Since, however, a low percentage of false-negative US explorations due, for example, to accumulation of bowel gas or obesity, final therapeutic decisions be based on a careful consideration of US findings together with history, symptoms and clinical findings.
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PMID:[Ultrasound first in acute appendix? Unnecessary laparotomies can often be avoided]. 1092 79

Omental infarction, an uncommon cause of acute abdominal pain, is the result of compromised perfusion to the greater omentum. Although its etiology remains uncertain, predisposing factors include obesity [Surg. Today 30 (2000) 451], strenuous activity [N. Z. Med. J. 111 (1998) 211], trauma, and idiopathic omental torsion. Often confused with acute appendicitis or cholecystitis on clinical grounds [Surg. Today 30 (2000) 451], its diagnosis has traditionally been one of exclusion, based on intraoperative and pathologic findings. This diagnosis can be made radiologically based on the characteristic findings of an inflammatory mass containing fat and fluid. We describe a case of right lower quadrant omental infarction temporally related to bowel surgery.
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PMID:Omental infarction as a delayed complication of abdominal surgery. 1168 93

We examined the fact that 12 years old obese girl who applied to our clinic with acute abdomen symptoms and we determined primer omental torsion (POT) at laparotomy in this case. This disease is rare in childhood and imitates the signs of acute appendicitis. Obesity and anatomic variations ofthe omentum are predisposingfactorsfor POI ln this study we wanted to share our experiences in diagnosis and treatment ofPOI
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PMID:[A rare cause of acute abdomen in childhood: primary omental torsion]. 1218 66

Graded compression sonography is an established imaging modality in the clinical setting of acute right lower quadrant pain or to diagnose acute appendicitis because of its easy assessability, noninvasiveness, real-time imaging. However, the ability to accurately diagnose appendicitis can be affected by several factors including operator dependence, deeper-located appendix, and obesity or muscularity of the patient. However, adjuvant techniques utilizing advanced equipment and accumulated operator's experience to conventional graded compression sonography will yield more frequent detection of the vermiform appendix and more accurate results of acute appendicitis on sonography. This article introduces adjuvant techniques and various know-how of real field in the detection of the vermiform appendix and diagnosis of acute appendicitis.
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PMID:Sonography of acute appendicitis. 1274

The negative influence of obesity on the detection rate of the appendix for US in adults has been reported. It has been assumed that obesity is a limiting factor in the detection of the appendix with US in children as well, but this has not yet been proven. The aim of our study was to evaluate whether nutritional condition (defined by the body mass index-for-age percentiles: BMI-FAP) influences the detection of the appendix in children on US. One hundred twenty-six children (65 girls and 61 boys) with a mean age of 11.4 years with clinically suspected acute appendicitis underwent ultrasound on a commercially available high-end machine (HDI 5000, ATL, Bothell, Wash.). The BMI was calculated, and children were divided in three weight groups in accordance with the BMI-FAP, and were correlated with US findings. Evaluation of the three weight groups in accordance with the BMI-FAP demonstrated significant differences ( p=0.04) in the detection of the appendix. There was no statistical significance for the BMI, weight, height, and age solely for the detection of the appendix. In children there is a correlation between the nutritional condition as defined by the BMI-FAP and the detection of the appendix.
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PMID:Ultrasound of the appendix in children: is the child too obese? 1276 62

Primary omental torsion (POT), is a rare cause of acute abdomen commonly affecting obese male adults, whereas it is extremely rare in children. In this retrospective study, we present our experience regarding the management of five children with POT and discuss the diagnostic and therapeutic implications of this entity. We retrospectively reviewed the medical records of children diagnosed for POT, from January 1996 to July 2006 at our department. Among 2,734 children operated for acute appendicitis, five patients were diagnosed with POT (ratio 1:587 or 0.18%). Clinical presentation, laboratory findings, diagnostic imaging results as well as surgical and histological findings were reviewed. There were four boys and one girl, M/F ratio 4:1, with a mean age of 9.5 years (range 7.2-10.3). All subjects were obese and their weight percentages were over 85% for their age group. On admission the clinical symptoms and laboratory findings were similar to those of acute appendicitis. They were submitted to laparotomy and the surgical findings were; free serosanguineous fluid in the peritoneal cavity, normal appendix and an ischemic twisted mass of the omentum at the right side of the abdomen. The mass and the appendix were excised and the postoperative course was uneventful. The histological examination of the specimens revealed hemorrhagic ischemic necrosis of the omentum and normal appendix. POT is very rare in children. In the pediatric age group the clinical presentation and the laboratory findings are similar to those of acute appendicitis and it is extremely difficult to be diagnosed preoperatively. Obesity seems to be an important predisposing high-risk factor. Excision of the twisted omentum is the treatment of choice.
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PMID:Primary omental torsion in children: ten-year experience. 1760 20

Appendicitis and diverticulitis are very common entities that show some similarities in diagnosis and course of disease. Both are widely believed to be simple clinical diagnoses, which is in contrast to scientific evidence. An accurate diagnosis has to describe not only the initial detection, but particularly the severity of the disease. It is based mainly on cross-sectional imaging by ultrasound (US) and computed tomography (CT). Appendectomy is the standard treatment for acute appendicitis and is mandatory in complicated cases. Antibiotic therapy is similarly effective in uncomplicated appendicitis, but long-term results are not sufficiently known. Treatment of diverticulitis is related to the disease status. Complications such as perforation and bleeding require intervention. Uncomplicated diverticulitis as graded by US or CT are subject to conservative management, in the form of outpatient or hospital care. It is an unresolved debate as to whether antibiotic treatment offers benefits. Mesalazine seems at least to improve pain. The real challenge is treatment of recurrent diverticulitis. Lifestyle measures such as nutritional habits and physical activity are found to influence diverticular disease. Besides immunosuppression, obesity is a significant risk factor for complicated diverticulitis. Whether any medication such as chronic antibiotics, probiotics or mesalazine offers benefits is unclear. The indication for sigmoid resection has changed; it is no longer given by the number of attacks, but rather by structural changes as depicted by cross-sectional imaging.
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PMID:Appendicitis/diverticulitis: diagnostics and conservative treatment. 2379 26


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