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

An analysis of the medical records of 103 women with Crohn's disease points up the following observations. There is a slight increase in spontaneous abortions and a substantial degree of subfertility. The obstetric experience is the same as in the normal obstetric population and the effects of the disease on pregnancy and of pregnancy on the disease are minimal. Features seemingly unrelated to Crohn's disease and of a gynecologic nature may be present months before the onset of the main bowel inflammation. These features consist of abscesses, fistulas, ulcers, fissures, and infections involving not only the internal pelvic organs but also the vulvovagina, perineum, labia, rectovaginal septum, rectum, and anus. The onset of Crohn's disease may be acute and present the picture of an abdomen requiring surgical treatment. A tender, low abdominal, adnexal, or pelvic mass may incorrectly be diagnosed as acute appendicitis, pelvic inflammatory disease, or ovarian cyst, and lead to surgery. In 23 instances the diagnosis of Crohn's disease was established only after laparotomy. A total of 27 appendectomies were performed and none of these patients had acute appendicitis. Four pelvic abscesses developed after the appendectomies. To avoid the pitfalls of misdiagnosis and mismanagement, the nature of Crohn's disease should be understood and the gynecologic aspects of the disease recognized.
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PMID:Crohn's disease: "its gynecologic aspect". 64

Microsurgery is used extensively for reconstruction after an inflammatory disease, for reversal of sterilization, and surgery in young or unmarried women. Peritubal and periovarian adhesions are 2 main causes of infertility in women. In salpingolysis cases, it has been shown that with over 53% ciliated cells in the fibria there can be a 60% pregnancy rate using microsurgery. In salingostomy cases, there is an increased pregnancy rate although still less than 30%; however, there is a corresponding increase in the number of ectopic pregnancies. Cornual occlusions due to salpingitis isthmica nodosa, endometriosis, cornual fibromyomata, endosalpingitis, puerperal infection, or polyposis was corrected by tubal implantation before microsurgery, which avoids the disadvantages of implantation. Nearly 45% of the women with inflamed tubes and 60% of sterilization reversals have achieved intrauterine pregnancies. Surgery for ovarian cysts, bleeding corpora lutea, and acute appendicitis may lead to infertility, but by using microsurgery, adhesion formation is limited or removed entirely; however, for ectopic pregnancies, 50% will probably remain infertile even after microsurgery. It is suggested that microsurgery techniques be practiced on extirpated tubes and hysterectomy specimens.
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PMID:The future of microsurgery in infertility. 73 44

Among the 5612 pregnancies followed at the 2nd Obstetrical and Gynaecological Clinic of the University Hospital of Athens, from July 1969 to December 1974, laparotomy was undertaken 32 times for conditions not associated with pregnancy, an incidence of 0,58%. The laparotomy was performed because of ovarian cysts, fibroids, acute appendicitis and bowel obstruction. The accurate diagnosis, the fetal loss rate, maternal morbidity and mortality were discussed.
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PMID:[Laparotomies during pregnancy. Apropos of 32 cases]. 95 16

From February 1990 to December 1991, 16 laparoscopic procedures were performed for right lower quadrant pain. There were nine men and seven women, aged 16 to 47 years (mean, 27.2 years). All procedures were performed by surgical chief residents with prior experience in laparoscopic cholecystectomy, first-assisted by an attending surgeon. The appendix was visualized and a definitive diagnosis was made in all patients. One patient with acute salpingitis underwent diagnostic laparoscopy only; two patients underwent laparotomy (perforated appendicitis, perforated diverticulitis). A fourth patient had an acute torsion of an ovarian cyst managed laparoscopically. Laparoscopic appendectomy was successfully performed in 12 patients (acute appendicitis, 9; fibrosis or chronic inflammation, 2; normal appendix, 1). Mean operative time for laparoscopic appendectomy was 95.7 minutes, and mean postoperative stay was 2.5 days. The authors conclude that operative time, diagnostic accuracy, and complication rates for laparoscopic appendectomy are acceptable. Within the context of a training program, laparoscopic appendectomy provides an opportunity for surgical residents to expand laparoscopic skills.
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PMID:Laparoscopic appendectomy. Initial experience in a teaching program. 138 42

The authors used color Doppler ultrasonography (US) to evaluate 33 children with suspected appendicitis and found locally increased blood flow in all of 10 patients with appendicitis or periappendiceal abscess; the studies were normal in 16 patients without appendicitis. The gray-scale sonographic results were concordant in all 26 of these patients. In two other patients with presumptive mesenteric adenitis and in one patient with a hemorrhagic ovarian cyst at gray-scale US, color Doppler imaging showed no increased perfusion and aided in confirming the absence of a significant inflammatory process. In four other children, color Doppler US clarified gray-scale sonographic findings that might have been confused with complicated appendicitis and aided in the diagnosis of other causes of acute abdominal pain. These findings indicate that color Doppler US is a useful adjunct to gray-scale US in evaluating children with suspected acute appendicitis.
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PMID:Appendicitis in children: color Doppler sonography. 811 55

Urachus is a tubular structure lined between foetal bladder and the umbilicus and is susceptible to complete or partial involution after birth. Persistence of the urachus results in a wide spectrum of anomalies: patent urachus, vesicourachal diverticulum, urachal sinus and cysts are more frequently seen than rare multiple urachal remnants. This kind of pathology focuses the problem of differential diagnosis (tumours, omental and ovarian cysts, vesical diverticulum or duplication) and may be complicated by a superinfection. The Authors discuss a bizarre multiple urachal remnant, presenting with urinary tract symptoms, which may be clinically confused with acute appendicitis or Meckel's diverticulitis. Contribution of sonography for a complete diagnosis is stressed, such as the precise correlation with surgical findings.
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PMID:[Persistent multiple urachal complex. Echographic-surgical correlations]. 162 Apr 82

Seventeen girls were treated following the diagnosis of ovarian cysts. Four patients were operated on within the first 6 months of age and the other 13 patients were 10-15 years old at the time of diagnosis. Antenatal diagnosis was made in 3 cases. The presenting symptoms in the infants were distended abdomen in 3 cases, abdominal pain in 1 and vomiting in 1. In the older children the presenting symptoms were abdominal pain in 12, vomiting in 5 and elevated temperature in 6. Preoperative ultrasound was performed in 5 patients, 3 neonates and 2 older children. Sixteen of the 17 girls were operated on. The indication for surgery was an ovarian cyst with complication in the infants and in the older children the suspicion of acute appendicitis. The operative procedure was cyst uncapping in 7 cases, salpingo-oophorectomy in 4, ovarian resection in 2, ovarian fixation only in 1 and no ovarian intervention in 2. Asymptomatic infants with an ovarian cyst less than 4 cm in diameter can be managed conservatively. Surgery can be recommended after documented change of the cyst on ultrasound, large cysts giving rise to symptoms or presentation of an acute abdomen. Salvage of variable ovarian tissue is desirable.
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PMID:Diagnosis and treatment of ovarian cysts in children. 188 16

With the continuing advancement in the treatment of childhood leukemia and the lengthened survival of these patients, an increased incidence of abdominal complications has been observed. A retrospective analysis of 364 patients with leukemia treated at the National Taiwan University Hospital from January 1977 through April 1988 was undertaken. Eleven patients (3.0%) developed abdominal complications during their course of disease, including acute appendicitis, intussusception, intestinal perforation, ovarian cyst rupture, etc. All of these patients had abdominal complications during the initial presentation or relapse of leukemia, and 9 (82%) of them had just received chemotherapy. Ten patients (91%) had thrombocytopenia and 7 (64%) had leukopenia. Blood cultures were positive in 5 patients (45%), and gram-negative enteric bacilli were isolated in 4 of them. All 5 septicemic patients had leukopenia or neutropenia. The clinical manifestations were nonspecific and were often masked. Most of the complications occurred in the right lower abdominal structures. Of the 7 children treated surgically, 3 had long term survival. Among the 4 patients who did not receive an operation, only 1 survived for more than 4 weeks. The mean length of survival tended to be longer in patients with additional surgical treatment. Prompt diagnosis and early aggressive treatment, under modern supportive facilities, appear to offer a more favorable outcome.
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PMID:Acute abdomen in childhood leukemia. 197 4

Among a variety of acute abdomens, acute torsion of omentum, first reported by Marchett in 1851, is least suspected under the impression of, most commonly, acute appendicitis and then acute cholecystitis, mesenteric thrombosis, ovarian cyst, perforated peptic ulcer, etc. A 52-years-old woman was admitted on May 2, 1987 with anorexia, nausea and RLQ pain for 2 days. Physical examination revealed tenderness, guarding and rigidity over RLQ. White cell count was 12.100/mm3. A reducible hernia was found in the right inguinal region. The operation through McBurney's incision showed blood-stained fluid. Appendix was slightly congested. A solid, gangrenous mass was palpated at right iliac fossa that disclosed a completely tight torsion of omentum twisting 6 times counterclockwise with distal infarction. Segmental omentectomy, appendectomy and hernioplasty were done. The patient's recovery was uneventful. This case emphasizes the necessity of routine examination of the omentum during the course of abdominal exploration especially when serosanguinous fluid was encountered in the peritoneal cavity.
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PMID:[Acute torsion of greater omentum. Report of a case mimicking acute appendicitis]. 263 74

Interstitial pregnancy is an infrequent type of ectopic pregnancy. Two cases of acute abdomen due to ruptured interstitial pregnancy following salpingectomy, a rare event, are presented. Both patients were young women who had had a previous salpingo-oophorectomy due to ovarian cyst. The presenting symptoms were in the first case abdominal pain followed by hemorrhagic shock, and in the second a right iliac fossa syndrome simulating acute appendicitis. Surgical intervention consisted of wedge resection of the uterine segment involved. A review of the literature and practical considerations are presented.
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PMID:Acute abdomen in ruptured interstitial pregnancy following unilateral salpingectomy. 366 74


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