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

On the basis of an analysis of 84 observations the authors describe special features of the clinical course and diagnosis of gynecological diseases simulating acute appendicitis (rupture of the ovary, extrauterine pregnancy, torsion or rupture of the ovarian cyst, adnexitis).
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PMID:[Erroneous diagnosis of acute appendicitis in acute gynecological diseases]. 401 10

In a series of 48,482 pregnancies laparotomy was undertaken 74 times for conditions not associated with pregnancy (1 in 655 pregnancies). It showed no abnormality in 26 cases; ovarian cysts and acute appendicitis were the commonest pathological findings. The preoperative diagnosis was proved correct in 53% of cases, and in 66.2% laparotomy proved to be necessary for an alternative diagnosis.The fetal loss rate after surgery was 23%. Spontaneous abortion was more likely in the presence of peritonitis, with fluid in the peritoneal cavity, or when operative procedures involving the ovary were performed within the first trimester. The risk of precipitating labour following diagnostic laparotomy is negligible, provided no unnecessary surgical manoeuvres are undertaken.
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PMID:Laparotomy during pregnancy: an assessment of diagnostic accuracy and fetal wastage. 472 Jul 68

An antibiotic drug of aminoglycoside group, gentamicin (GM) for parenteral use was used to 14 hospitalized patients; 5 with acute or subacute cholecystitis, 6 with acute peritonitis (4 cases were due to acute appendicitis, a case was torsion of right ovarian cyst and a case was cecal CROHN's disease), 1 with fistula ani and abscess, and 2 with localized peritonitis after gastrectomy due to gastric ulcer. GM in a dose of 60 mg were administered by intravenous drip infusion for 1 to 2 hours, twice a day for 4 to 12 days. To the cases of biliary tract infection, GM was treated for preoperative chemotherapy and to the other cases GM was treated for postoperative chemotherapy. Clinical response was excellent in 7 cases, good in 6 cases, fair in 1 case and poor in none. No adverse effect was observed. The organisms were isolated in 7 cases, 7 were Escherichia coli, 2 were Klebsiella pneumoniae and 3 were Bacteroides fragilis. The MICs for GM were 0.78--1.56 micrograms/ml in 10(8) and 10(6) cells/ml, except B. fragilis. Before the operation of above cases, GM in a dose of 60 mg (a case was 40 mg) were administered by intravenous drip infusion for 1 to 2 hours in 7 cases (3 biliary tract infection, 2 acute peritonitis and 2 gastric ulcer) and 7 cases by intramuscularly. The materials of common duct bile, gall bladder bile, gall bladder wall, the appendix and other tissues, ascites and serum samples were taken during the operation. GM concentration was measured by bioassay method with Bacillus subtilis ATCC 6633 as test organism. GM concentrations in bile and gall bladder wall after intravenous drip infusion were higher than those after intramuscular administration. In the appendicitis with localized peritonitis, GM concentration in the appendix wall with catarrhal appendicitis was 0.90 microgram/g after intramuscular administration. In the cases with diffuse peritonitis and catarrhal appendicitis, GM concentrations in appendixes were 1.18 micrograms/g and 1.37 micrograms/g after intravenous drip infusion. Therefore, it was supposed that GM could be used safety and usefully by intravenous drip infusion than that by intramuscular administration.
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PMID:[Clinical studies on gentamicin for infectious diseases following intravenous drip infusion]. 684 28

An antibiotic drug of aminoglycoside group, amikacin (AMK) for parenteral use was used to 8 hospitalized patients: 4 with acute or subacute cholecystitis and cholangitis, 4 with acute peritonitis (3 cases were due to acute appendicitis and a case was torsion of right ovarian cyst). AMK in a dose of 200 mg were administered by intravenous drip infusion for 1 to 2 hours, twice a day for 4 to 9 days. To the cases with biliary tract infection, AMK was treated to preoperatively and to the cases with acute peritonitis, AMK was treated to the postoperatively. Clinical response was excellent in 2 cases, good in 6 cases, fair and poor in none. No adverse effect was observed. The organisms were isolated in 4 cases, 4 were Escherichia coli, 1 was Klebsiella pneumoniae and 1 was Bacteroides fragilis. The MIC for AMK were 3.13-1.56 micrograms/ml in 10(8) and 10(6) cells/ml, except Bacteroides fragilis. Before the operation of above cases, AMK in a dose of 200 mg were administered by intravenous drip infusion in 2 cases (acute and subacute cholecystitis and cholangitis with cholelithiasis), 5 cases by intramuscularly and 1 case by intravenously (acute appendicitis with localized peritonitis). The materials of A-bile, B-bile, wall of gallbladder, the appendix, ascites and serum samples were taken during the operation. AMK concentration was measured by bioassay method with Bacillus subtilis ATCC 6633 as test organism. AMK concentration in B-bile were higher than those in the A-bile. AMK concentrations in wall of gallbladder were much higher than those in A and B-bile. The concentrations after intravenous drip infusion were higher than those after intramuscularly administration. AMK changes of inflammation. In a case of gastric ulcer, AMK 200 mg by intravenous drip infusion was administrated, the AMK concentrations of the tissues at 25 minutes after end of infusion, they were 15.00 micrograms/g in gastric ulcer, 7.20 micrograms/g in normal gastric wall, 9.14 micrograms/g in duodenal wall and 8.12 micrograms/g in the omentum, respectively. Serum concentration of AMK on this case at 58 minutes was 15.7 micrograms/ml. Therefore, it was supposed that AMK could be used safety and effective by intravenous drip infusion.
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PMID:[Clinical studies on amikacin for infectious diseases following intravenous drip infusion (author's transl)]. 709 87

Abdominal pain in pregnancy is most commonly caused by complications of the pregnancy, e.g., abortion, ectopic pregnancy and abruptio placentae. A careful history and methodical physical examination and, if necessary, simple ultrasonographic investigations will reveal the cause in most of these conditions. In a few cases of abdominal pain in pregnancy a gynaecological condition, such as torsion of an ovarian cyst, or a nongynaecological (medical or surgical) one is the cause. Some of these conditions are serious, e.g., acute appendicitis, and unless the correct diagnosis is made and the appropriate management promptly instituted both the mother and her baby may suffer tragic consequences. Moreover, these conditions are more likely to be misdiagnosed during pregnancy. This is because the anatomical and physiological changes which occur in pregnancy tend to change and obtund the expected clinical features and laboratory data which are used to diagnose these conditions. Their early diagnosis therefore requires a high index of suspicion together with awareness of the ways in which they may present in pregnancy.
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PMID:Abdominal pain in pregnancy. 794 66

The aim of this paper is to show our experience in Laparoscopic Surgery in the pediatric age. We make a review of 37 patients, in whom we carried out a laparoscopy. In 20 (54%) the laparoscopy was therapeutic: 15 appendectomies, 1 cholecystectomy, 1 ventriculo-peritoneal catheter extraction, 1 ovarian cyst, 1 bilateral oophorectomy and 1 adhesiolysis. In others 17 (46%) was diagnostic: 15 hepatic biopsies, 1 intussusception and 1 abdominal mass biopsy. Of 15 appendectomies, 8 were for acute appendicitis and 7 for chronic process. The age have ranged from 1 month to 18 years. The operative time from 2 h 30 min to 35 min. We had not complications and the average hospital stay was of 2 days. We can say that this is an useful technique in pediatric surgery.
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PMID:[Laparoscopy in pediatric surgery]. 812 37

A total of 10 young women with suspected acute appendicitis were studied. We investigated the value of laparoscopy in the diagnostic evaluation for possible appendicitis in women of reproductive age. At laparoscopy, appendicitis was diagnosed in seven patients (acute-6, subacute-1). Three women had a normal appendix and a pelvic inflammatory disease, a ruptured ovarian cyst and an ovarian cyst with torsion. Laparoscopic appendectomy was performed in 7 cases; a conversion to open operation were because of torsion of ovarian cyst; a laparoscopic cystectomy was necessary. There were no intraoperative and postoperative complications (no wound infections). Reintroduction of normal diet and discharge from hospital occurred earlier after laparoscopic than open surgery. It is concluded that diagnostic laparoscopy permits earlier definitive diagnosis and prompt institution of appropriate therapy for disease of the female reproductive tract that simulates appendicitis; laparoscopic appendectomy is practical and may have advantages over conventional operation (reduction of wound infections and earlier return to normal activities).
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PMID:[Laparoscopic appendectomy: the indications, limits and results]. 945 6

In the submitted case-records the authors present interesting peroperative findings--a coprolith obturing the lumen of the appendix, the torsion of an ovarian cyst and torsion of the omentum during diagnosis of acute appendicitis. The authors discuss the reliability of preoperative sonography for the diagnosis of pathological conditions in the appendical region which despite its falsely negative results are considered by the authors a useful method in the differential diagnosis of pain in the right iliac fossa.
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PMID:[Differential diagnosis of pain in the right lower abdominal quadrant--case reports]. 1037 78

Over the period of 4 years from 1993 to 1996 the authors recorded a 6% incidence of patients with periappendicular mass (PM) in a group of 786 patients with acute appendicitis. The aim of the study is to compare the two methods in the management of patients (operation-A, conservative treatment-B) by applying the same criteria. In the subacute phase of the disease 22 patients (group A) were operated on, while 24 patients (group B) were successfully treated conservatively, with recommendation of elective appendectomy after 6 months. In group A indication for operation was PM in 7 patients, diagnostic problems (tumour, hydronephrosis) or complications (peritonitis, intestinal obstruction) in 15 patients. Antibiotic therapy was nearly the same in both group. Peritoneal drainage in postoperative care was performed in 10 patients of group A for 4.7 days on the average. In this group, secondary wound healing was recorded in 3 patients. In group B, elective appendectomy was performed only in 12 patients (50%). In 2 patients, however, a diagnostic error was revealed, i.e. Crohn's disease and an ovarian cyst had been suspected to be a periappendicular mass. Conservative treatment with subsequent elective appendectomy after 6 months seems to be an effective method in the treatment of patients with a typical clinical picture and well bordered periappendicular mass. Appendectomy in the subacute phase of the disease appears to be a safety technique of PM treatment in patients with complications or diagnostic problems.
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PMID:[Subacute appendicitis in children]. 1059 76

From 1992 to November 1999, 225 consecutive cases of acute abdomen were observed: 163 suspicious acute appendicitis, 7 ovarian cysts with suspect torsion, 4 intestinal occlusions, 1 digestive hemorrhage due GIST (Gastro-Intestinal Stromal Tumor), 1 case of hemoperitoneum after laparoscopic appendectomy and 49 cases of acute cholecystitis. In the 225 cases of emergency laparoscopic operations for acute abdomen the diagnostic accuracy has been of 99.5%, with only one case of conversion in to laparotomy for diagnosis. The conversion from laparoscopic to laparatomic surgical technique was registers in 2 cases (1%). The realimentation started in all the cases with a liquid diet as soon as 6 hours after the operation and with solid foods the following morning. The Authors haven't registered wound contaminations. The patients of working age rehabilitated in 8 days (between 7 and 21 days). In the athletic patients the average rehabilitation time was 15 days. On the base of the results obtained with their video-laparoscopy experience in acute abdomen emergency surgery, the Authors confirm that this technique can be advised as Emergency Surgery's first choice treatment.
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PMID:[Laparoscopy in emergency: treatment of choice in acute abdomen]. 1112 42


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