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

Seven cases of the Curtis-Fitz-Hugh syndrome diagnosed over a six month period are reviewed with particular reference to the widely ranging modes of presentation. All presented as acute surgical emergencies but unlike other series, right upper quadrant pain was the presenting symptom in only one case. Right upper quadrant pain nonetheless, featured to a variable extent in all cases, being relatively shortlived in three. Conditions mimicked included left renal colic, acute appendicitis, pulmonary embolism, acute cholecystitis, chronic cholecystitis and urinary tract infection. In five cases symptoms dated back to a difficult or complicated termination of pregnancy and in one case a hysterectomy had been performed twelve years previously at which time the patient had documented evidence of pelvic inflammation. Diagnosis was made laparoscopically and all symptoms responded satisfactorily to a four week course of tetracycline.
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PMID:Curtis-Fitz-Hugh syndrome: the new mimicking disease? 294 32

The authors report two cases of puerperal right ovarian vein thrombophlebitis (POVT) with floating thrombus in the inferior vena cava (IVC). The originality of this report lies in the first line surgical treatment approach. POVT is recognized as presenting usually within the first week post-partum after about 0.05% of deliveries. The syndrome consists of lower abdominal or flank pain, unexplained fever and a tender abdominal mass. Abdominal or pelvic findings are often scanty. In some cases, the thrombus may extend to the inferior vena cava, leading to the risk of pulmonary embolism or low grade renal insufficiency. Diagnosis has been difficult in the past. Since acute appendicitis is the commonest differential diagnosis, laparotomy is frequent. CT scan provides a readily available, accurate, non invasive technique for the diagnosis of POVT. Criteria are: enlargement of the vein, a low density lumen within the vessel wall and a sharply defined vessel wall enhanced by contrast media. The treatment of POVT is initially medical. Antibiotics should be given to cover the commonest infecting organisms. Heparin should also be prescribed at therapeutic IV doses to be followed by oral anticoagulants for at least six weeks. Surgery is usually only recommended when the patient remains symptomatic despite proper medical management, develops clinical, scan or arteriographic evidence of pulmonary embolism, or cannot be anticoagulated. The recommended surgical technique is to clamp the anastomosis of the ovarian vein with the vena cava.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Thrombophlebitis of the ovarian vein. New therapeutic approach]. 824 95

Helical CT has become a valuable imaging tool for detection of pulmonary embolism, deep venous thrombosis, ureteral colic, acute small-bowel obstruction, and acute appendicitis. Generally, helical CT has good sensitivity and specificity values, and scans can be performed more quickly than previous gold standard diagnostic examinations for the conditions mentioned. In some cases, helical CT can also identify other findings that may be responsible for a patient's symptoms. One notable disadvantage of helical CT is the charge for the procedure, which in some circumstances can be considerably more costly than diagnostic examinations preferred previously. However, because helical CT can often obviate the need for other tests--and may consequently reduce hospital stays--this technology may have the ability to reduce overall expenditures. Cost of helical CT is therefore a multifaceted issue and requires further study before conclusions can be drawn.
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PMID:Expanded applications of CT. Helical scanning in five common acute conditions. 1142 48

The association between tuberculosis and underlying risk factors was evaluated in Texas patients hospitalized in the 15 counties along the Mexico border within the remaining non-border counties. A case control analysis of the hospital discharge dataset from the Texas Health Care Information Council was performed for the years 1999-2001. A discharge diagnosis of tuberculosis identified cases (N = 4,915). Deep venous thrombosis, pulmonary embolism, and acute appendicitis conditions identified controls (N = 70,808). Risk factors associated with tuberculosis were identified by logistic regression. Diabetes patients were almost twice as likely to have tuberculosis after adjusting by sex, age, and race/ethnicity. The association was strong for the population in the Texas border region, where there are higher incidence rates of tuberculosis (odds ratio [OR](adj) = 1.82; 95% CI = 1.57-2.12) compared with non-border counties (OR(adj) = 1.51; 95% CI = 1.36-1.67).
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PMID:Association between tuberculosis and diabetes in the Mexican border and non-border regions of Texas. 1660 93

Use of diagnostic imaging studies for evaluation of pregnant patients with medical conditions not related to pregnancy poses a persistent and recurring dilemma. Although a theoretical risk of carcinogenesis exists, there are no known risks for development of congenital malformations or mental retardation in a fetus exposed to ionizing radiation at the levels typically used for diagnostic imaging. An understanding of the effects of ionizing radiation on the fetus at different gestational stages and the estimated exposure dose received by the fetus from various imaging modalities facilitates appropriate choices for diagnostic imaging of pregnant patients with nonobstetric conditions. Other aspects of imaging besides radiation (ie, contrast agents) also carry potential for fetal injury and must be taken into consideration. Imaging algorithms based on a review of the current literature have been developed for specific nonobstetric conditions: pulmonary embolism, acute appendicitis, urolithiasis, biliary disease, and trauma. Imaging modalities that do not use ionizing radiation (ie, ultrasonography and magnetic resonance imaging) are preferred for pregnant patients. If ionizing radiation is used, one must adhere to the principle of using a dose that is as low as reasonably achievable after a discussion of risks versus benefits with the patient.
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PMID:Imaging the pregnant patient for nonobstetric conditions: algorithms and radiation dose considerations. 1802 13

Ovarian vein thrombosis (OVT) is a rare cause of abdominal pain that may mimic a surgical abdomen. The differential diagnosis of OVT includes acute appendicitis, endometritis, pelvic inflammatory disease, pyelonephritis, nephrolithiasis, tubo-ovarian abscess, and ovarian torsion. The complications of OVT, including sepsis and pulmonary embolism, are significant. Diagnosis relies on a careful examination of the radiographic findings. This diagnosis should be considered not only in postpartum patients but also in women with pelvic inflammatory disease, recent abdominal surgery, malignancy, or known hypercoagulable state. In this report we present a case of OVT in a 29-year-old woman presenting with 3 days of sharp left-sided abdominal pain, nausea, and vomiting after bilateral salpingectomy. We then discuss the epidemiology, pathophysiology, and clinical management of OVT.
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PMID:Ovarian vein thrombosis: a rare cause of abdominal pain outside the peripartum period. 1819 26

There has been a substantial increase in the use of computed tomography (CT) and magnetic resonance imaging (MRI) in pregnancy and lactation. Among some physicians and patients, however, there are misperceptions regarding risks, safety, and appropriate use of these modalities in pregnancy. We have developed a set of evidence-based guidelines for the use of CT, MRI, and contrast media during pregnancy for selected indications including suspected acute appendicitis, pulmonary embolism, renal colic, trauma, and cephalopelvic disproportion. Ultrasonography is the initial modality of choice for suspected appendicitis, but if the ultrasound examination is negative, MRI or CT can be obtained. Computed tomography should be the initial diagnostic imaging modality for suspected pulmonary embolism. Ultrasonography should be the initial study of choice for suspected renal colic. Ultrasonography can be the initial imaging evaluation for trauma, but CT should be performed if serious injury is suspected. Pelvimetry now is used rarely for suspected cephalopelvic disproportion, but when required, low-dose CT pelvimetry can be performed with minimal risk. Although iodinated contrast seems safe to use in pregnancy, intravenous gadolinium is contraindicated and should be used only when absolutely essential. It seems to be safe to continue breast-feeding immediately after receiving iodinated contrast or gadolinium. Although teratogenesis is not a major concern after exposure to prenatal diagnostic radiation, carcinogenesis is a potential risk. When used appropriately, CT and MRI can be valuable tools in imaging pregnant and lactating women; risks and benefits always should be considered and discussed with patients.
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PMID:Guidelines for computed tomography and magnetic resonance imaging use during pregnancy and lactation. 1866 32

Ovari an vein thrombosis (OVT) is an uncommon, life-threatening complication of pregnancy. OVT clinical presentation is similar to that of acute appendicitis, and the latter is therefore the suspected diagnosis in most cases. We describe a case of a 36-year-old woman experiencing deep vein thrombosis and pulmonary embolism during the course of pregnancy and presenting to the emergency department with sudden pain in the right lower quadrant and severe abdominal pain. This case illustrates the difficulty in diagnosing OVT, which should be considered in any pregnant woman with unexplained lower abdominal pain suggestive of acute appendicitis.
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PMID:Acute right lower quadrant abdominal pain as the presenting symptom of ovarian vein thrombosis in pregnancy. 1884 Jan 80

The goal of this study was to develop and validate text-mining algorithms to automatically identify radiology reports containing critical results including tension or increasing/new large pneumothorax, acute pulmonary embolism, acute cholecystitis, acute appendicitis, ectopic pregnancy, scrotal torsion, unexplained free intraperitoneal air, new or increasing intracranial hemorrhage, and malpositioned tubes and lines. The algorithms were developed using rule-based approaches and designed to search for common words and phrases in radiology reports that indicate critical results. Certain text-mining features were utilized such as wildcards, stemming, negation detection, proximity matching, and expanded searches with applicable synonyms. To further improve accuracy, the algorithms utilized modality and exam-specific queries, searched under the "Impression" field of the radiology report, and excluded reports with a low level of diagnostic certainty. Algorithm accuracy was determined using precision, recall, and F-measure using human review as the reference standard. The overall accuracy (F-measure) of the algorithms ranged from 81% to 100%, with a mean precision and recall of 96% and 91%, respectively. These algorithms can be applied to radiology report databases for quality assurance and accreditation, integrated with existing dashboards for display and monitoring, and ported to other institutions for their own use.
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PMID:Automated detection of critical results in radiology reports. 2203 14