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

Over a five and one half year period, four of nine patients with endstage renal failure due to polycystic kidney disease managed by continuous ambulatory peritoneal dialysis (CAPD) developed peritonitis following intestinal perforation. Two patients had colonic perforation associated with diverticular disease, one necrosis of the terminal ileum, and one acute appendicitis. Two of the patients died subsequent to these complications. The survivors had early transfer to haemodialysis. In contrast, over the same period, only two of 125 patients with renal failure due to other causes and managed by CAPD had acute intestinal perforation. In both cases this was associated with acute appendicitis. Both patients survived. All episodes of peritonitis in CAPD patients with polycystic kidneys demand very close monitoring, cessation of CAPD, and early surgical intervention. CAPD is relatively contraindicated in such patients.
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PMID:Endstage renal failure due to polycystic kidney disease managed by continuous ambulatory peritoneal dialysis. 346 82

A prospective, randomized trial was performed to compare open appendectomy with laparoscopic appendectomy in men with a clinical diagnosis of acute appendicitis. Sixty-four patients with a median age of 25 years (range 18-84 years) were randomized to open appendectomy (n = 31) or laparoscopic (n = 33) appendectomy. Of the 64 men, 56 (87.5%) had appendicitis (27 open, 29 laparoscopic procedures). The mean operating times were 50.6 +/- 3.7 minutes (+/- SEM) for open and 58.9 +/- 4.0 minutes for laparoscopic appendectomy (p = 0.13). Five (15%) patients randomized to laparoscopic appendectomy had an open operation. The mean postoperative hospital stay was significantly longer for open appendectomy (3.8 +/- 0.4 days) than for laparoscopic appendectomy (2.9 +/- 0.3 days) (t = 2. 05,df = 62,p = 0.045). The complication rate after open appendectomy (25.8%) was not significantly different from that after laparoscopic appendectomy (12.1%). There was a single postoperative death due to a pulmonary embolus in the laparoscopic group and a single death due to cardiac and renal failure in the open group. The mean time to return to normal activities was significantly longer following open appendectomy (19.7 +/- 2.4 days) than after laparoscopic appendectomy (10.4 +/- 0.9 days), (t = 3.75,df = 49,p = 0.001). In conclusion, laparoscopic appendectomy in men has significant advantages in terms of a more rapid recovery compared to open appendectomy. There were no significant disadvantages to laparoscopic appendectomy compared to open appendectomy.
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PMID:Prospective randomized comparison of open versus laparoscopic appendectomy in men. 866 28

Gastroenteritis due to Escherichia coli O157:H7 occurs in young children and is associated with consumption of under cooked beef. Approximately 5-10% of patients will develop hemolytic uremic syndrome (HUS): renal failure, microangiopathic hemolytic anemia, and thrombocytopenia. A 6-year-old boy was admitted with abdominal pain, guaiac positive stool, decreased urine output and elevated creatinine levels. Hemodialysis was initiated upon rapid progression to anuria. On hospital day # 5 he developed acute abdominal pain, which was different from his initial assessment. Exam revealed focal tenderness in the right lower quadrant with localized guarding and rebound. Ultrasound demonstrated a dilated, fluid filled tubular structure in the RLQ concerning for appendicitis. Based on these findings the patient was taken to the operating room for a laparoscopic appendectomy. The patient had undergone dialysis the previous day and was preoperatively treated with DDAVP to minimize the risk of bleeding. The procedure occurred without complication and final pathology confirmed acute appendicitis. This case highlights the unique clinical scenario in which patients with HUS require operative intervention. Surgical procedures can be performed on these patients, however, all precautions should be taken to minimize the risk of bleeding, including the use of preoperative DDAVP.
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PMID:Acute appendicitis in a patient with hemolytic uremic syndrome: an unusual clinical scenario. 1741 Mar 68

Dobrava-Belgrade hantavirus infection mimicked acute appendicitis in a patient suffering from hemorrhagic fever with renal syndrome in Hungary. The 27-year-old man was admitted to the local hospital with severe abdominal pain localized mainly at the right lower quadrant of the abdomen and with fever, nausea, vomiting and bloody diarrhea. Based on these findings supported by computerized tomography acute perforated appendicitis was suspected and an explorative laparatomy was performed, which did not confirm the diagnosis. Next day he developed acute oliguric renal failure raising the possibility of hantavirus infection. Specific serum IgG and IgM antibodies against hantavirus were identified, and by molecular methods the presence of Dobrava-Belgrade virus was proven. This report describes a rare clinical manifestation of hemorrhagic fever with renal syndrome (HFRS), and shows that HFRS might be difficult to diagnose especially when symptoms mimick those of an acute abdominal inflammation.
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PMID:Dobrava-Belgrade hantavirus infection mimics acute appendicitis. 2107 78

The most common disease ofappendix is acute appendicitis. There have been at least 20 case reports of metastasis-induced appendicitis in English literature. The authors reported a 62-year-old Thai man who underwent appendectomy due to classical symptoms and signs of acute appendicitis and was subsequently referred to Siriraj Hospital for proper management after a pathological report of metastatic adenocarcinoma to the appendix. By morphology, the primary site was thought to be the prostate gland. Confirmation was done based on serum PSA study, transrectal ultrasound-guided core needle biopsy, and review of the material from Hua Hin Hospital. Orchidectomy was performed with satisfactory outcome. The patient was doing well for two years before upper gastrointestinal hemorrhage and obstructive jaundice caused by another aggressive tumor developed. He died of the second tumor associated with subsequent renal failure in spite of good response to orchidectomy.
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PMID:Acute appendicitis as primary symptom of prostatic adenocarcinoma: report of a case. 2111 14

Isolated necrosis of the caecum is a rare cause of abdominal pain. In the absence of occlusive vascular disease it has a number of well documented associations, the commonest of which is patients' receiving haemodialysis for endstage renal failure. It has also been associated with shock states, cardiac failure, ischaemic heart disease, diabetes and drugs such as cocaine, thiopentone and cytotoxic agents. However, there are few reported cases in the literature without the aforementioned associations and the majority of cases, regardless of aetiology, were treated with either hemicolectomy or wedge resection and ileocolic anastamosis. This report describes a case of isolated caecal necrosis, mimicking acute appendicitis, successfully treated by local excision of the necrotic segment. It also provides a systematic review of the literature and proposes an updated classification of associations in isolated caecal necrosis.
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PMID:Spontaneous, isolated caecal necrosis: report of a case, review of the literature, and updated classification. 2355 Apr 74

Partial necrosis of the cecum is a rare form of ischemic colitis with unknown etiology. A 68-year female patient was admitted due to a severe pain in the right lower quadrant of the abdomen for one week. One month ago, she had coronary artery bypass graft surgery with carotid endarterectomy. During physical examination, tenderness and rebound tenderness at the right lower quadrant were detected. Computed tomography showed a 7-mm tubular structure extending from the back of the cecum to the lower border of the liver. Laparoscopic appendectomy was planned with a preoperative diagnosis of acute appendicitis. During laparoscopy, a 3x3 cm necrotic area was noticed on the lateral wall of the cecum. After conversion to open surgery, partial cecum resection and ileocolostomy with appendectomy were performed. She was discharged on the 6th postoperative day, uneventfully. An isolated non-occlusive mesenteric ischemic event should be thought as a differential diagnosis in elderly patients who have right lower quadrant pain with atypical presentation, if there is chronic cardiac or renal failure.
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PMID:Partial Cecum Necrosis as a Rare Cause of Acute Abdominal Pain in an Elderly Patient. 2986 28