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

The clinicopathological features of schistosomiasis of the appendix are discussed, based on the clinical presentation, operative findings and morphological changes in the specimens of patients seen in Ibadan between 1980 and 1989. Schistosoma haematobium was implicated as the causal agent of a granulomatous inflammatory reaction with eosinophilia and fibrosis. Intramuscular oviposition was associated with frank acute appendicitis, and serosal involvement resulted in peritoneal adhesions, with ileoileal intussusception in one patient. The actual role of schistosomal infestation as a contributory factor in appendicitis is still open to debate, but the diagnosis must be entertained in patients in the tropics with features of acute appendicitis or recurrent abdominal pain.
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PMID:Schistosomiasis of the appendix. 195 89

Acute appendicitis is among the most common indications for exploratory laparotomy during pregnancy. Although usually pyogenic in origin, parasitic infections account for a small percentage of cases. We report here the association of pregnancy and appendicitis caused by Schistosoma japonicum. Schistosomiasis is a very common complication of pregnancy, with 250,000,000 persons infected worldwide, including 20% of pregnant women living in hyperendemic areas. Schistosome egg masses can lodge throughout the body and cause acute inflammation of the appendix, fallopian tube, liver, and spleen. Congestion of pelvic vessels during pregnancy facilitates passage of eggs into the villi and intervillous spaces, causing an inflammatory reaction. Fetal anoxia and subsequent death has been attributed to heavy infestation of the placenta. Tourism, far-ranging military actions, and immigration make this disease a potential challenge for practitioners everywhere.
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PMID:Schistosomiasis associated with rupture of the appendix in pregnancy. 250 94

The role of schistosomes in the pathologenesis of acute appendicitis in an endemic area was investigated. Of 1600 appendicectomies received in our laboratory, 26 showed appendiceal schistosomiasis, which prompted what we believe to be the first detailed histopathological evaluation of all appendices with schistosomal infestation, without prior knowledge of the clinical and operative diagnoses. The results suggest that there are two types of schistosomal appendicitis, each with distinct clinicopathological features and different pathogenetic mechanisms. They could be called obstructive and granulomatous schistosomal acute appendicitis, respectively.
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PMID:Appendicular schistosomiasis: a cause of clinical acute appendicitis? 310 29

Twenty surgical specimens of appendiceal schistosomiasis were reviewed retrospectively. They constituted 1 percent of 1984 appendices seen among approximately 15,000 surgical specimens examined at free central laboratories serving the Igbos of Nigeria, West Africa. Oviposition by Schistosoma haematobium was classified according to its association with suppurative appendicitis and normal appendices. Seven of ten infested appendices obtained at curative operations showed suppurative appendicitis, whereas eight of nine infested appendices removed at incidental appendectomies were negative. One interval appendectomy was also negative. It is postulated that utilization of this novel classification on a worldwide basis will help to end the controversy concerning the etiologic role of schistosome ova in acute appendicitis.
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PMID:Appendiceal schistosomiasis. Method of classifying oviposition and inflammation. 400 34

The association of appendicitis with schistosomiasis in the appendix is extremely rare in France. We report herein a new case in which the diagnosis was made, in the presence of pseudo-tumoral appendicitis, by frozen section biopsies. The patient presented with a typical acute appendicitis, without urinary symptoms, and with granulocytosis (14000 white cells/mm3, without eosinophilia). At laparotomy, the appendix was voluminous, with necrotic abscess, and lymph node masses were noted on the greater omentum. Frozen section biopsies of an omental tumor showed schistosoma eggs, without malignant cells. Appendicectomy and partial omentectomy were performed. Postoperative course was uneventful. Pathologic examination of the resected specimen showed schistosoma eggs in all layers of the appendix, and in the omentum. Final diagnosis was established by positive serology and by findings Schistosoma haematobium eggs in the urine. The patient was treated postoperatively by praziquantel. In conclusion, in case of acute appendicitis, with pseudotumorous appendix and lymph node masses, even with poor epidemiological findings on the clinical history, frozen section biopsies can sometimes establish the diagnosis of schistosomiasis with appendicitis, and avoid unjustified bowel resection.
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PMID:[Appendiceal localization of bilharziasis: value of extemporaneous histological examination]. 808 64

Schistosomiasis is endemic in many parts of the world but is rare in the UK. It usually affects the bladder or intestine, resulting in bleeding and fibrosis. However, schistosomal eggs are frequently found in the appendix and these can be symptomatic. The present case describes appendiceal infestation accompanied by acute appendicitis.
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PMID:Schistosomiasis of the appendix in the UK. 929 65

Schistosomiasis, a waterborne trematode infestation, is one of the most widespread parasitic diseases in the world. It occurs in well-defined endemic geographical areas. Schistosomiasis of the appendix was first described by Turner in 1909, and has been reported from endemic areas. However, appendicular schistosomiasis in travelers has not been reported in the English literature. We describe an Israeli traveler with acute appendicitis as the presenting symptom of schistosomiasis, 2 years after a visit to Africa.
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PMID:Schistosomiasis presenting as acute appendicitis in a traveler. 977 33

An unexpected inflammatory cecal mass of uncertain etiology encountered during surgery for presumed appendicitis poses a dilemma to the surgeon when deciding the appropriate operative management. A retrospective study was performed to review the pathology and surgical management of this condition. Among 3224 patients who had emergency surgery for a diagnosis of acute appendicitis between January 1990 and December 1997, a group of 52 patients (1.6%) underwent either ileocecal resection or right hemicolectomy for an inflammatory cecal mass of uncertain etiology. The final pathologic diagnosis was cecal diverticulitis in 26 patients (50%), appendiceal phlegmon or abscess in 21 patients (40%), cecal carcinoma in 3 patients (6%), tuberculosis in 1 patient (2%) and schistosomiasis in another patient (2%). Altogether 34 patients underwent ileocecal resection, and 18 patients underwent right hemicolectomy, including the 3 patients with cecal carcinoma. Ileocecal resection was associated with a shorter mean operative time (144 vs. 201 minutes; p < 0.001), a lower morbidity rate (3% vs. 22%; p = 0.043), and a shortened mean postoperative hospital stay (6.8 vs. 11.2 days; p = 0. 011) than right hemicolectomy. There was no mortality in either group. In conclusion, most inflammatory cecal masses are due to benign pathologies and could be managed safely and sufficiently with ileocecal resection. Careful intraoperative assessment including examination of the resected specimen is essential to exclude malignancy, which would require right hemicolectomy.
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PMID:Inflammatory cecal masses in patients presenting with appendicitis. 1039 May 92

A 20-year-old African female was hospitalized several times for diffuse chronic abdominal pain. The following exclusions were made: Acute adnexitis (by laparoscopy), acute appendicitis (by appendectomy), gastric ulcerations (by esophagogastroduodenoscopy) as well as Crohn's disease and ulcerative colitis. However, once taking a closer microscopical look at the mucosa, that otherwise appeared colonoscopically to be normal, multiple eggs of schistosomiasis mansoni (S. mansoni) were found in the colon as well as the rectum. Thus, the diagnosis of an intestinal bilharziosis was finely established. In retrospect even the sample taken for the appendix could have indicated this diagnosis already earlier on. Both the antibodies (ELISA/IFAT) and the specific immunoglobulins (IgE) for S. mansoni proved significantly positive. Therapy of choice was a single oral dosage of praziquantel. Migration and tourism have considerably increased the range of tropical and infectious diseases that need to be included into differential diagnosis. This case report focuses on intestinal bilharziosis as a potential underlying cause of chronic abdominal pain in immigrants of endemically affected areas. Direct diagnosis is the most important diagnostic method. The adult worms are usually inaccessible, so the method of choice to assess both diagnosis and the degree of activity of a chronic infection is evidence of living eggs in the stool. Alternatively, in case of lack of direct evidence diagnosis can be established by endoscopy and rectal biopsy.
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PMID:[Chronic abdominal pain and eosinophilia in a young African patient]. 1107 77

Schistosomiasis is a widely prevalent disease in the world and usually involves the gastro-intestinal and urinary tract. The involvement of the female genital tract has been well-established in S. haematobium infections and is rare with S. japonicum infections. This case involves a Filipino female who was admitted to the University Hospital Kuala Lumpur for right iliac fossa pain and was diagnosed initially as acute appendicitis. Ultrasound showed a multi-septated pelvic cyst leading to a provisional diagnosis of ovarian torsion. Intraoperatively a right parovarian cyst was detected and removed. Histology revealed a congested cyst wall with areas of haemorrhage with several viable and calcified eggs of S. japonicum measuring 85 microns x 62 microns. Within the cystic cavity blood admixed with eggs were seen. Confirmation was carried out by using the indirect haemagglutination (IHA) test. This is a first report of upper genital schistosomiasis mimicking an ovarian tumour.
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PMID:Upper genital schistosomiasis mimicking an ovarian tumour. 1120 Jul 20


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