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

A series of 102 patients with presumptive acute appendicitis entered a prospective, randomized, clinical trial of intrarectal metronidazole given over a 48-h period commencing before surgery. Adequate levels of circulating metronidazole were achieved. A significant reduction in the incidence of anaerobic wound infection was observed in the treated group (P less than 0.02). The convenience and short duration of the prophylactic regimen allowed early discharge from hospital. No untoward effects were observed.
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PMID:Intrarectal metronidazole in the prevention of anaerobic infections after emergency appendicectomy: a controlled clinical trial. 38 Jul 35

Starting with one case of acute granulomatous appendicitis of their own observation, the authors review the scant literature on the subject (only 23 published cases to date) and advocate systematic appendicectomy in all isolated appendicular localizations of Crohn's disease. On the grounds that no post-appendicectomy fistulization has ever been reported in such patients, the authors recommend prophylactic appendicectomy also in the far more frequent cases of acute ileitis, to forestall the possibility of evolution into chronic Crohn's disease and the risk of missing a nongranulomatous acute appendicitis appearing with the same clinical symptoms.
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PMID:[Acute granulomatous appendicitis. (Contribution to preventive appendectomy in acute ileitis)]. 39 53

Diverticular disease of the appendix involves about 1 per cent of all appendices removed. Considering the large number, the subject appears to have been neglected in medical literature. Since the symptomatology is similar to that of appendicits and diverticula are frequently very small, they could go unnoticed. A comparison of 30 cases of diverticular disease and 30 cases of acute appendicitis reveals a few fine differences. The patients with diverticular disease are at least a decade older, the duration of pain in these patients is longer, and the diverticula and appendix may or may not be inflamed.
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PMID:Diverticular disease of the appendix. 40 91

Acute appendicitis with abscess often produced a distinctive extrinsic pressure deformity of the cecum. If the abscess is large or disseminated, other parts of the gastrointestinal tract may be secondarily involved. Abscesses usually produce extrinsic compression defects with benign radiologic characteristics, but occasionally the lesions may simulate malignant disease. Even careful evaluation of the clinical symptoms and signs may not be helpful in the differentiation of benign from malignant disease. Three examples of atypical acute appendicitis are described in patients with clinical and radiologic findings strongly suggestive of malignant disease.
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PMID:Acute appendicitis with abscess stimulating carcinoma of the sigmoid. 41 58

Solitary diverticulum of the caecum is very rare and assumes clinical interest only when inflamed. Preoperatively the condition is virtually impossible to distinguish from acute appendicitis, and even during operation its differentiation from carcinoma is difficult. It is also important to determine whether or not an underlying solitary diverticulum of the caecum is present. In the present series the symptoms and clinical examination as well as laboratory findings pointed to acute appendicitis, which was in fact the preoperative diagnosis in all our patients. In one case the operative findings were strongly suggestive of carcinoma, which was only excluded by inspection and histological examination of the specimen. The wall of the diverticulum was necrotic in all cases. It had already perforated in the previously mentioned case, and right hemicolectomy was performed. An inflamed, but recognizable, solitary diverticulum of the caecum was treated by excision, but the tumour-like mass produced by the diverticulum was removed by resection. In view of the considerable possibility of underlying carcinoma, the authors support an aggressive trend in the treatment of "inflammatory tumours" of the caecal wall.
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PMID:Solitary diverticulum of the caecum and its complications. 41 67

Although the radiological features of acute appendicitis have been well documented, the value of the plain abdominal radiograph has not been fully appreciated. This article summarises the role of radiology in acute appendicitis, especially in atypical cases and extremes of age, where there is often delay in diagnosis.
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PMID:The plain abdominal radiograph in acute appendicitis. 42 Apr 93

The association of ectopic pregnancy and acute appendicitis has seldom been discussed in literature. This report presents 2 patients who had simultaneous right tubal pregnancies and acute periappendicitis. The cases reported here suggest the possibility that an ectopic pregnancy can produce an inflammatory reaction of the appendix. Ectopic pregnancy as an etiological stimulus for acute appendicitis is discussed. The advisability of examining the appendix at the time of surgery for pelvic disease, and performing an appendectomy at the same time, if pathology of the appendix is suspected, is emphasized. The use of elective appendectomy in surgery for ectopic pregnancy is reviewed.
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PMID:Ectopic pregnancy as an etiologic agent in appendicitis. 42 25

Case reports (1970--1977) of thirty-five pregnant women with acute appendicitis were reviewed. Eighty-eight per cent had symptoms less than 24 hours and were operated on within 12 hours. No maternal or fetal loss occurred. Morbidity and mortality should be minimal if, when appendicitis is suspected in a pregnant woman, immediate operation is performed.
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PMID:Acute appendicitis during pregnancy. 42 73

Fourteen patients with primary Crohn's disease of the appendix have been seen in a 12 year period. These patients represent 12.8% of the total number undergoing surgical resection because of Crohn's disease. Twenty-three cases of appendiceal Crohn's disease have been previously reported in the literature. A correct preoperative diagnosis is rarely made; the usual diagnosis is that of acute appendicitis or appendiceal abscess. The removed appendix in twelve of our 14 cases had marked thickening of the wall with transmural fibrosis and often with granulomatous inflammation. The enlarged appendix had an external appearance similar to that of ileal Crohn's disease, and we consider a correct surgical diagnosis might be possible with better awareness of its existence. The diagnosis might be suspected earlier when the clinical course of apparent appendicitis is protracted or atypical. Contrary to the previous estimation of high recurrence rate, this series and the cumulative evidence in the literature show a relatively low rate at 14%. The feared fistula formation following the removal of the appendix has not been seen in either our series or the literature. These patients, however, merit long-term follow-up.
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PMID:Primary Crohn's disease of the appendix: report of 14 cases and review of the literature. 42 64

The results of rectal examinations of 495 patients with suspected acute appendicitis were correlated with six other variables from the patients' histories and results of physical examinations. Positive rectal examination results were recorded for 46 per cent of all patients with acute appendicitis and for 53 per cent of those with normal appendices. The diagnosis of acute appendicitis should not be based solely or primarily on the results of the rectal examination. The examination should, however, be performed in all suspected cases of appendicitis to rule out gynecologic and urologic disease.
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PMID:The significance of a "positive" rectal examination in acute appendicitis. 42 84


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