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

Three cases are described in which there was concurrent development of acute cholecystitis and a second acute abdominal illness. Acute cholecystitis occurred in patients with acute appendicitis, small bowell obstruction, and acute colonic diverticulitis. Experience with three such cases over the course of eight years by a single surgeon suggests a possible aetiological link between the two diseases. It is suggested that, under some circumstances, exploration of an acute abdomen may need to be more than cursory.
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PMID:Double pathology in acute cholecystitis. 27 27

During a two-year period, major operations were performed on 874 males and 649 females at the first-aid section of a major hospital. Acute appendicitis was the most common intraoperative diagnosis (45.63%), followed by intestinal obstruction (21%), gastroduodenal perforation (6.83%), abdominal injury (5.98%), angiosurgical emergency situations (5.19%, including amputation for gangrene), gynaecological emergency situations (3.74%), acute cholecystitis (3.35%), haematemesis (1.44%), acute pancreatitis (1.31%), and various other diseases. Further surgery as a result of complications was required in 2.63%. Mortality (1 year only) was 7.42%. The results achieved and the tactical criteria employed are discussed.
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PMID:[Epidemiological study of emergency surgical pathology in the first aid department of a large hospital]. 30 23

Amebic abscess of the liver has protean manifestations that often resemble causes of an acute surgical abdomen. Patients presenting at University of California, Los Angeles Hospital with acute abdominal injuries who underwent exploratory laparotomy and subsequently were found to have an amebic hepatic abscess were studied. There are various clinical symptoms of amebic hepatic abscess as well as problems of differentiating this pathologic entity from an acute surgical abdomen. Most patients with amebic hepatic abscess that mimics an acute abdomen present as acute cholecystitis or acute appendicitis. All patients recovered uneventfully once the diagnosis was made and appropriate therapy instituted. The salient features of the history, physical examination and laboratory data that can identify the amebic abscess were analyzed. The key to correct diagnosis is cognizance of the condition.
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PMID:The symptoms of an amebic abscess of the liver simulating an acute surgical abdomen. 43 69

The authors present an analysis of the results of complex treatment in 4318 patients operated upon for acute peritonitis, caused by acute appendicitis, perforating gastric and duodenal ulcers, acute cholecystitis, ruptures and perforations of the intestine and other surgical and gynecological diseases. Patients with diffuse purulent peritonitis showed marked disorders in protein-aminoacid, nitrogen, and water electrolyte metabolism, acid-base balance, a reduced nonspecific immune responsiveness of the organism. Therpeutic tactics was delineated taking into account the revealed changes.
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PMID:[Some aspects of the complex treatment of acute suppurative perionitis]. 101 21

During the past decade, noninvasive imaging has assumed an increasingly prominent role in the evaluation of patients who have acute abdominal conditions. Ultrasonography is often the initial diagnostic imaging modality used to examine patients who are clinically suspected of having acute cholecystitis, choledocholithiasis, and acute appendicitis. This article focuses on the clinical considerations and the ultrasonographic findings that relate to each of these conditions. In addition to describing the ultrasonographic appearances for each of these entities, this article also emphasizes useful scanning techniques that will provide optimal images.
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PMID:Ultrasonography of the acute abdomen. 153 63

The authors studied the data concerning 101 patients who had undergone erroneous laparotomy for suspected acute surgical disease; these accounted for 0.4% of all the patients who were operated on for emergency indications in the same period. Eleven patients died. The operation was undertaken for an erroneous diagnosis of acute appendicitis (32 patients), acute cholecystitis (18), perforating gastric ulcer (15), peritonitis of unknown etiology (14), acute intestinal obstruction (5), strangulated hernia (3), destructive pancreatitis (3), tumor of the large intestine complicated by obstruction (3), abdominal abscess (2), thrombosis of the mesenteric vessels (1), ovarian apoplexy (1), closed abdominal trauma with injury to the viscera (4 patients). Diseases simulating the clinical picture of "acute abdomen" but not requiring an emergency operation were as follows: female reproductive (20 patients), pancreatic (11), renal diseases (11), hepatitis, cirrhosis of the liver (10), cardiovascular (9), pulmonary diseases (5), mesoadenitis (5), Crohn's disease (3), chronic colitis (3), carcinomatosis of the peritoneum (3), herpes zoster (3), and other diseases and injuries (20 patients). The main causes of the diagnostic and tactical errors were objective difficulties in the differential diagnosis due to similar symptomatology, as well as errors in the examination of the patient and haste in making a decision to make an operation.
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PMID:[Erroneous laparotomy in emergency surgery]. 177 33

Plain film of the abdomen is widely used in the diagnostic evaluation of intestinal occlusion. Even though this technique can yield a panoramic and high-resolution view of gas-filled intestinal loops, several factors, such as type and duration of occlusion, neurovascular status of the intestine and general patient condition, may reduce the diagnostic specificity of the plain film relative to the organic or functional nature of the occlusion. From 1987 to 1989, fifty-four patients with intestinal occlusion were studied combining plain abdominal film with abdominal ultrasound (US). This was done in order to evaluate whether the additional information obtained from US could be of value in better determining the nature of the ileus. US evaluation was guided by the information already obtained from plain film which better demonstrates gas-filled loops. The results show that in all 27 cases of dynamic ileus (intestinal ischemia, acute appendicitis, acute cholecystitis, acute pancreatitis or blunt abdominal trauma) US demonstrates: intestinal loops slightly increased in caliber, with liquid content, or loops containing rare hyperechoic particles, intestinal wall thickening and no peristalsis. In 27 cases of acute, chronic or complicated mechanical ileus (adhesions, internal hernia, intestinal neoplasm, peritoneal seedings) US shows: 1) in acute occlusion: hyperperistaltic intestinal loops containing inhomogeneous liquid; 2) in chronic occlusion: liquid content with a solid echogenic component; 3) in complicated occlusion: liquid stasis, frequent increase in wall thickness, moderate peritoneal effusion and inefficient peristalsis. In conclusion, based on the obtained data, the authors feel that the combination of plain abdominal film and abdominal US can be useful in the work-up of patient with intestinal occlusion. The information provided by US allows a better definition of the nature of the ileus.
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PMID:[Plain radiographic examination and abdominal echography in intestinal occlusion syndrome. Preliminary note]. 201 34

One hundred patients with suspected acute abdominal inflammation were imaged at 0.5, 2-3, 4-6, and 24 hours after the administration of Tc-99m HMPAO labeled autologous leukocytes. Scan findings were retrospectively compared with final diagnosis, serum C-reactive protein (CRP), and antibiotic treatment. Clinical findings were confirmed with surgery, barium enema, or sigmoidoscopy in 61 patients, and diagnosis was based only on clinical findings in 13 patients. In 26 patients, symptoms subsided before a final diagnosis was made. Tc-99m leukocyte images were positive in 45 of the 61 patients with a confirmed diagnosis, including all patients with acute cholecystitis (N = 4) and inflammatory bowel disease (N = 8). They were also positive in nineteen out of 25 patients who had acute colonic diverticulitis and in 6 out of 7 who had intra-abdominal abscesses. Abnormal activity was found in patients with colonic carcinoma, small bowel infarction, and acute appendicitis. Abnormal activity was visualized in 0.5-hour images in all but one of the positive cases. With the exception of two postoperative cases, malignant lymphoma, and a liver abscess, a CRP level of greater than 75 mg/L was associated with positive image findings. Antibiotic treatment did not affect imaging findings. Imaging with Tc-99m labeled leukocytes appears to be valuable for detecting and localizing abdominal inflammation, and three-phase imaging during the first 4-6 hours is recommended. In some cases, 24-hour images may be useful for distinguishing small bowel from large bowel inflammation.
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PMID:Tc-99m labeled leukocytes in imaging of patients with suspected acute abdominal inflammation. 220 80

Among a variety of acute abdomens, acute torsion of omentum, first reported by Marchett in 1851, is least suspected under the impression of, most commonly, acute appendicitis and then acute cholecystitis, mesenteric thrombosis, ovarian cyst, perforated peptic ulcer, etc. A 52-years-old woman was admitted on May 2, 1987 with anorexia, nausea and RLQ pain for 2 days. Physical examination revealed tenderness, guarding and rigidity over RLQ. White cell count was 12.100/mm3. A reducible hernia was found in the right inguinal region. The operation through McBurney's incision showed blood-stained fluid. Appendix was slightly congested. A solid, gangrenous mass was palpated at right iliac fossa that disclosed a completely tight torsion of omentum twisting 6 times counterclockwise with distal infarction. Segmental omentectomy, appendectomy and hernioplasty were done. The patient's recovery was uneventful. This case emphasizes the necessity of routine examination of the omentum during the course of abdominal exploration especially when serosanguinous fluid was encountered in the peritoneal cavity.
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PMID:[Acute torsion of greater omentum. Report of a case mimicking acute appendicitis]. 263 74

A thermographic study has revealed zones of hyperthermia in the epigastrium and other abdominal regions in 91.4 per cent of the patients with food poisoning. The temperature gradient in the epigastrium depended on the degree of severity of the disease (in mild course--0.60 +/- 0.11 degrees C, in moderately severe and severe course--1.15 +/- 0.09 degrees C). In salmonellosis a zone of hyperthermia was also found in the right iliac region. Clinical recovery in most cases preceded temperature normalization on the abdomen. In patients with acute dysentery the hyperthermic zone was constantly revealed in the left iliac region, in acute appendicitis in the right iliac region, in acute cholecystitis in the right hypochondrium, in acute pancreatitis in the epigastrium or in the hypochondrium with a clearly defined upper border. Thermography contributed to the differential diagnosis of food poisoning and the above diseases.
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PMID:[Thermographic semeiotics of food poisoning and its differential diagnosis]. 275 59


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