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

Laparoscopy, which has been well known as a diagnostic procedure for more than a century, has recently established itself as an important therapeutic procedure in several branches of surgery. In the present study the authors report on 221 patients over a 10-year period (1991-2001), admitted to hospital with a diagnosis of acute abdomen or abdominal trauma. All patients were submitted to emergency laparoscopic surgery; 128 patients (57%) presented acute appendicitis, 40 (18%) acute cholecystitis, 13 (6%) occlusive ileus, 10 (5%) adnexal pathologies, 9 (4%) perforation of abdominal viscera, 3 (1.4%) acute diverticulitis, 3 (1.4%) subdiaphragmatic abscesses, 3 (1.4%) intestinal infarction, 2 (0.8%) other diseases and 10 (5%) abdominal trauma. The operation was completed laparoscopically in 192 cases (87%), while conversion to laparotomy proved necessary in 29 cases (13%). The morbidity of the cases completed laparoscopically was 3%, the mortality 0.5%, and the mean hospital stay 4 days. Advantages of laparoscopy (shorter hospital stay, rapid postoperative recovery and faster return to social activities) emerge from the present study and are confirmed by the literature. The possibility of combining a diagnostic procedure with curative therapy suggests that laparoscopy may have an important role in emergency surgery, demonstrating its efficacy also in acute abdominal syndromes. Nevertheless, emergency laparoscopic surgery is still a technically difficult procedure that needs to be performed by an expert surgical team.
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PMID:[Laparoscopy in abdominal emergencies. Indications and limitations]. 1203 7

Most cases of malignant mesothelioma present with obvious diffuse tumor, and the presence of grossly visible diffuse tumor is usually cited as an important criterion for making the diagnosis. We report four cases of unsuspected malignant mesothelioma of the peritoneum presenting as localized acute inflammatory lesions. The clinical diagnoses were acute appendicitis in two cases, acute cholecystitis in the third case, and incarcerated umbilical hernia in the fourth case. In all cases tumor was not evident at initial surgical exploration or on gross pathologic examination, and the diagnosis was only made on microscopic examination of the resected specimens. All cases showed a tubulopapillary form of epithelial mesothelioma with obvious tissue invasion, but the foci of tumor were too small to be seen grossly or were present deep in fibrous tissue. On follow-up all patients developed grossly evident tumor, and one of these patients is alive without evidence of disease 5 years after presentation. We conclude that peritoneal mesotheliomas may occasionally present as inflammatory processes without grossly evident tumor and can be diagnosed by microscopic findings alone.
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PMID:Malignant mesothelioma of the peritoneum presenting as an inflammatory lesion: a report of four cases. 1254 73

Diagnostic efficiency and the means to achieve it constitute one of the main parameters that evaluates quality of hospital care within an institution. In addition, concerning surgery acute appendicitis is without doubt the most frequent pathology we face at our service. Therefore, we conceived of a way to determine degree of concordance and other parameters of diagnostic efficiency for this disease. This is an analytic, longitudinal study that took into account the cases of acute appendicitis out of the most frequent pathologies of surgical acute abdomen (acute appendicitis, perforated peptic ulcer, intestinal occlusion, and acute cholecystitis) from April 1 to June 17, 2002 for a total of two hundred cases. To establish correlation, main symptoms and signs upon admission were recorded, as well as presumptive, operatory, histopathologic, and laparoscopic diagnoses in cases in which such procedures were performed. Other aspects were also considered as efficiency parameters, namely Kappa correlation index, sensitivity, specificity, positive and negative predictive values, and positive and negative verisimilitude reasons. Clinical-surgical correlation found was very good, with Kappa value of 0.92. Clinical-pathological concordance was good also, with Kappa value of 0.71. The same can be said concerning the surgical-anatomopathologic case, with a value of 0.79. Regarding laparoscopy, both clinical-laparoscopic and surgical-laparoscopic concordances were poor, with Kappa value of 0.15. Also, concordance between laparoscopic and anatomopathologic diagnoses was weak, with a value of 0.25. Diagnostic efficiency in acute appendicitis was good, contrary to laparoscopic efficiency as diagnostic evidence.
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PMID:[Diagnostic efficiency in acute appendicitis]. 1461 8

HIV infection is a very actual disease widespread all over the world (40 million people), including up to 10 thousand Romanian, are infected with HIV; there are 950 HIV-infected patients in Oltenia, 450 of them are in our county (Dolj area), 80% of the HIV-infected persons are children. The authors are studying a group of 17 cases of HIV-infected children with surgical problems (Acute appendicitis, acute cholecystitis, pulmonary and kidney abscess, lymphadenophlegmons, abdominal tumours), which have been transferred to our department from the Infectious Diseases Clinic, between 1995-2004. The medical records of all patients were reviewed: strategies of management, particularity of antiretroviral therapy of children, and also strategies of prevention the perioperative HIV transmission. The most frequent cases were the lymphadenophleg mons (40%) and chronic abdominal pain (25%). The acute abdominal pathology consisted in 2 cases of acute appendicitis and 1 case of acute cholecystitis, which were successfully treated. The HIV infection remains in actuality, because there is not an efficient antiretroviral therapy. Surgeons planning treatment must consider the risks of the patient against the potential benefits of surgery.
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PMID:[Surgical management of clinical problems in children with HIV infection]. 1556 May 57

Sickle cell disease is characterized by chronic hemolytic anemia and vaso-occlusive painful crises. The vascular occlusion in sickle cell disease is a complex process and accounts for the majority of the clinical manifestation of the disease. Abdominal pain is an important component of vaso-occlusive painful crises. It often represents a substantial diagnostic challenge in this population of patients. These episodes are often attributed to micro-vessel occlusion and infarcts of mesentery and abdominal viscera. Abdominal pain due to sickle cell vaso-occlusive crisis is often indistinguishable from an acute intra-abdominal disease process such as acute cholecystitis, acute pancreatitis, hepatic infarction, ischemic colitis and acute appendicitis. In the majority of cases, however, no specific cause is identified and spontaneous resolution occurs. This chapter will focus on etiologies, pathophysiology and management of abdominal pain in patients with sickle cell disease.
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PMID:Unusual causes of abdominal pain: sickle cell anemia. 1583 95

The clinical and economic efficacies of antibiotic prophylaxis in the surgical unit of the Hospital were confirmed by the results of the analysis of 1313 case records of the patients operated during a year for acute appendicitis and acute cholecystitis. At the same time it was shown advisable to use antibiotic therapy in the patients with various pathological processes. The dynamics of the microbial dissemination in the surgical unit and some other units of the Hospital, as well as the dynamics of antibiotic resistance of the microflora, its interrelation with the volume of the antibacterials used and their rotation are described.
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PMID:[Antibiotic prophylaxis, antibiotic therapy and microbiological situation in surgical unit]. 1585 53

Results of treatment of 10 patients with primary infarction of the greater omentum were analyzed. Young and middle-aged persons prevailed. Majority of the patients were hospitalized from 27 to 72 hours after disease manifestation. The cause of disease was not revealed in all the patients. Pains in right half of the abdomen were the main symptoms of primary infarction of the greater omentum. There were no specific clinical or laboratory signs. Seven patients were operated for suspected acute appendicitis, and 3 patients - for suspected acute cholecystitis. Pathology of the greater omentum was combined with hemorrhagic effusion in 8 of 10 patients. Resection of affected part of the greater omentum was performed in all the patients, 6 patients underwent simultaneous appendectomies. There were no postoperative complications. All the patients recovered. Mistakes leading to incorrect diagnosis are analyzed.
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PMID:[Primary infarction of the greater omentum]. 1604 25

Results of treatment of 10 patients aged from 16 to 62 years with omentum torsion were analyzed. The majority of them were hospitalized 1.5 -- 3 days after disease beginning. The main symptom was pains in the right half of the abdomen. Clinical picture was characterized by slow progress and late manifestation of peritoneal symptoms. All the patients underwent surgery under general anesthesia. Eight of them were suspected for acute appendicitis, 2 -- for acute cholecystitis. Five patients were operated during the first 2 hours, others -- from 6 hrs 40 min to 20 hrs after hospitalization. In all the patients segmental torsion of the right side of the omentum on 360-720 degrees was revealed. Nine patients had abdominal hemorrhagic effusion. Resection of the affected part of the omentum with additional appendectomy in 5 cases was performed. Destruction in the appendix was revealed only in one patient. There were no complications and lethal outcomes. Problems of diagnostic and surgical policy are discussed.
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PMID:[On omentum torsion]. 1609 95

Among 328 patients with dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS), 14 (4 men and 10 women, median age 44 years) had acute abdomen. DHF/DSS was initially suspected in only 2 of these 14 patients. Presumptive diagnoses of acute cholecystitis (6 acalculus and 4 calculus cholecystitis) were made in 10 patients, non-specific peritonitis in three patients, and acute appendicitis in one patients. Cholecystectomy, percutaneous transhepatic gallbladder drainage, and appendectomy were performed in three patients. Transfused blood in the three patients who underwent invasive procedures and the 11 patients who received supportive treatment included packed red blood cells (24 versus 0 units; P = 0.048), fresh frozen plasma (84 versus 0 units; P = 0.048), and platelets (192 versus 180 units; P = 0.003). Patients who underwent invasive procedures also had prolonged time in the hospital (median = 11 versus 7 days; P = 0.015). To avoid unnecessary invasive procedure-related morbidity and mortality, this report underscores the importance of a careful differential diagnosis in patients with acute abdomen in a dengue-endemic setting.
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PMID:Dengue hemorrhagic fever patients with acute abdomen: clinical experience of 14 cases. 1668 99

Results of treatment of 9 patients (3 male, 6 female) with acute omentitis are analyzed. Omentitis was primary in 8 patients, and secondary -- in 1 patient. Right-sided abdominal localization of pains was the cause of incorrect entrance diagnosis (acute appendicitis and acute cholecystitis). All the patients were operated, the resection of affected parts of great omentum was performed; in 3 cases it was supplemented with appendectomy. Problems of pre-operative diagnosis of acute omentitis and the choice of optimal variant of surgery are discussed.
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PMID:[Acute inflammation of greater omentum]. 1688 36


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