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

A rare case report of leiomyosarcoma of Meckel's diverticulum, which caused torsion and strangulation of the diverticulum, is presented. The clinical picture was similar to acute appendicitis, which was the working diagnosis when the 42-yr-old Arab woman was sent to surgery. Although rare, leiomyosarcoma is the most common tumor of Meckel's diverticulum, and has to be considered in the differential diagnosis of right lower abdominal pain.
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PMID:Torsion of leiomyosarcoma of Meckel's diverticulum. 396 55

A case of a primary lymphoma of Meckel's diverticulum in a 6-year-old Iraqi boy presenting clinically as acute appendicitis is reported. Exploration revealed a ruptured gangrenous Meckel's diverticulum with an ileo-ileal intussusception at the diverticulum origin. A fairly comprehensive search through the English language literature has failed to reveal any other report of a primary lymphoma of Meckel's diverticulum leading to acute intestinal obstruction.
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PMID:Primary lymphoma of Meckel diverticulum: a case report. 396 85

Appendectomy was performed on 1,059 children at the University Clinic of Paediatric Surgery in Mainz from 1. 1. 1975 to 31. 6. 1983. For the retrospective examination of the indication for appendectomy histopathological and intraoperative findings were analysed and evaluated. Histologically five types of appendicitis were differentiated: 1. acute appendicitis (two forms: acute ulcero-phlegmonous appendicitis with or without perforation and acute superficial appendicitis), 2. chronic appendicitis, 3. lymphatic hyperplasia, 4. submucosal fibrosis, 5. rare diseases. In 618 cases (= 58.3%) acute appendicitis was diagnosed histologically. In another 203 cases (= 19.2%) intraoperative findings (e.g. Lymphadenitis mesenterialis, Meckel's diverticulum) were retrospectively collected; they caused symptoms similar to those of appendicitis. However, there remain retrospectively 22% of all appendectomised children with no indication for laparotomy. The statistical analysis of postoperative complications showed a significant dependance from the histopathological findings. The highest rate of complications was seen in cases with perforated (34%) or non-perforated (10%) ulcero-phlegmonous appendicitis. Children with acute superficial appendicitis had a complication-rate of 5%; those with lymphatic hyperplasia and submucosal fibrosis of 6% each. Relaparotomies were almost exclusively necessary in cases with acute appendicitis; septic and pulmonary complications were mostly seen either in infants with malformations or other perinatal risks, or in children with additional severe diseases. Therefore non-acute appendicitis justifies a wide indication for appendectomy because of a low complication-rate; this, however, is not valid for high-risk children (e.g. malformations). In these cases sonography might be useful for preoperative diagnosis.
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PMID:[Appendicitis in childhood]. 401 Jun 71

An operation was performed on a 37-year-old man with symptoms of acute appendicitis. A severely inflamed appendix was removed. Histology, however, showed an atypical picture of inflammation: the outer layers of the appendix were severely inflamed but the epithelium was intact. Re-laparotomy revealed an abscess around a perforated Meckel's diverticulum, with no evidence of complications at the site of appendicectomy. It appeared that the appendix had become inflamed directly from the primarily inflamed Meckel's diverticulum. The case shows that a careful exploration of the neighbouring organs as well as the dissection of the specimen by the surgeon himself is indicated during laparotomy despite detection of appendicitis. To distinguish the situation described here from classical appendicitis we suggest the term secondary appendicitis to define the direct invasion of inflammation to the appendix from an adjacent organ.
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PMID:Secondary appendicitis--a sign of some other intra-abdominal inflammation. 406 14

Perforation of a Meckel's diverticulum by a sharp object often presents with subtle nonspecific abdominal findings. A 53-year-old man had features resembling acute appendicitis and right ureteral obstruction. At laparotomy a wooden toothpick was found perforating a Meckel's diverticulum. The diagnosis of complicated Meckel's diverticulum should be considered when there is typical right lower quadrant pain or the patient is known to have ingested a sharp foreign body. The mortality resulting from perforation is low. The authors discuss other complications of Meckel's diverticulum.
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PMID:Perforation of a Meckel's diverticulum by a foreign body. 682 11

The authors report what they believe is the first report in the English literature of acute inflammation of ectopic pancreatic tissue in a Meckel's diverticulum. A 29-year-old man presented with acute abdominal pain and a clinical diagnosis of acute appendicitis was made. Laparotomy revealed a normal appendix and a Meckel's diverticulum with gross inflammation at the distal end. Microscopic examination showed acute inflammation limited to ectopic pancreatic tissue in the wall of the diverticulum. Fat necrosis was present. The possible pathophysiologic mechanisms are discussed.
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PMID:Acute inflammation of pancreatic tissue in a Meckel's diverticulum. 713 21

Meckel's diverticulum usually presents as a diagnostic problem. Its most common clinical manifestations--lower GI bleeding, small bowel obstruction, and features suggesting acute appendicitis--are fairly well known. Other clinical presentations include a Meckel's diverticulum in an omphalocele, lower GI bleeding followed by perforation, perforation secondary to blunt trauma, and presentation as iron deficiency anemia with and without episodes of overt hemorrhage. Illustrative cases emphasize indications for and usefulness of abdominal scanning as a diagnostic aid.
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PMID:The many faces of Meckel's diverticulum. 744 21

In 1978-1988 operations were performed on 92 children: 35 with diverticulitis, 7 with intestinal intussusception, 5 with hemorrhage from an ulcer of the diverticulum, 13 with strangulation or mechanical ileus, 2 with strangulated Littre's hernia, one with torsion of the omentum, 22 with secondary diverticulitis, and in 7 children Meckel's diverticulum was a chance finding during other operations in the cavities. Boys accounted for 60.9' (56) of cases. There were 12 children under one year of age, nine from 1 to 3 years, 17 from 3 to 5 years, 17 from 5 to 7 years, and 12 children aged from 7 to 10 years. The clinical manifestations depended on the pathological changes developing in Meckel's diverticulum. A clinical picture of acute appendicitis developed in diverticulitis, six children had a typical picture of intussusception, and one child had a picture of acute abdomen. Anemia and a stool with dark blood were encountered in hemorrhage from a diverticular ulcer. Seven out of 13 children with ileus had a pronounced clinical picture, in the remaining 5 it was unclear and resembled that of acute appendicitis. Meckel's diverticulum was suspected before the operation in 17 (9.95%) patients. The Volkovich-Dyakonov laparotomy approach was used in 64 children, a pararectal incision in 9, a transrectal incision in 15, a median incision in one patient, hernio-laparotomy was conducted in one and Shpizi's operation in 2 children. Diverticulectomy was accomplished by the oblique-transverse method in 79 children, by the wedge techniques in 5, by the purse-string method in 2 patients, and resection of the intestine with the diverticulum was conducted in 5 children.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Meckel's diverticulum in children]. 767 99

In two autopsy prospective studies, at the Prosectures of the Departmental Hospital and of the Pediatric Hospital in Cluj, we found an incidence of Meckel's diverticulum of 1.16%, 1.46% respectively. Besides, we have retrospectively followed the incidence of the ileal diverticulum during the laparatomies performed at the Pediatric Hospital in Cluj between 1981 and 1990 on an acute abdomen of a supposed appendicular cause. Consulting the pathological bulletins which registered 8,385 laparatomies we found 200 Meckel's diverticula. Of the 200 diverticula, 64 exhibited a pathological process and 136 were trophic, and we suppose that they were found incidentally (incidence of 1.63%, corrected incidence of 1.38%). Up to the age of 16, 4.5% of the diverticula were excised. In the 64 symptomatic cases of ileal diverticulum, 50 presented inflammatory complications, 10 were ulcero-hemorrhagic, two were obstructive, one diverticulum presented an entero-umbilical fistula and one displayed a hemorrhagic infarction. Seventeen of the 200 diverticula presented heterotopic tissues; 12 of the 17 cases were symptomatic; in 64.7% of the cases the heterotopic tissue was the gastric mucous coat. Out of 8,385 laparatomies performed on an acute abdomen of a supposed appendicular cause, in 64 cases the symptomatology was generated by a meckelian pathological process (0.76%). An acute appendicitis was concomitantly present in 22 of the 64 cases.
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PMID:The ileal diverticulum. Morpho-clinical and epidemiological study. 803 19

Acute appendicitis is the first cause of emergency surgery in children. Actually, emergency abdominal sonography has evolved in differential diagnosis of acute appendicitis in children to differentiate it from other causes of acute abdomen as mesenteric lymphoadenitis, acute right pyelonephritis, acute diverticulitis in Meckel's diverticulum, intestinal intussusception, regional enterits, primary peritonitis, anaphylactoid purpura of Henoch-Schonlein. The aim of this study is the evaluation of the usefulness of abdominal sonography in diagnosing acute appendicitis in our current series of pediatric patients. We have operated 102 patients afflicted by appendicitis admitted to the pediatric department of Ospedale San Raffaele, Milano in a period of 5 years and operated on for appendectomy. In the last 2 years 36 patients were evaluated with abdominal sonography. This diagnostic tool showed in 34 (94.4%) a liquid effusion, sometimes thick of the right iliac fossa. In 2 patients the appendix had thickened layers, was edematous and the lumen was clearly filled with debris. Abdominal sonography has given a clear cut picture of the acute inflammatory process of the appendix. None of these patients has suffered from septic or obstructive complications. Mean duration of hospital stay was 6.35 days (3-15 days). Differential diagnosis of acute appendicitis can be extremely variable, from simple, paradigmatic situations to the most intriguing ones. This concept is well emphasized by William Silen when he says that "differential diagnosis of acute appendicits is an encyclopedic compendium of every abdominal disease that causes pain" in the 11th edition of Harrison's Principles of Internal Medicine.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Current diagnostic-therapeutic trends in treatment of pediatric appendicitis]. 803 58


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