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

This report is a retrospective evaluation of 12 case histories. All patients had been subjected to laparotomy on suspicion of acute appendicitis. The operative situations seemed to corroborate clinical expectations: an inflamed ileocecal process was assumed to be a result of performation of a gangrenous appendicitis. In three patients a primary adenocarcinoma arising from the appendiceal base was the incidental histologic finding postoperatively. In three other patients this inflammatory-looking process was related to a cecal carcinoma. In six patients a carcinoma existed unrecognized as the basic disease, these patients being subjected to intra-abdominal drainage only or in connection with appendectomy. In five instances a fecal fistula was the main persisting symptom of postoperative morbidity, in one patient even as long as two years after laparotomy. The problem in diagnostic verification of the initially unidentified carcinoma is illustrated. Attention is directed towards avoiding a false feeling of security in the presence of inflammatory manifestations in the right lower abdominal quadrant, which may misleadingly suggest a ruptured appendix.
Dis Colon Rectum 1976 Oct
PMID:Acute appendicitis and postoperative fecal fistula: symptoms of an unrecognized carcinoma of the colon. 18 27

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.
Dis Colon Rectum 1977 Sep
PMID:Diverticular disease of the appendix. 40 91

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.
Dis Colon Rectum 1979 Mar
PMID:The significance of a "positive" rectal examination in acute appendicitis. 42 84

Clinicopathologic correlation and survival were evaluated in 11 patients with adenocarcinomas of the appendix. This extremely rare tumor was seen most often in patients in the fifth decade of life. Acute appendicitis was the most common mode of presentation (8/11). A few patients (3/11) showed signs of distant metastases from an occult primary tumor in the appendix.
Dis Colon Rectum 1977 Mar
PMID:Adenocarcinoma of the appendix: a clinicopathologic study. 84 97

An analysis of 101 tumors of the appendix is presented. During the period under study (from 1949 to 1972), 8,699 appendectomies had been performed. Only 17 of the 101 tumors were malignant. In this group, there were two primary carcinomas, 12 metastatic carcinomas, and three lymphomas. Most of the tumors (84) were benign, including 43 carcinoids, 32 mucoceles, five neuromas, two leiomyomas, and two villous adenomas, Some of the clinical and pathologic features of carcinoids, adenocarcinoma, and mucoceles are discussed. The most significant observation in this study is the statistically significant evidence that, even without associated acute appendicitis, mucoceles 2 cm or more in diameter probably do cause clinical symptoms, which may be alleivated by appendectomy.
Dis Colon Rectum
PMID:Tumors of the appendix. 112 68

The infrequent occurrence of right colon diverticulitis in the developed West has led to a controversy in the management of this disease. In Singapore, we continued to avoid colectomy whenever possible because this disease is usually nonprogressive. We reviewed 68 patients treated by conservative surgery to evaluate the effectiveness of this treatment policy. Almost 70 percent of our patients were below 40 years of age, and the clinical presentation was indistinguishable from acute appendicitis. Diverticulectomy was done only for inflamed and perforated diverticula (25 cases), while the nonperforated diverticulum was left alone (40 cases). The inflammation invariably responded to antibiotic therapy. Only three patients had colonic resection since a malignant neoplasm could not be excluded. There were no adverse sequelae over a mean follow-up period of three and one-half years, except for one patient who had recurrent attacks of right colon diverticulitis necessitating colectomy. With this policy of management we encountered no mortality, and morbidity was acceptable.
Dis Colon Rectum 1992 Aug
PMID:Surgical management of right colon diverticulitis. 164 6

The diagnostic value of C-reactive protein (CRP), total white blood cell (WBC) count, total neutrophil count, and neutrophil differential count were evaluated in a prospective blinded study of 204 patients submitted with the tentative diagnosis of acute appendicitis. The laboratory tests were performed on blood samples obtained at the time of admission, and the results were stored until the patients were discharged. One hundred patients were operated on: 59 had appendicitis, 3 had other surgically correctable diseases, and 38 had a superfluous exploration. All 104 nonoperated patients recovered spontaneously. The sensitivity, specificity, and predictive values of single tests and test combinations were calculated at different cutoff levels. Using standard reference intervals, WBC count demonstrated the best sensitivity (83 percent) and predictive value of a negative result (88 percent). Combining the tests by an "or" rule enhanced the sensitivity to 100 percent, employing WBC count or CRP or neutrophil percentage above the reference range (triple test), but at the expense of the predictive value of a positive test (37 percent). It was concluded that both single tests and combined tests are of limited value in predicting acute appendicitis. However, the same triple test combination proved a predictive value of a negative result at 100 percent (95 percent confidence limits 92 to 100 percent), indicating that acute appendicitis is unlikely when these tests are simultaneously negative. The triple test combination was valid in 32 percent of the patients who were free from appendicitis. In the study group, 10 of the patients (25 percent) who had a superfluous exploration had a negative triple test, and they might have avoided surgery if it had been used. Therefore, the triple test is recommended as a help in reducing the significant rate of negative laparotomies in patients suspected of having acute appendicitis.
Dis Colon Rectum 1989 Oct
PMID:Laboratory aid in the diagnosis of acute appendicitis. A blinded, prospective trial concerning diagnostic value of leukocyte count, neutrophil differential count, and C-reactive protein. 267 22

Hemolytic uremic syndrome is seen occasionally by the surgeon in adult patients with colorectal manifestations. Two cases of hemolytic uremic syndrome are presented here, one misdiagnosed clinically as acute appendicitis and the other as acute ulcerative colitis. In each case the diagnosis was only established postoperatively and both patients died of this disease. These cases serve to remind colorectal surgeons that this potentially lethal disease may occur with symptoms and signs suggestive of more common colorectal pathology.
Dis Colon Rectum 1989 May
PMID:Beware of hemolytic uremic syndrome presenting as colorectal disease in adults. Report of two cases. 271 35

This case of villous adenoma of the appendix reported is unique by virtue of its having been diagnosed preoperatively using colonoscopy. Only 45 such lesions have been described previously, and a review of those cases reveals that 93 percent were discovered at appendectomy performed either incidentally or for acute appendicitis. The malignant potential of this entity is unknown and its treatment is controversial. Because of a report association between adenomas of the appendix and other gastrointestinal neoplasms, long-term surveillance is recommended.
Dis Colon Rectum 1988 May
PMID:Preoperative colonoscopic diagnosis of villous adenoma of the appendix. Report of a case and review of the literature. 328 27

The etiology of cecal diverticulitis remains unclear. The majority of diverticula are solitary and probably false and may be the result of the same degenerative process seen in the more common left-sided diverticulosis. A minority are true diverticula and may be of congenital origin. Cecal diverticulitis is clinically indistinguishable from acute appendicitis although patients with cecal diverticulitis tend to be older (average age, 40 years), have a longer duration of symptoms, and present less often with nausea and vomiting. In patients with previous appendectomy and in those with more indolent symptoms, barium enema may be helpful in making the diagnosis. If nonoperative treatment is chosen, careful follow-up with air contrast barium enema and colonoscopy should be carried out. The majority of patients require surgery and two types of cecal diverticulitis are encountered at laparotomy. The usual type, accounting for two thirds of cases, is easy to recognize, has an inflamed projection from the cecal wall, and is dealt with by a limited local diverticulectomy. Some authors advocate nonsurgical treatment for this first group of patients. Incidental appendectomy is advocated to avoid confusion should symptoms occur postoperatively. The hidden variant presents as a large, indurated phlegmon and is difficult to distinguish from a perforated cecal carcinoma. With the hidden variant, right hemicolectomy is the surgical treatment of choice and carries a 1.4 percent mortality.
Dis Colon Rectum 1987 Oct
PMID:Cecal diverticulitis. A review of the American experience. 330 72


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