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

An analysis of the medical records of 103 women with Crohn's disease points up the following observations. There is a slight increase in spontaneous abortions and a substantial degree of subfertility. The obstetric experience is the same as in the normal obstetric population and the effects of the disease on pregnancy and of pregnancy on the disease are minimal. Features seemingly unrelated to Crohn's disease and of a gynecologic nature may be present months before the onset of the main bowel inflammation. These features consist of abscesses, fistulas, ulcers, fissures, and infections involving not only the internal pelvic organs but also the vulvovagina, perineum, labia, rectovaginal septum, rectum, and anus. The onset of Crohn's disease may be acute and present the picture of an abdomen requiring surgical treatment. A tender, low abdominal, adnexal, or pelvic mass may incorrectly be diagnosed as acute appendicitis, pelvic inflammatory disease, or ovarian cyst, and lead to surgery. In 23 instances the diagnosis of Crohn's disease was established only after laparotomy. A total of 27 appendectomies were performed and none of these patients had acute appendicitis. Four pelvic abscesses developed after the appendectomies. To avoid the pitfalls of misdiagnosis and mismanagement, the nature of Crohn's disease should be understood and the gynecologic aspects of the disease recognized.
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PMID:Crohn's disease: "its gynecologic aspect". 64

Primary pneumococcal peritonitis is an uncommon condition 1st identified in 1885. It occurs when peritoneal inflammation is present in the absence of an intraabdominal source of infection. In the preantibiotic era, the condition accounted for 2% of childhood abdominal emergencies largely among girls aged 2-10 years. Mortality was 42-100%, with death sometimes occurring within 48 hours of the onset of symptoms. This condition now present in female adults, is associated with IUD use, and is comparatively common in India. Consideration should therefore be given to the existence of primary pneumococcal peritonitis when diagnosing and managing abdominal emergencies. The pneumococcus may enter the peritoneal cavity via the female genital tract, blood, or through transmural spread from the gastrointestinal tract. No evidence supports a relationship between type of IUD and/or length of time in place, and the onset of peritonitis. Given pneumococcus' commensal existence in the upper respiratory tract, urogenital sex may facilitate its entrance to the peritoneal cavity through the female genital tract. Abdominal pain, diarrhea, and vomiting generally present, while the patient may also be pyrexial and dehydrated. In diagnosing this condition, the practitioner may confuse it with acute appendicitis, pelvic inflammatory disease, or gastroenteritis if in the early stages of peritonitis. Diagnosis is often confirmed only thorough laparotomy, but abdominal paracentesis and/or abdominal ultrasound may also be employed as diagnostic aids. Laparotomy and a regime of antibiotics is the preferred treatment. 2 case studies are discussed.
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PMID:Primary pneumococcal peritonitis. 159 42

Patients with traumatic or non-traumatic acute abdomen, often exhibit difficulties in the assessment of the real intra-abdominal visceral compromise. This study intends to compare laparoscopy and ultrasonography in patients with non-traumatic or traumatic acute abdomen, in whom there is a doubt on the actual visceral compromise. Forty-five patients were studied in this protocol. Both procedures were performed in 28 and in 17 patients with non-traumatic or traumatic acute abdomen, respectively. The laparoscopic examination was shown to be superior to the ultrasound even when one subtracts from the ultrasound data all pathologies that involved bowel transit and the bowel wall such as the acute appendicitis and cases of pelvic inflammatory disease. The laparoscopic and ultrasound accuracy were 97.8% and 53%, respectively.
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PMID:[Comparative analysis of the diagnostic value of ultrasonography and laparoscopy in acute abdomen]. 166 42

The reliability of the signs and symptoms of acute appendicitis are reviewed. The wide variation in clinical findings when the different studies are compared can probably be explained by the huge quantity of retrospective studies. Migration of pain to the right iliac fossa and/or guarding/rigidity support the diagnosis of appendicitis. The diagnosis of appendicitis should be doubted when anorexia, nausea and vomiting are absent, when symptoms have persisted for more than 72 h without apparent perforation, or when tenderness in the right iliac fossa is absent. Presentation in proximity to menstruation, cervical dislocation tenderness and bilateral adnexal tenderness indicates pelvic inflammatory disease. Small children have high perforation rates because of their uniform response to many illnesses and relative inability to express themselves and cooperate. The clinical findings in young and old patients are similar, except for a higher rate of abdominal distension in old patients. With a more thorough knowledge of the signs and symptoms of acute appendicitis and a constant awareness of its possible presence, it should be possible to increase the diagnostic accuracy.
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PMID:Assessment of the reliability of the symptoms and signs of acute appendicitis. 140 57

Unnecessary abdominal explorations in severely injured patients can be reduced by employing emergent or urgent laparoscopy in blunt abdominal trauma and the obscured, acute abdominal cases. In 150 blunt abdominal trauma cases, a mini-laparoscopy was used in the emergency room or the intensive care unit without major complications. In 56%, the findings were negative. In 19%, the laparoscopic findings were corroborated by surgery. In 25%, a minimal to moderate hemoperitoneum was found and the laparoscopic impression dictated close observation. Unnecessary exploration was avoided except in one case. In the elderly high-risk patient with a poor history, abdominal examination can be noninformative. Laparoscopy can detect acute appendicitis or organ perforation. In the young female, appendicitis can be differentiated from pelvic inflammatory disease. Laparoscopy is more accurate and gives a larger latitude for decision-making than lavage. It can also be useful in the obscured problematic abdominal case.
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PMID:Emergency laparoscopy. 182 52

On the basis of his own observations and experience, compared with literary data from recent years, the author think that the most proper planning of prophylactic measures in connection with pelvic inflammatory disease (PID) could be carried out after thorough study and good knowledge of risk factors and groups. Some with special medico-social significance are outlined among them: age groups up to 20,20--24 and 25--29 years; sexual education and behaviour, delivery and postpartal period, intrauterine diagnostic and therapeutic manipulations, intrauterine contraceptive devices, abdominal operative interventions with special significance of the operations for acute appendicitis and ectopic pregnancy; latent, clinically unsuspected, or accompanying other diseases PID. The necessity of effective cooperation between a gynecologist and physicians from other specialties (surgeons, internists, urologists, etc.) for timely establishment of a latent disease, examination of a sexual partner, ect. Important condition for effective work is improvement of the functional connections and bilateral information between polyclinic obstetric-gynecological sector gynecological ward.
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PMID:[Pelvic inflammatory disease--prophylactic trends]. 274 84

A total of 40 patients with acute pelvic inflammatory disease (acute PID) were examined over a period of 7 months to determine the diagnostic value of laparoscopic examination in these cases. The most important findings were: the clinical diagnosis of acute PID was confirmed by laparoscopy in 55% of patients; laparoscopy was especially of value in differentiating potentially lethal conditions such as ectopic pregnancy and acute appendicitis from acute PID in 15% of patients; laparoscopically obtained microbiological specimens provide a more accurate means of determining the microbiological aetiology of acute PID than vaginally obtained specimens.
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PMID:The value of laparoscopy in the diagnosis of acute pelvic inflammatory disease. 295 32

To find a way to decrease the incidence of laparotomies negative for appendicitis, we studied 108 female patients between the ages of 15 and 45 years who had undergone appendectomy with the diagnosis of acute appendicitis. Of these 108 patients, 56 had acute appendicitis and 52 had normal appendixes. The patients between the ages of 15 and 25 years had a 59% incidence of negative laparotomies, in comparison with those patients between 36 and 45 years old, who had an incidence of 22%. In patients with normal appendixes, 18 had no intra-abdominal pathologic findings. Twenty had pelvic inflammatory disease, and nine had ovarian abnormalities. There were no differences in the clinical symptoms, vital signs, roentgenographic findings, or other laboratory studies between the two groups. There were no in-hospital perforated appendixes in the patients who were operated on within 48 hours of admission. To decrease the incidence of negative appendectomies, we recommend in-house observation and simultaneous examination of the patient by the surgeon and a gynecologist.
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PMID:Acute appendicitis in women of childbearing age. 374 Nov

In order to determine whether any clinical or laboratory findings were helpful in differentiating acute appendicitis (AP) from acute pelvic inflammatory disease (PID), this retrospective study was undertaken. Records of all female patients 12 to 50 years of age, undergoing laparotomy with a preoperative diagnosis of AP over the past 15 years, were reviewed and pertinent data recorded. In comparing AP (n = 106) with PID (n = 39), longer duration of symptoms, relationship of onset of pain to the menstrual cycle, and frequent requests for gynecological consultation distinguished the PID from the AP cases. Although complete reliance cannot be placed on any clinical or laboratory finding in differentiating AP from PID, the final satisfactory outcome justifies laparotomy when the diagnosis cannot be established by other means.
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PMID:Appendicitis versus pelvic inflammatory disease. A diagnostic dilemma. 398 88

At the University Hospital, Lund, Sweden, laparoscopy has been routinely used as a diagnostic aid in cases for acute pelvic inflammatory disease since 1960. No significant complications have been encountered. The material of the study comprises 905 cases covering an 8 year period, 1960-1967. The operation was always performed under general anesthesia. The laparoscope was inserted in the midline below the umbilicus and a cannula inserted 10 cm laterally to manipulate the pelvic organs. A previous clinical diagnosis was required. In 814 cases acute inflammatory disease was suspected on clinical grounds. In 532 of these cases (65%) acute salpingitis was visually confirmed. Observation through the instrument was seldom difficult or uncertain. In 98 cases (12%) laparoscopy revealed other pathologic conditions. In 184 cases (23%) no pathologic changes were found. In another 91 cases acute salpingitis was found unexpectedly at laparoscopy (or in some cases by exploratory laparotomy) undertaken on other provisional clinical diagnoses. Altogether 623 patients were visually diagnosed as having acute salpingitis. Acute appendicitis was found in 24 cases, ectopic pregnancy in 11 cases, pelvic endometriosis in 16 cases, and several other pelvic disorders occasionally. In the total series of 623 confirmed cases of acute salpingitis 223 (365) were of gonococcal origin. These were mostly in the younger, unmarried, and nulliparous patients. Previous curettage was responsible for most othe r cases. The authors conclude that the diagnosis of acute adnexal inflammation based on commonly accepted clinical criteria was found inaccurate to an unsatisfactory high degree as 12% proved to have other disorders, several of a serious nature. Also 23% had no inflammatory reaction of the tubes or other pelvic structures leaving 65% of cases correctly diagnosed on clinical grounds. The prognosis as to later tubal patency varied with the stage of development of the salpingitis. Later studies show that patency was more frequent in cases of salpingitis diagnosed and treated early before adnexal swelling or mass was diagnosed clinically. Gonococcal cases showed a lower subsequent bilateral occlusion than others. 5 of the salpingitis patients were later operated on for ectopic pregnancy.
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PMID:Objectivized diagnosis of acute pelvic inflammatory disease. Diagnostic and prognostic value of routine laparoscopy. 424 30


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