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

Using a data base of 7,000 acute abdominal pains, we here described the assessed clinical manifestations of the main diseases responsible for right lower quadrant pain. However, percentages of sensibilities have been replaced by adverbs or adjectives, applying a scale of equivalence. The possible modifications of the positive predictive values have been also replaced by verbs or typical expressions. We first described the acute appendicitis syndrome (which covered congestive endoappendicitis and suppurated appendicitis) with the clinical shades or the gathered and gangrenous forms or even of the diffuse peritonitis. Features of the acute appendicitis contrast with those of the so called "non specified abdominal pains" (a new entity), and those of the subacute or chronic appendicitis. We found a good correlation between clinical and pathological findings. One of the difficulties has been to determine if a subgroup of subacute appendicitis should be or not included into the acute appendicitis.
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PMID:[Quantified symptomatology of acute appendicitis in adults. The signs and their value]. 159 20

The vermiform appendix is a frequent surgical specimen in most routine histopathology laboratories. This is because acute appendicitis is one of the commonest reasons for undertaking emergency laparotomy in most hospitals, even in developing countries. Three hundred and sixteen appendices removed for acute appendix in our hospital over a 10-year period were analysed, of which 37 (11.7%) were found to be normal while 221 (69.9%) showed histopathological evidence of acute inflammation. There were 25 cases of chronic appendicitis, four (1.3%) of which were granulomatous. Of these, schistosomal appendicitis was observed in three cases (0.95%) and tuberculous appendicitis was seen in one case. Of the 33 cases classified as miscellaneous, intraluminal ova of parasites with phlegmonous eosinophilic infiltration of the appendix was observed in 17 cases (5.4%) and Toxoplasma appendicitis was observed in five cases. Carcinoid tumour was diagnosed in three cases (0.95%), and in two of these the tumour had spread beyond the appendix.
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PMID:Review of the histopathological findings in appendices removed for acute appendicitis in Nigerians. 194 41

In a prospective study comprising 154 patients, the efficacy of clinical, sonographic and combined assessment of appendiceal perforation was evaluated. 39 patients had appendiceal perforation, 44 no signs of inflammation and 71 chronic appendicitis as proven by histologic examination. Cases of 'simple' acute appendicitis were excluded. Clinical assessment yielded with respect to appendicitis a sensitivity of 87%, a specificity of 97% and an accuracy of 94%. With respect to appendiceal perforation a sensitivity of 74%, a specificity of 97% and an accuracy of 91% were observed. Sonographic diagnosis of acute appendicitis as the cause of complaints gave a sensitivity of 85%, a specificity of 98% and an accuracy of 95%, and with special respect to real appendiceal perforation a sensitivity of 69%, a specificity of 98% and accuracy of 91%. By overlap of clinical and sonographic findings, diagnosis of perforation was feasible in 80%, diagnosis of acute appendicitis in 92%. Our results indicate that sonography is a valuable adjunct to clinical assessment, whereas clinical assessment alone seems to be superior to ultrasonography as an isolated procedure.
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PMID:[Ultrasonic diagnosis in appendiceal perforation]. 240 43

In the period between 1965-1986 with a collective sum of 5369 gynecological laparotomies, the appendix was removed as a preventive measure in 1718 cases (32%). In all these cases, the recovery period proceeded without any complications. The results of the histological studies on the appendices showed an acute appendicitis in 136 cases (7.9%). In 1118 cases (65.1%) a chronic appendicitis was found, with differing severity of fibroid scarring, including total obliteration. In 96 cases (5.6%), there was evidence of carcinoid, mucocele, and endometriosis. Only 368 appendices (21.4%) were normal morphologically. The large percentage of histopathological findings confirms, that the appendix--being a rudimentary lymphatic organ--appears to be predestined for inflammatory changes. For this reason, the risk of illness and death from appendicitis remains, especially for older people. It is usually possible, to perform a prophylactic appendectomy under optimal conditions and we experienced, that this additional operation does not increase the risk to the patient. We consider, that the routine practice of the prophylactic simultaneous appendectomy during gynecological laparotomies is justified, providing, that the contra-indications mentioned are observed.
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PMID:[Preventive appendectomy in gynecologic surgery. Report of 1,718 cases]. 261 43

Appendiceal disease can be acute, acute recurrent, or chronic. Acute appendicitis is the most common form. Acute recurrent appendicitis is more common than chronic appendicitis. In children the clinical manifestations of appendicitis are variable. Patients who have an appendicolith usually develop appendicitis, often with perforation. A case is presented of 3-year follow-up of a patient with an appendicolith and acute recurrent appendicitis. The literature about appendicoliths is reviewed. In the appropriate clinical setting, a history of prior episodes of similar right lower quadrant pain does not preclude the diagnosis of appendiceal disease. Awareness of the less common forms of appendicitis is important so that appropriate treatment is not delayed.
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PMID:Acute recurrent appendicitis with appendicolith. 305 84

576 patients admitted for suspected acute appendicitis were prospectively assessed by sonography following physical examination. The collective comprised - as proven by operation - 156 patients with acute appendicitis, 178 patients with chronic appendicitis or mesenteric lymphadenitis, as proven by observation, 186 patients suffering from gastroenteritis. 56 patients suffered from other diseases and 21 of them required urgent surgery. Based on clinical symptoms, correct diagnosis had been made in 433 patients (75%): gastroenteritis n = 186, chronic appendicitis or lymphadenitis n = 111 and acute appendicitis n = 136 (87%). In 123 patients the diagnosis was false positive, in 20 patients false negative. Based on sonographic assessment, 537 patients (93%) were correctly diagnosed; thus, in 129 patients (83%) an inflamed appendix was confirmed, in 56 patients; diagnosis of unrelated entities requiring urgent surgery correct in 21 cases. In 12 patients with mesenteric lymphadenitis - as proven by operation-a false positive, in another 27 patients with acute appendicitis a false negative diagnosis was made. The combination of clinical assessment and sonographic diagnosis yielded a correct diagnosis in 97% (560/576) comprising 414 true negative and 146 true positive results (94%) in respect of acute appendicitis.
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PMID:[Ultrasound study of "acute appendicitis," an elective procedure or obligation in general surgery. A prospective study]. 331 23

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

Of 200 consecutive appendicectomies performed at Royal Prince Alfred Hospital the indications for operation were suspected acute appendicitis (65%), chronic or recurrent appendicitis (11.5%), interval appendicectomy (3%) and appendicectomies incidental to other operations (20.5%). Of those operated upon for suspected acute appendicitis, the appendix revealed acute inflammation pathologically in 64% of patients. Pathological changes occurred with the same frequency in both the incidental appendicectomy group and the chronic appendicitis group. Within the group with a provisional diagnosis of acute appendicitis there were marked variations in the documentation of peroperative symptoms, signs and investigations. On average 11.5 hours passed between the time these patients presented and when appendicectomy was performed. The patients spent an average of 6.4 days in hospital and only 33% had any documentation follow-up in the hospital records. Auditing systems can only be instituted in Australia if the structure of medical services is borne in mind. Adoption of overseas systems based on different patterns of medical care will add little to patient care.
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PMID:Appendicectomy audit. 657 9

The existence of chronic appendicitis is controversial. In this prospective study, we investigated possible changes in the innervation of the appendix under different pathological conditions and correlated histological findings with clinical observation. Thirty appendectomy specimens and 14 appendices obtained from organ donors or patients who underwent right hemicolectomy were immediately fixed in Bouin's solution and processed for immunocytochemistry using an antiserum directed against the panneuronal marker protein gene product 9.5 (PGP 9.5). The density of PGP 9.5 immunostaining was evaluated by digitized morphometry. Significant differences in the density of the PGP 9.5-immunoreactive area were detected in the mucosal layer. In the nonacute appendicitis group, PGP 9.5 was increased (10.99 +/- 3.15%) as compared to acute appendicitis (3.89 +/- 1.77%) and controls (4.98 +/- 1.25%). The significant increase of PGP 9.5 in nonacute appendicitis may suggest axonal sprouting leading to hyperinnervation of the mucosa. This may be a neuronal factor in the pathophysiology of the disease and pain symptoms.
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PMID:Changes of protein gene product 9.5 (PGP 9.5) immunoreactive nerves in inflamed appendix. 753 35

Episodic abdominal pain, a common clinical problem, can be a diagnostic and therapeutic conundrum when the surgeon encounters it acutely in the emergency department. Appendicitis is often excluded from the differential diagnosis because the natural history of appendicitis is usually appreciated as acute, progressing to some degree of peritonitis quite rapidly and inevitably. However, recurrent and chronic forms of appendicitis occur also and can mislead the clinician. Herein, we describe two patients with recurrent appendicitis that were misinterpreted as other abdominal conditions, and we review the literature implicating recurrent and chronic appendicitis as disease processes, distinct from acute appendicitis, that occur with an incidence of approximately 10 per cent and 1 per cent, respectively.
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PMID:Recurrent and chronic appendicitis: the other inflammatory conditions of the appendix. 811 86


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