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

Irritable bowel syndrome and (or) non complicated diverticulosis, associated with fever, could simulate diverticulitis. Cancer of the sigmoid colon appears the main differential diagnosis, when diverticulitis is associated with an atypical or complete colonic stenosis on opaque enema, with a vesicoenteric fistula or with a peritonitis due to a colonic perforation. Even at laparotomy, a pseudotumoral diverticulitis cannot easily be differentiated from a colonic carcinoma. Acute diverticulitis of the caecum or ascending colon is usually mistaken for acute appendicitis. When massive and life-threatening bleeding occurs, the diverticular origin is difficult to assess. Bleeding due to peptic ulcer disease and thermometric ulceration being precluded, arteriography performed on emergency is necessary to differentiate between diverticular bleeding and angiodysplasia.
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PMID:[Diagnostic pitfalls of complicated colonic diverticulosis]. 776 84

Following a brief introduction regarding the epidemiology of diverticular disease, the authors report a rare case of diverticulitis of the cecum which had developed into an abscess. The patient was a 37-year-old man who was referred to the authors' attention with classic symptoms of acute appendicitis and it was therefore decided to operate. During laparotomy a small paracecal abscess involving a diverticulum with suppurating infection was found on the anterior wall of the cecum, whereas the appendix appeared to be completely unaffected. The diverticulum was removed together with a small area of the surrounding healthy tissue using a double-layer suture of the cecal wall. In the discussion the authors analyse the similarities and rarities of the case and compare it with national and international findings. Special attention is drawn to the problems of differential diagnosis raised by this rare pathology. In conclusion, the authors state that it is difficult to make a preoperative diagnosis and that therefore the decision to operate must be extemporary.
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PMID:[Acute diverticulitis of the cecum]. 797 67

While diagnostic laparoscopy is a well established tool, therapeutic laparoscopy for acute abdominal disorders has recently been made possible by video-endoscopic techniques. From July 1989 to April 1992, 243 laparoscopic interventions were carried out in patients with an acute abdomen. After a pilot phase, patients with acute appendicitis were entered into a randomized trial, those with acute cholecystitis were operated within the next day list. Among the 243 operations were 202 appendectomies, 12 closures of perforated peptic ulcers, 4 successful interventions for intestinal obstruction, 4 irrigations for intraabdominal abscesses and 35 further operations, some of which had to be finished as laparotomies. Laparoscopic appendectomy was less painful but technically more difficult. In cases which needed bowel resection for ischemic necrosis or diverticular disease, conversion to open surgery had to be performed. Laparoscopic treatment of acute abdominal disorders including peritonitis can be effective and beneficial in one out of two patients. Adequate surgical training, expertise and respect to the safety of the patient are mandatory. The application of endoscopic suture devices will further enlarge the spectrum of laparoscopic treatment options for the acute abdomen.
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PMID:[Value of laparoscopy in diagnosis and therapy of the acute abdomen]. 814 45

Diverticulosis of the vermiform appendix, either single or multiple, congenital or acquired, is rather infrequent and usually asymptomatic. However, it may be complicated by flogosis configuring an acute abdomen hardly recognizable from an acute appendicitis not related to the diverticular disease. The Authors report a case of acute appendicular diverticulitis surgically treated. A brief review of the literature is also reported.
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PMID:[Diverticulitis of the appendix: a rare cause of acute abdomen]. 839 20

Terminal ileum diverticulosis is a rare entity, but it can be complicated by diverticulitis and perforation, which clinically can be indistinguishable from acute appendicitis. A case report and review of the literature is presented.
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PMID:Perforation of terminal ileum diverticulitis: a case report and literature review. 889 17

The incidence of appendiceal diverticulosis in pathologic specimens is 0.004-2.1%. Diverticular disease of the appendix is classified as congenital (true) or acquired (false). The clinical presentation differs from that of acute appendicitis. The average age is older, the pain is often intermittent, and while localized in the right lower abdominal quadrant, is of longer duration. No further treatment besides appendectomy is needed. Since a high rate of perforations, peritonitis and lower gastrointestinal bleeding have been reported as complications, it is recommended that in those with an incidental finding of diverticula of the appendix during surgery, that appendectomy be performed. It is not recommended to perform prophylactic appendectomy when diverticula of the appendix are found on barium enema.
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PMID:[Diverticular disease of the appendix]. 915 23

Right colon diverticulitis, representing 1-3.6% of cases of diverticular disease is an uncommon cause of right lower quadrant pain. Its presentation is difficult to distinguish from acute appendicitis. Patients are between 35 and 50 years old, have a history of 2-3 days of abdominal pain and few gastrointestinal symptoms. The diagnosis is best confirmed by computed tomography and colonoscopy. Conservative treatment is justified in uncomplicated disease, whereas perforations, abcesses and inflammatory tumors require resection. We describe the cases of six patients treated at our institution from 1991 to 1996. Presentation, geographic variations, diagnostic procedures and management are discussed.
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PMID:[Diverticulitis of the cecum and ascending colon]. 955 Dec 61

The discovery of a tumour mass of the appendix, in an acute or chronic context, raises the problem of its benign or malignant, inflammatory or infectious nature. We report five cases of patients operated by the same surgical team between June 1991 and September 1996, who presented macroscopically and histologically with unusual appendicular pseudotumours: appendicular diverticulosis (n = 1), Crohn's disease localized to the appendix (n = 2), yersiniosis (n = 1), actinomycosis (n = 1). The preoperative diagnosis was acute appendicitis (n = 2) or tumour (n = 3). The postoperative course was uneventful in every case, and specific medical treatment was prescribed in two cases (yersiniosis and actinomycosis). These differential diagnoses must be considered in all appendicular diseases, but they are extremely difficult to confirm preoperatively.
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PMID:[Appendicular pseudo-tumors: unusual diagnosis]. 975 64

This study demonstrates the appearance of large bowel diseases on magnetic resonance (MR) images using breath-hold T2-weighted half-Fourier acquisition snapshot turbo spin-echo (HASTE), breath-hold T1-weighted spoiled gradient-echo (SGE), and breath-hold gadolinium-enhanced T1-weighted SGE with and without fat-suppression sequences. The study represents a collective experience using a generalized combined abdominal-pelvic imaging protocol. Of 29 patients, 27 had surgical, endoscopic, microbiological, and/or histopathological correlation, and 2 had a diagnosis based on characteristic imaging findings. Fifteen patients had neoplastic disease including colon adenocarcinoma (n = 11), rectosigmoid carcinoid (n = 1), familial adenomatous polyposis (n = 2), and cecal lipoma (n = 1). Fourteen patients had non-neoplastic disease including diverticulosis (n = 6), ischemic colitis (n = 2), pseudomembranous colitis (n = 2), acute appendicitis with periappendiceal abscess (n = 2), Mycobacterium avium intracellulare (MAI) colitis (n = 1), and Crohn's proctocolitis (n = 1). In all 15 patients with neoplastic diseases, MR imaging depicted the primary lesions and demonstrated local extent. Mass lesions were best shown on T2-weighted HASTE and gadolinium-enhanced fat-suppressed SGE images. Of 14 patients with non-neoplastic diseases, inflammatory changes were best shown on gadolinium-enhanced fat-suppressed T1-weighted SGE images in all cases. MR imaging with fast scanning breath-hold techniques and intravenous gadolinium enhancement provided good depiction and characterization of large bowel diseases.
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PMID:Colon diseases: MR evaluation using combined T2-weighted single-shot echo train spin-echo and gadolinium-enhanced spoiled gradient-echo sequences. 1093 93

Diverticulum of the appendix is rarely encountered. A case of appendiceal diverticulosis is described. A 46-year-old male patient was sent to our hospital with presentation of acute appendicitis-like symptoms. The appendix was removed by laparoscopic appendectomy, and it showed erythematous change with local peritoneal reaction and omental shift at the tip. Pathological examination revealed three diverticula in the appendix. One of them was inflamed but the appendix itself was not. All three diverticula were pseudodiverticula, lacking muscularis propria. The appendix in this case showed only focal inflammatory change, which differs from what occurs in acute appendicitis, where diffuse inflammation of the appendix is usually noted. In cases of an appendix with only focal erythematous change, minor lesions such as diverticulitis may be revealed by pathological examination, and an appendectomy is still warranted. Diverticulitis of the appendix cannot be differentiated from acute appendicitis preoperatively. Image studies including abdominal computed tomography scan, ultrasonography, and plain film cannot improve the diagnosis. To our knowledge, diverticulosis of the appendix has never been reported in Taiwan.
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PMID:Diverticulosis of the appendix with diverticulitis: case report. 1119 Mar 82


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