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

We conducted a retrospective study of 305 patients hospitalized with abdominal pain suggestive of acute appendicitis. Signs, symptoms, and laboratory findings were analyzed for specificity, sensitivity, predictive value, and joint probability. The total joint probability, the sum of a true-positive and a true-negative result, was chosen as a diagnostic weight indicative of the accuracy of the test. Eight predictive factors were found to be useful in making the diagnosis of acute appendicitis. Their importance, according to their diagnostic weight, was determined as follows: localized tenderness in the right lower quadrant, leukocytosis, migration of pain, shift to the left, temperature elevation, nausea-vomiting, anorexia-acetone, and direct rebound pain. Based on this weight, we devised a practical diagnostic score that may help in interpreting the confusing picture of acute appendicitis.
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PMID:A practical score for the early diagnosis of acute appendicitis. 184 49

Gilbert's syndrome is a benign disorder characterized by intermittent hyperbilirubinemia. Jaundice is provoked by anorexia and fever, conditions associated with acute abdominal illnesses. Three cases of Gilbert's syndrome and acute appendicitis are presented. The presence of jaundice resulted in errors of diagnosis with serious complications.
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PMID:Acute appendicitis in patients with Gilbert's syndrome. 409 75

The essence of the problem, as previously reported, indicated that few complications of acute appendicitis occur as long as the infection is contained within the appendix, but once the invading bacteria have penetrated the peritoneal appendicular surface or have invaded the regional circulation, any one or more of a series of serious complications can develop. Thus, rightfully, emphasis has been placed upon early removal of the inflamed appendix before penetration has occurred as the best method of preventing complications. We have shown that early appendectomy is predicated on early diagnosis and that diagnostic delay is not limited to extremes of age. The diagnosis may be obscured by an accurate, although misleading, history of prior acute attacks, by precident acute disease, such as viral gastroenteritis and by unimpressive symptoms blunted by intercurrent chronic illness, such as diabetes mellitus. If the elements of periumbilical pain, anorexia, nausea or vomiting and the migration of pain to the right lower abdominal quadrant are contained within the clinical history, one must suspect transmural progression of acute appendicitis; frequent inpatient examinations will allow earliest diagnosis and, thereby, fewest perforations and their attendant serious complications. Misdiagnosis is common. Any patient observed for an ostensibly nonsurgical acute condition of the abdomen who fails to improve markedly during a brief course of appropriate specific or supportive therapy must be thoroughly re-evaluated as a potential surgical candidate. Despite the proliferation of accessible laboratory tests and imaging procedures, the early diagnosis of appendicitis rests upon the clinical skills of the physician. A high index of suspicion is crucial. As Doctor Warfield M. Firor, former senior surgeon commented: "Pain and tenderness at any point where the appendix can lie must raise the diagnostic possibility of appendicitis."
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PMID:Reasons for delay of the diagnosis of acute appendicitis. 670 39

In this study, the hypothesis that computer aided diagnosis could enable a more accurate differentiation between patients with acute appendicitis and those with abdominal pain but normal appendixes was examined. A data base was established by analyzing the records of 476 patients having an emergency measure appendectomy during a five year period. There were 360 or 76 per cent with acute appendicitis, 98 or 20 per cent with normal appendixes and 18 or 4 per cent with other diseases requiring operation. The records were analyzed with regard to history, physical examination and laboratory findings. The data base was then divided randomly into two parts. Part 1 was subjected to univariate discriminant analysis, using the chi-square test. The only quantities which were significantly different between appendicitis and a normal appendix were sex, duration of symptoms, anorexia and vomiting. Multivariate discriminant analysis was used to derive an abdominal pain index which discriminated between appendicitis and a normal appendix with a sensitivity of 0.82 and a specificity of 0.39. Using the abdominal pain index to evaluate the patients in part 2 of the data base, 23 or 40 per cent of the 58 patients with a normal appendix would have avoided operation. However, 31 or 18 per cent of the 169 patients with appendicitis would have not been operated upon; three of those 31 had perforated appendixes. Computer aided diagnosis was no more effective than unaided clinical diagnosis in appendicitis.
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PMID:A feasibility study of computer aided diagnosis in appendicitis. 675 99

Two neonates with acute appendicitis have been treated at the Paediatric Surgery Clinic, Tygerberg Hospital, during the past 6 months. One presented with red blood in the stool and had had persistent anorexia for 1 week. The second baby presented with a large tender swelling of the scrotum which was indistinguishable from a torsion of the testis or strangulation of an inguinal hernia. Both babies made an uneventful recovery.
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PMID:Unusual presentations of acute appendicitis in the neonate. A report of 2 cases. 714 40

From January 1st, 1987 to December 31st, 1989, 267 patients were operated upon for acute appendicitis representing 97% of emergency laparotomies at the Pediatric Surgery Department of Santa Maria Hospital (HSM); of these, 207 records were analysed using a retrospective protocol and the results were as follows: most frequent symptoms were abdominal pain (99% of cases) and anorexia (86%). Referral for surgical evaluation was made in 35.8% of cases 48 hours after the onset of symptoms; surgery was performed in 129 patients (62.4%) in advanced stages of disease, with histopathological examinations of necrotic, perforated and gangrenous appendices. 15 patients (7.2%) had no appendicitis-11 were found to have follicular hyperplasia and 4 normal histology; of these, luminal distention by parasitic eggs was found in 4. Antibiotic therapy was used in 89 patients preoperatively and in 200 patients postoperatively; cefoxitin was the most commonly used in 89.9% and 83.0% respectively. There were 19 complications (9.2%): 8 parietal, 5 pelvic and 1 subphrenic abscesses, 4 total or partial obstructions and 1 lost drain; 4 patients (1.9%) were reoperated and there was no mortality.
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PMID:[Acute appendicitis in children]. 818 27

Primary torsion of the omentum is an unusual cause of an acute abdomen and commonly mimics acute appendicitis. The following report of four obese children is supportive of obesity as a predisposing factor. The paucity of gastrointestinal symptoms, anorexia, nausea, vomiting, and the relatively long duration of symptoms, may increase the index of suspicion. In the majority of cases, the diagnosis is made intraoperatively by digital exploration through the muscle-splitting incision. The torsed omentum is easily delivered through the same incision, and excision results in complete recovery.
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PMID:Primary omental torsion in children. 766 14

Fifty-four cases of acute appendicitis were studied prospectively within a period of 11 months spanning between February-September, 1991 and December, 1991-February, 1992. The mean age was 25.4 years with a range of 8-70 years. Ninety percent of the patient were between 11-40 years of age. Male patients accounted for 54% of the cases. Students and civil servants accounted for 68%, while artisans and traders accounted for remaining cases. Low abdominal pain was present in all cases, loss of appetite in 77.7%, and previous history of abdominal pain in 76%. Abdominal tenderness was present in all the patients, rebound tenderness in 77.7%, guarding in 81.5% and Rovsings sign in 50%. In 12 cases (22%) the diagnosis was incorrect 8 of which were female patients. In 9.3% there was perforation. Wound infection and wound dehiscence occurred in 20.4% and 7.4% of the cases respectively. It is concluded from this study that acute appendicitis is commonly encountered in private Hospital, clinical course and postoperative outcome are not different from what obtained in major medical establishments.
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PMID:Acute appendicitis: a prospective study of 54 cases. 819 59

A retrospective study was performed to evaluate the usefulness of various historical, clinical, and laboratory findings in differentiating acute appendicitis from pelvic inflammatory disease (PID) in women of childbearing age. The records of all female patients presenting to the emergency department with abdominal pain who were found to have histologically proven appendicitis (n = 80) or PID confirmed on endocervical culture (n = 71) were reviewed. Clinically useful indicators favoring appendicitis included the presence of anorexia and the onset of pain later than day 14 of the menstrual cycle. Indicators favoring PID included a history of vaginal discharge, urinary symptoms, prior PID, tenderness outside the right lower quadrant, cervical motion tenderness, vaginal discharge on pelvic examination, and positive urinalysis. Despite these indicators, differentiating acute appendicitis from PID remains difficult.
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PMID:Differentiating acute appendicitis from pelvic inflammatory disease in women of childbearing age. 824 May 53

For studying abdominal tuberculosis (TB) in Ahmadi, files off all patients admitted to our hospital with abdominal TB over 15 years (1981-1996) were reviewed. Nineteen patients are reported here. Young adults were predominant in our study. The non-Arab Asians were the most frequently affected group in relation to their population in Ahmadi, and Kuwaitis were the least frequently affected group. Abdominal pain, sweating, anorexia and fever were the most frequent presenting symptoms. Ascites and intestinal obstruction were the most frequent clinical presentations. Two patients presented with acute appendicitis and one patient had tuberculous pancreatitis. Abdominal lymph nodes, peritoneum, ileum and and caecum were the most frequently affected abdominal structures. We found laparoscopy very helpful in diagnosis of abdominal TB and we recommend it as the diagnostic method of choice. All our patients responded well to antituberculous chemotherapy. It should be kept in mind that abdominal TB still affects the indigenous and expatriate population of Kuwait.
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PMID:Abdominal tuberculosis in Ahmadi, Kuwait: a clinico-pathological review. 970 Feb 74


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