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

Seventeen cases of acute appendicitis complicating pregnancy were analysed. The presenting symptoms were abdominal pain, nausea and anorexia. The usual physical findings were direct abdominal tenderness and rectal tenderness. Correct diagnosis was more difficult when gestation was advanced. This was reflected both by the severity of the disease process found at operation and by the increasing foetal mortality rate. Delay in diagnosis and treatment is the main factor causing high maternal and foetal death rates, especially when pregnancy is advanced.
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PMID:Acute appendicitis complicating pregnancy. 73 85

Thirty-four pregnant women with acute appendicitis presented at Parkland Memorial Hospital during a 15-year period. Abdominal pain, usually accompanied by nausea with or without vomiting, was the most common presenting symptom. Anorexia was less constant, and its occurrence decreased with advancing gestation. Physical findings usually included direct abdominal tenderness and, less often, rebound tenderness. Leukocytosis and/or a "left shift" were common laboratory findings, and the urinalysis was normal in most cases. Diagnosis was increasingly difficult as gestation progressed. This was reflected both by the increasing severity of the disease process found at surgery and by increasing fetal loss. If the diagnosis of appendicitis is suspected in the gravid patient, immediate surgical intervention is indicated to prevent the catastrophic complications associated with procrastination in diagnosis and treatment.
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PMID:Appendicitis complicating pregnancy. 112 71

This article discusses the findings of a study of pre-adolescent children to determine if the mode of presentation of appendicitis had changed over the past 10 years, if the incidence of perforations decreased with age, and if diagnosis related groups (DRGs) impacted the length of hospital stay. The charts of 42 children under the age of 12 years who were discharged from two inner-city hospitals with a diagnosis of acute appendicitis from 1980 to 1989 were reviewed. There were 20 blacks and 22 whites, 26 males and 16 females with an average age of 7.31 years (range: 2 to 11 years). Over 95% of patients presented with right lower quadrant pain, 78% with guarding, 80% with a positive psoas sign, 93% with a positive Rovsing's sign, and 65% with rectal tenderness. Over 85% of patients had a history of nausea, vomiting, and anorexia. The mean duration of pain was 52.8 hours and the mean temperature was 99.6 degrees F. The mean white blood cell count was 18,176 +/- 4682 for whites versus 14,615 +/- 5459 for blacks. At surgery 15/42 (36%) of patients had a perforation, 11 of whom had positive wound cultures. Escherichia coli was recovered in all 11 of these patients. The average duration of pain in the perforated group was 50.9 hours, and the average age was 7 years. Eleven of these patients had normal bowel sounds on admission. Only 31% of the total cohort had a fecalith identified by pathology. The average postoperative length of stay was 6.5 +/- 2.5 days before the initiation of DRGs and 7.5 +/- 3 days afterward.
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PMID:Appendicitis in children: a continuing clinical challenge. 140 59

A 45 year old man with personal history of B-Lactamic antibiotics allergy and one episode of hemochezia was admitted to hospital because of abdominal pain in the lower right quadrant and nausea, and diagnosed of acute appendicitis. At laparotomy he was found to have histological evidence of transmural eosinophilic enteritis in the terminal ileon and ascitis. After an intestinal resection a full evaluation was performed.
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PMID:[Acute abdomen caused by transmural eosinophilic enteritis]. 148 88

In this series, nine pregnant patients had appendectomy. Seven patients had acute appendicitis; pyuria and symptoms suggesting urinary tract infection delayed diagnosis in one whose appendix perforated. Abdominal pain and nausea with or without vomiting were presenting symptoms in all of the patients. Tenderness in the right lower quadrant was present in six. Eight patients, including two with a normal appendix, had leukocytosis with a left shift. There was no fetal or maternal loss. In addition, I reviewed more than 900 other cases of appendectomy during pregnancy, as reported in the literature since 1960. Among 713 previously reported cases of confirmed appendicitis, rupture had occurred in 25%. There were five maternal deaths, all in the group of patients with perforation. Perinatal mortality was 4.8% among patients with acute inflammation only and 19.4% in those with perforative appendicitis. The diagnosis rests on clinical acumen, and prompt surgical intervention is the key to good outcome.
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PMID:Appendicitis complicating pregnancy. 173 28

The retrospective analysis comprised 986 of 1050 patients operated on for acute appendicitis in the period 1983-1987. Appendicitis was most common in the age group from 11 to 20 years. The perforation frequency was 12.4%. Seventy four percent of patients came to the first medical examination with already perforated appendix. The necessary period of observation is the first 12 hours after onset of troubles. Probable presence of phlegmonous appendicitis is small if 48 hours have passed after initiation of troubles. The frequency of the studied symptoms (nausea, vomiting, temperature, leukocytosis) ranged from 49.4% to 64.8%. The most common postoperative complication is wound infection. The overall mortality rate was 0.1%.
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PMID:[Age distribution and clinical characteristics in acute appendicitis]. 189 69

Among a variety of acute abdomens, acute torsion of omentum, first reported by Marchett in 1851, is least suspected under the impression of, most commonly, acute appendicitis and then acute cholecystitis, mesenteric thrombosis, ovarian cyst, perforated peptic ulcer, etc. A 52-years-old woman was admitted on May 2, 1987 with anorexia, nausea and RLQ pain for 2 days. Physical examination revealed tenderness, guarding and rigidity over RLQ. White cell count was 12.100/mm3. A reducible hernia was found in the right inguinal region. The operation through McBurney's incision showed blood-stained fluid. Appendix was slightly congested. A solid, gangrenous mass was palpated at right iliac fossa that disclosed a completely tight torsion of omentum twisting 6 times counterclockwise with distal infarction. Segmental omentectomy, appendectomy and hernioplasty were done. The patient's recovery was uneventful. This case emphasizes the necessity of routine examination of the omentum during the course of abdominal exploration especially when serosanguinous fluid was encountered in the peritoneal cavity.
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PMID:[Acute torsion of greater omentum. Report of a case mimicking acute appendicitis]. 263 74

Fifty patients with a presumptive diagnosis of acute appendicitis based on usual Western medicine criteria (e.g., McBurney point tenderness, increase WBC, history of nausea, etc.) were examined prospectively for tenderness of the Lanwei acupoint, just prior to the administration of general anesthesia, to evaluate this well known 'Appendix' point as a useful aid to diagnosing appendicitis. The presence or absence of tenderness was statistically not a good indicator of appendicitis.
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PMID:The lack of importance of Lanwei point in the diagnosis of acute appendicitis. 338 May 55

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

One hundred eighteen patients with acute appendicitis operated on at Kawasaki Medical School Hospital during the 8-year period from Aug. 1, 1976 to Feb. 29, 1984 were reviewed. There were 78 children and 40 adults. The clinico-pathological types of acute appendicitis were: simple acute in 35 cases (29.7%); phlegmonous in 30 cases (25.4%); gangrenous in 24 cases (20.3%) and perforated in 29 cases (24.6%). Of the 78 children, 27 (34.6%) had perforated appendixes, whereas of the 40 adults only 2 (5.0%) showed perforated appendicitis. The initial symptoms were abdominal pain in 96.6%; nausea, vomiting or both in 33.1%, and fever in 11.9%. The physical findings on admission were abdominal tenderness in 99.2%, rebound tenderness in 52.5% and palpable mass in 17.8%. The mean body temperature on admission was 37.2 degrees C, and mean WBC count was 12,900/mm3. The roentgenography of the abdomen revealed the "sentinel loop sign" in 66.3%. In the patients under 15 years of age, the frequency of perforation seen in those underwent operation within 24 hours after onset and in those after 24 hours was 12.7% and 56.4%, respectively. From this result, it is advised that all the young patients suspected of having acute appendicitis should be admitted to the hospital promptly, and the diagnosis should be made within 24 hours.
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PMID:[Acute appendicitis: a study on 118 patients]. 400 Jan 2


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