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

A 6-year-old boy developed macroscopic haematuria on the 4th day after appendectomy for acute appendicitis, at which the appendix was found to be perforated. During the next few days the urine secretion decreased and malaise, pain in the lower abdomen, nausea and vomiting occurred. On a management of ample fluid administration, the urine secretion recovered and the symptoms subsided in a few days. In the early postoperative stage after appendectomy in children the possibility should be kept in mind of the development of acute renal insufficiency due to bilateral ureteral obstruction as a result of oedema of the posterior bladder wall, even if by means of ultrasonography only mild to moderate abnormalities are noted. Awaiting decompression by means of the introduction of bilateral ureteric stents, in order to prevent irreversible renal damage, supportive therapy with fluid administration depending on the diuresis seems indicated.
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PMID:[Acute renal insufficiency caused by bilateral ureteral obstruction after appendectomy in a 6-year old boy]. 1081 44

The goal of this study was to validate Alvarado's predictive model as a diagnostic test and to assess the effectiveness of computed tomography (CT) scan as a supplemental tool in the evaluation of acute appendicitis. Clinical and radiologic data of 215 patients with acute abdominal pain were evaluated. Clinical assessment was based on positive findings of migration of pain, anorexia, nausea and vomiting, tenderness of the lower right quadrant, rebound tenderness, fever, and leukocytosis with a left shift. Evaluation by CT scan had a sensitivity of 90.1% and a specificity of 94.1%. Clinical assessment based on the MANTRELS criteria had a sensitivity of 91.6% and a specificity of 84.7%. With the assistance of CT scan, sensitivity and specificity increased to 98.3% and 95.8%, respectively.
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PMID:The diagnosis of acute appendicitis: clinical assessment versus computed tomography evaluation. 1148 98

Diverticulitis of the right colon is a rare disease in the Western countries, so that the diagnosis still remains very difficult and frequently indistinguishable from acute appendicitis preoperatively. In presence of acute abdominal discomfort with pain referred to the right lower quadrant region, fever and hyperleukocytosis, nausea and vomiting, surgeons operate with a margin of uncertainty, because of the increased morbidity and mortality associated with delay in diagnosis and consequent perforation of acute appendicitis. Moreover the unexpected inflammatory colonic mass of uncertain etiology is sometimes mistaken for carcinoma at laparotomy and consequently a right hemicolectomy is performed. In these cases it should be better that right-sided colonic diverticulitis should be taken into account allowing a more correct surgical approach and even conservative treatment alone. Therefore, in case of suspected appendicitis, since our experience and literature data indicate that the mean age for right diverticulitis is over 40 years, also in presence of a significative Alvarado's score, computed tomography is strongly recommended, if the age is over 40 years.
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PMID:[Acute appendicitis or diverticulitis of the right colon? Diagnostic dilemma in emergency surgery]. 1593 28

Acute abdomen is a common presentation to the emergency department (ED), accounting for 5% to 10% of ED visits. Of these, 10% require surgery, and 25% go undiagnosed. Usually, most of the cases of undiagnosed abdominal pain are in young women with pelvic etiologies, although occasionally, unusual causes of abdominal pain lead to diagnostic dilemmas and can have adverse clinical outcomes. We present an unusual etiology of abdominal pain in a young man, who presented with acute onset of right lower quadrant pain accompanied by nausea and vomiting. He was an amateur boxer who had recently intensified his training regimen and admitted to binge drinking for several days before presentation. The initial diagnosis was acute appendicitis, but a computed tomographic scan done revealed a normal appendix. Creatine kinase level was then checked and found to be significantly elevated, and a diagnosis of isolated abdominal wall rhabdomyolysis was made.
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PMID:Rhabdomyolysis: a lesson on the perils of exercising and drinking. 1841 Aug 42

Tuberculous peritonitis is rare in most Western counties, and can cause significant diagnostic and therapeutic problems. A 28-year-old pregnant female presented with nausea and vomiting, right lower quadrant abdominal pain, fever and intra-abdominal fluid. During surgery for presumed complicated acute appendicitis, many small masses (considered to be 'implants') were found within the peritoneal cavity, with a larger mass in the pelvis, mainly on the right. The clinical intra-operative diagnosis was advanced ovarian cancer and multiple biopsies were taken. The histological diagnosis was peritoneal tuberculosis. The patient was successfully treated conservatively. Hasty decisions to undertake radical and irreversible surgery should be avoided; this type of surgery should be performed only after histological confirmation.
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PMID:Peritoneal tuberculosis in pregnancy mimicking advanced ovarian cancer: a plea to avoid hasty, radical and irreversible surgical decisions. 1913 1

Right iliac fossa pain, nausea and vomiting in young adults are common symptoms that require careful surgical assessment with acute appendicitis being a common cause. Uncommonly, other conditions can mimic this presentation such as caecal diverticulitis. This condition is often misdiagnosed due to lack of characteristic features and the commonest method of detection is an intraoperative one. Hereby, we describe a rare case of right iliac fossa pain in a 34-year-old female which mimicked an acute appendicitis. The ability to recognize such condition is vital as its management is different and worse outcome can be prevented by earlier detection and proper management.
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PMID:Perforated caecal diverticulitis mimicking an acute appendicitis: a case report. 1991 95

Stump appendicitis is a rare delayed complication of appendectomy. The delay in diagnosis is usually because of a prior history of appendectomy. We report a case of stump appendicitis diagnosed pre-operatively with a computerized tomography (CT) scan after laparoscopic appendectomy. An 18-year-old male presented with a one-week history of lower abdominal pain, nausea and vomiting. He had a history of laparoscopic appendectomy for acute appendicitis. Physical examination revealed tenderness and guarding in the lower abdomen. CT scan showed free pelvic fluid with a tubular structure of about 2.5 cm in length and 0.78 cm in diameter located posterior to the ileo-cecal junction. Laparoscopic exploration confirmed the findings. A residual appendiceal stump was found and dissected from the adhesion and removed. Histopathology showed a residual appendix with transmural neutrophilic infiltration associated with multifocal hemorrhagic necrosis. The postoperative period was uneventful. The diagnosis of stump appendicitis can be challenging. CT scan has proven to be a useful tool for the diagnosis of this rare condition.
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PMID:Stump appendicitis after laparoscopic appendectomy: case report. 2193 7

Acute appendicitis can be the first symptom of the malignant tumour of the cecum. In the article we described case of 76 years old patient who came to the hospital on account pain in the right iliac hole, occurrent for 4 days with nausea and vomiting. Primarily patient classified to the appendectomy. The ultrasound examination showed the pathological mass in projection ileocecal valve and appendicitis. The computer tomography of the abdomen confirmed this diagnosis. The patient became classified to the right-sides hemicolectomy. The result of histopathological examination is adenocarcinoma of the ileocaecal valve and the appendicitis phlegmonous. Patient became classified to the adiuvant chemotherapy in the regional oncological centre.
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PMID:[Acute appendicitis masking adenocarcinoma of the cecum]. 2576 85

Acute abdominal pain in pregnancy remains a surgical conundrum. A 25-year-old primigravid at 29 weeks gestation presented with a two-week history of epigastric pain, nausea and vomiting. She had a distended abdomen consistent with a full term gravid uterus; tender at the epigastric and right hypochondrium suggestive of small bowel obstruction or acute appendicitis. Abdominal ultrasound was inconclusive but abdominal Computed Tomography (CT) suggested small bowel volvulus. An exploratory laparotomy revealed a segmental jejunal volvulus and small bowel diverticulum contributing to the volvulus. A short segmental bowel resection was performed. Histopathology confirmed a Meckel's Diverticulum. The patient recovered well but underwent premature labour 10 days later. Small bowel obstruction secondary to Meckel's diverticulum is rare in pregnancy. In an acute gestational abdomen, clinical examination is key. Radiological imaging may be helpful, whilst surgical intervention is confirmatory and therapeutic in the event of an obstructive volvulus.
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PMID:Pregnant and severe acute abdominal pain: A surgical diagnostic dilemma. 2615 17

Timely management of patients presenting to the ED while in their first trimester of pregnancy can improve outcomes for both the patient and the fetus. Common obstetric problems encountered include vaginal bleeding and miscarriage, ectopic pregnancy and pregnancy of undetermined location, and nausea and vomiting of pregnancy, including hyperemesis gravidarum. Optimal diagnostic approaches and management strategies are covered, including which antiemetics are safe to give in pregnancy. Common nonobstetric problems include asymptomatic bacteriuria, urinary tract infections including pyelonephritis, and acute appendicitis. This article also reviews the various imaging modalities available for pregnant patients and reviews the risks of ionizing radiation as well as various contrast media.
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PMID:First trimester pregnancy emergencies: recognition and management. 3057 Feb 48


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