Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0085693 (acute appendicitis)
 3,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The case of a 6-year-old girl with right lower quadrant pain is presented. For several days, she had experienced pain that worsened and then was accompanied by vomiting and low-grade fever. Acute appendicitis was considered, but at laparotomy she was found to have a necrotic, torsed ovary. The natural history, clinical presentation, and diagnostic features of ovarian torsion are reviewed.
 ...
PMID:Ovarian torsion: an unusual cause of abdominal pain in a young girl. 775 24

Initial experience with laparoscopic and thoracoscopic surgery in children during the year Sept. 1992-Sept. 1993 is presented. The 36 procedures included 20 appendectomies, 3 cholecystectomies, 10 upper thoracic sympathectomies, 1 bilateral oophorectomy and 2 diagnostic laparoscopies. Indications were appendicitis, symptomatic gallstones, idiopathic primary palmar hyperhidrosis, and gonadal dysgenesis (xo/xy mosaicism) in a 13-year-old girl. 2 diagnostic laparoscopies were performed for chronic abdominal pain and for a possible retroperitoneal lesion, respectively. All procedures were successfully managed without complications. In 2 cases of acute appendicitis it was necessary to change to the open conventional technique because of technical difficulties. Duration of hospitalization for cholecystectomy and sympathectomy was significantly shorter than with the conventional surgical approach and convalescence was excellent, with less postoperative pain. As for the surgical approach in acute appendicitis, we cannot as yet decide whether or not laparoscopy is superior to the conventional technique.
 ...
PMID:[Laparoscopic and thoracoscopic surgery in children and adolescents]. 780 99

The article deals with the results of clinical use of a laparoscopic suturing instrument in appendectomy in 2 patients with acute appendicitis. The authors describe the techniques of laparoscopic appendectomy with application of a mechanical suture to the mesentery and stump of the process. The advantages of this operation over the traditional interventions in acute appendicitis are shown: the absence of the pain syndrome after the operation, shorter duration of in-patient treatment, and the best cosmetic effect.
 ...
PMID:[Use of laparoscopic suturing devices in abdominal surgery]. 783 43

Laparoscopic appendectomy is an attractive option for the surgical treatment of acute appendicitis. When performed by an experienced laparoscopist, the procedure can be accomplished with little variation in time from the standard open technique, provide a superior cosmetic result, shorter hospital stay and a significant reduction in postoperative pain and length of convalescence. In this study a comparison of 42 open appendectomies and 37 laparoscopic appendectomies was made in regard to age, sex, length of stay, cost of stay, and length of convalescence.
 ...
PMID:Laparoscopic appendectomy: have we found a better way? 786 68

Cecal diverticulitis is a rare disease entity, the diagnosis of which remains a difficult problem. The clinical picture of cecal diverticulitis is almost indistinguishable from acute appendicitis. We reviewed 11 cases of pathologically documented cecal diverticulitis who underwent treatment from May 1981 to April 1992. They were diagnosed incorrectly as acute appendicitis, ruptured appendicitis or appendiceal abscess prior to operative intervention. Thirty patients diagnosed correctly with acute appendicitis from March 1992 to April 1992 were included for a comparative study. We found that cecal diverticulitis presented with a longer duration of symptoms, initial pain over the right lower quadrant of the abdomen, older age, less migration of pain, nausea, vomiting, fever and leukocytosis, and an incidence of Alvarado's score > or = 7 than acute appendicitis.
 ...
PMID:Can cecal diverticulitis be differentiated from acute appendicitis? 792 71

The role of clinical and computer based decision in the diagnosis of acute appendicitis in the elderly was studied in connection with the Research Committee of the World Organization of Gastroenterology (OMGE) survey of acute abdominal pain. A total of 220 patients over the age of 65 years presenting with acute abdominal pain were included in the study at the Central Hospital of Savonlinna and at the University Hospital of Tampere. Twenty-two preoperative clinical history variables, 14 clinical signs and three tests were evaluated in a single variable and multivariate analysis to find the best combination of predictors of acute appendicitis in the aged. In order to sum up the contributions of independent diagnostic factors, a diagnostic score (DS) was built: DS = 2.81 x (rectal digital tenderness; 1 = yes, 0 = no) + 2.54 x (rigidity; 1 = yes, 0 = no) + 2.06 x (renal tenderness; 1 = no, 0 = yes) + 2.33 x (bowel sounds; 1 = normal, 2 = absent/abnormal) - 8.13. The sensitivity of preoperative clinical decision in detecting acute appendicitis in the aged was 0.79 with a specificity of 0.92, an efficiency of 0.90 and usefulness index (UI) of 0.56. At a cut-off level of -2.78 the DS reached a sensitivity of 0.84 in detecting acute appendicitis with a specificity of 0.87, an efficiency of 0.87 and UI of 0.68. When the patients with a DS value between -2.78 and -0.45 were considered as non-defined (n = 28, follow-up required before the decision to operate), the sensitivity of the computer-aided diagnosis in detecting acute appendicitis in the elderly was 0.77 with a specificity of 0.97, an efficiency of 0.96 and UI of 0.57. In the elderly patients where a leucocyte count was available (n = 157), location of pain, rectal digital tenderness and leucocyte count predicted significantly acute appendicitis. At a cut-off level of -2.62 the DS reached a sensitivity of 0.81 in detecting acute appendicitis with a specificity of 0.92, an efficiency of 0.91 and UI of 0.59. When the patients with a DS value between -2.62 and 0.06 were considered as nondefined (n = 12, follow-up required before the decision to operate), the sensitivity of the computer-aided diagnosis (leucocyte count available) in detecting acute appendicitis in the elderly improved to 0.86 with a specificity of 0.94, an efficiency of 0.93 and UI of 0.69. In our study the diagnostic scoring system for the elderly performed well considering the simple nature of its structure.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:Acute appendicitis in patients over the age of 65 years; comparison of clinical and computer based decision making. 796 Feb 9

The immune status was studied during the development of the disease in 182 children who were operated on for acute appendicitis. T lymphocytes and their subpopulations circulating in the blood, as well as B lymphocytes, immunoglobulins A, M, G, and immune complexes were determined. The character of changes of these values before the operation and in various postoperative periods were determined. The effect of complex treatment, including T-activin, on the clinical and immunological parameters in children with acute appendicitis was appraised. Analysis of the results showed that a transitory immunodepressive state forms in children with the disease, which is more marked in the destructive form, with normalization of the main values of cell-mediated and humoral immunity by the 7th day after appendectomy. In a complicated course of acute appendicitis the state of immunodeficiency is torpid in character and does not return to normal values even after clinical recovery, i.e. before discharge from the clinic. Inclusion of the immunostimulating agent T-activin into the complex treatment of patients with appendicitis ensures a more rapid involution of the main clinical manifestations of the disease. The therapeutic effect was most pronounced in destructive appendicitis: after 3 days of treatment the pain syndrome was encountered twice less frequently and intestinal paresis more than twice less frequently in these patients, and the term of hospital stay (8.8 +/- 0.4 days) was less shorter than for children of the control group (12.2 +/- 1.9 days) who did not receive T-activin in the therapeutic complex.
 ...
PMID:[Immunotherapy for the treatment of acute appendicitis in children]. 799 Mar 19

Thirty-four patients (23 females and 11 males) aged 13-71 years had acute appendicitis on both clinical and laparoscopic evaluation. Twenty-eight patients (82%) were treated laparoscopically whereas conversion to open appendectomy was necessary in six patients. Operation time for laparoscopic appendectomy ranged from 25-90 min. (mean 58 min.), and the patients were discharged 1-14 days after the operation (mean 2.8 days). Five patients developed complications, wound infection in one case, intraperitoneal infectious complications in three cases and postoperative fever in one case. Mean convalescence was two weeks. All patients were satisfied with the performed procedure and the cosmetic result and all were doing well one month after the operation, except for one patient who had pain in the right iliac fossa. The initial results of laparoscopic appendectomy are promising.
 ...
PMID:[Laparoscopic appendectomy. Results and complications]. 800 16

To identify differences between correctly diagnosed appendicitis and misdiagnosed cases that resulted in litigation between 1982 and 1989 retrospective review of malpractice claims was conducted. A total of emergency department (ED) charts at the time of the initial ED visit were reviewed and compared with 66 concurrent controls. Missed cases appeared less acutely ill, had fewer complaints of right lower quadrant pain, received fewer rectal examinations, received intramuscular (IM) narcotic pain medication for undiagnosed abdominal pain or symptoms, and more often received an ED discharge diagnosis of gastroenteritis. Misdiagnosed patients had a 91% incidence of ruptured appendix, more extensive surgical procedures, and more postoperative complications. Data were analyzed using the Pearson's chi 2 Test, Mann-Whitney U Test, and stepwise discriminant analysis. Significance was defined as P < or = .05. Misdiagnosis of acute appendicitis is more likely to occur with patients who present atypically, are not thoroughly examined (as indexed by documentation of a rectal examination), are given IM narcotic pain medication and then discharged from the ED, are diagnosed as having gastroenteritis (despite the absence of the typical diagnostic criteria), and with patients who do not receive appropriate discharge or follow-up instructions.
 ...
PMID:Misdiagnosis of acute appendicitis: common features discovered in cases after litigation. 803 44

Randomised assessment of new laparoscopic surgical techniques is difficult. Surgeons need time to become experienced with the methods and tend, when they have experience, to favour one or other approach. We have carried out a prospective randomised comparison of laparoscopic and conventional appendicectomy done by surgeons of comparable experience in patients with suspected acute appendicitis. Postoperative management decisions were made by surgeons other than the operating surgeon. 140 patients were randomly assigned to open (OA) or laparoscopic (LA) appendicectomy (70 each). The age, sex ratio, duration of symptoms, and proportion of patients with histologically confirmed appendicitis was similar in the two groups. Operating time was longer for LA than for OA (mean 70.3 [SD 21.9] vs 46.5 [25.9] min; p < 0.001). There were no major intraoperative complications in either group. 14 (20%) patients in the LA group required conversion to an open operation. No significant differences between the groups were found postoperatively for pain score, analgesic requirement, time to reintroduction of diet, or hospital stay. 46 LA patients and 42 OA patients attended follow-up 3 weeks after surgery. Similar proportions had returned to work (36 [79%] vs 31 [74%]). The frequency of wound complications and wound pain after leaving hospital was lower after LA but not significantly so. We conclude that the postoperative course after LA and conventional OA does not differ significantly.
 ...
PMID:Laparoscopic versus open appendicectomy: prospective randomised trial. 790 71


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>