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

A retrospective review is presented of seven cases of epiploic appendagitis, with surgical confirmation in one case. The main clinico-analytical data and the US and CT findings are described, as well as the histopathologic features in the sole case that underwent surgical resection. We also calculated the frequency of this entity in patients undergoing emergency abdominal US on clinical suspicion of diverticulitis. In all seven cases the clinico-analytical evidence was nonspecific (localized acute abdominal pain and slight leukocytosis), mimicking in six cases the clinical presentation of sigmoid diverticulitis and in one case that of acute appendicitis. US imaging findings were characteristic: a hyperechoic mass localized under the point of maximum pain, adjacent to the anterior peritoneal wall and fixed during deep breathing. In none of the cases did color Doppler US show flow. CT findings were also typical and showed a mass with a peripheral hyperattenuated rim surrounding an area of fatty attenuation. Overall 7.1 % of patients investigated to exclude sigmoid diverticulitis finally showed findings of primary epiploic appendagitis. Primary epiploic appendagitis thus shows characteristic US and CT findings that allow its diagnosis and follow-up. This entity is much more frequent than previously reported, especially in patients referred for US to exclude sigmoid diverticulitis.
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PMID:Primary epiploic appendagitis: US and CT findings. 951 May 79

Paratubal cysts represent remnants of the paramesonephric or mesonephric duct, the former being more common. Most of them are asymptomatic, but they may rarely give rise to clinical problems due to enlargement or torsion. In this study, we looked for paratubal cysts or other pathological lesions of the right uterine adnexa in young females operated upon for right lower quadrant (RLQ) abdominal pain. Our material consisted of 338 white female patients aged 4-14 years. Laparotomy revealed only acute appendicitis in 283 cases, while 44 had acute appendicitis plus a coincidental paratubal cyst. Most of these cysts were smaller than 1 cm in diameter. However, 2 additional cases had torsion of a large paratubal cyst, while 5 had a ruptured corpus luteum. We suggest that a thorough search of the right adnexa for the presence of paratubal cysts during laparotomies performed for RLQ pain is a useful procedure. This approach also allows detection of other pathological lesions of the right adnexa that often produce symptoms similar to acute appendicitis.
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PMID:Paratubal cysts in young females as an incidental finding in laparotomies performed for right lower quadrant abdominal pain. 956 27

In the elderly, both the diagnosis and treatment of acute appendicitis require particular attention. The diagnosis is often made very late with 40% to 80% of the cases already having perforated. Reasons for the delayed hospitalisation include atypical course, reduction in sensitivity to pain in old age, and an inadequate ability to communicate. The prognosis of uncomplicated appendicitis is just as good in the old as in the young patient, but perforation and concomitant diseases worsen the situation appreciably. Early operation is therefore desirable. The preference of the author is for open, rather than laparoscopic, appendectomy.
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PMID:[Acute appendicitis in advanced age]. 957 72

The probability diagnosis in two patients, women aged 43 and 41 years, who for the last few days had had pain in the right lower abdomen, without nausea or vomiting, was acute appendicitis; a third patient, a woman aged 49 with the same symptoms, had undergone appendectomy in the past. Peroperative findings and, in two patients, microscopy of the resected specimen showed diverticulitis in the caecum or ascending colon. This is an uncommon disease, which mimicks acute appendicitis. Treatment depends on the severity of the inflammation. In the absence of perforation or abscess, conservative treatment suffices. Otherwise, resection of the colon is necessary.
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PMID:[Right-sided diverticulitis mimicking acute appendicitis]. 975 49

Acute scrotum is an exceptional form of presentation of acute appendicitis in the pediatric age group. Only 14 cases have been described in literature. The authors report a case of an 8-year-old boy with a 12-hour history of right hemiscrotal pain secondary to acute retrocecal nonperforated appendicitis. Surgical exploration showed a patent "processus vaginalis."
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PMID:Acute scrotum: an exceptional presentation of acute nonperforated appendicitis in childhood. 1044 16

We report a case of acute appendicitis in situs inversus treated by laparoscopy. In our opinion, diagnostic laparoscopy is indicated if acute appendicitis is suspected in a patient with situs inversus totalis, either because the pain can be referred to the right iliac fossa in about 50% of the patients, or because the incision in open surgery cannot be sufficient to allow complete exploration of the abdomen. The operation can then be carried out laparoscopically if possible; if not, an appropriate surgical incision can be made.
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PMID:Suspected appendicitis in situs inversus totalis: an indication for a laparoscopic approach. 979 54

The diagnostics of acute appendicitis is also a challenge for a surgeon today. The question of suitable, supplement diagnostics methods is topical. Experience with percutan sonography in the hand of surgeon in one-year-study are demonstrated and possibilities, problems and views should be to show. In skilled hand the sonography is an easy, little burden and helpful method to determinate right lower pain.
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PMID:[Value of ultrasound in diagnosis of appendicitis]. 988 Aug 69

The diagnostic laparoscopy represents a special technique with high impact for differential diagnosis especially in patients with chronic recurrent pain in the right lower abdomen. The East-German multicentric trial confirmed the actual trend of increasing importance of the laparoscopic method especially in patients with unclear abdominal findings. In case of surgical treatment because of chronic appendicitis in 61.7% (n = 370) of all these cases an laparoscopic procedure was preferred. Unclear abdominal findings were treated in 73.7% (n = 205) laparoscopically. In case of acute appendicitis in 72.2% (n = 2934) the open procedure was preferred. The diagnostic laparoscopy can avoid the overlook of findings requiring therapy. The consequent laparoscopic approach allows to achieve a decreased rate of non necessary laparotomies as well as non detected findings requiring surgery. The rate of gynaecological findings was 16.2% (n = 184) of all women who underwent diagnostic laparoscopy versus 6.4% who underwent open appendectomy (n = 116).
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PMID:[Diagnostic laparoscopy within the scope of appendicitis treatment. East German Working Group "Outcome Assessment and Quality Assurance in Surgery" of the CAQ of the German Society of Surgery]. 988 Aug 71

The appendicitis is the commonest cause of an acute abdomen in children older 1 year of age. Only 5% of children with appendicitis are younger than 2 years of age. There is a familial preponderance. The younger the child the faster the symptoms of the disease are increasing in intensity. The symptoms starts with unspecific periumbilical or epigastric pain, followed by nausea, vomiting and restlessness at night. Finally the pain moves to the position of the appendix. The position of the appendix shows a high variation in children thus the pain characteristic is not uniform. Laboratory tests are not reliable but ultrasonography is recommended to exclude other diseases and to try to confirm the diagnoses. With the technique of "Graded compression Sonography" the rate of non identified appendicitis has been reduced under 5%. Laparoscopy is another option. Its use just for diagnostic purposes is limited but is recommended widely for primary therapeutic treatment with laparoscopic performed appendectomy. Laparoscopy has a special advantage against conventional appendectomy in the diagnostic of recurrent unspecific abdominal pain in children and in cases with interval appendectomy. Finally in pseudoappendicitis and pseudoperitonitis in children with immunvasculitis and other extraabdominal diseases. Letality of the acute appendicitis is zero.
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PMID:[Acute appendicitis in the child]. 988 Aug 78

In a prospective study 950 appendectomies were done consecutively from May 1992 to September 1997. When indication for appendectomy was given all patients were operated on endoscopically. In 5.5% of cases had to be turned to open operation. 17 different surgeons are involved. Even the first appendectomy in adjucation of young residents was done endoscopically. 372 (39.15%) male and 578 (60.85%) female patients were operated. Average age was 25.3 years (4 to 84 years). In 11% of cases so-called chronic recurrent appenditicis as indication was accepted only after careful exclusion of other reasons for complaint. Mean duration of operation time was 44.5 min (15 to 170 min). Hospital stay was influenced subjectively 6.1 day (1 to 19 days). Examination of specimen by the pathologist shows following results: perforated appendicitis 7%; acute appendicitis 50%; chronic recurrent 33%; no pathologic changes 9%; carcinoide or oxyures 1%. The Postoperative complication rate was very small: only 2.7% (relaparotomy because of small bowel obstruction: 4, paracolic abscess after severe phlegmonic inflammation: 4, infected haematomas: 2, relaparotomy because of unobserved deverticula of Meckel with severe inflammation: 1, delayed woundhealing: 8, postoperative pain with duration long than: 24 hours: 7).
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PMID:[Endoscopic surgical technique in appendectomy. Experiences and results of 950 laparoscopic appendectomies]. 988 Aug 83


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