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

An eight year old female had laparotomy for general peritonitis due to acute appendicitis. Postoperative course was uneventful until the seventh day when abdominal pain, and distension and vomiting ensued which did not respond to conservative management. At repeat laparotomy, an ileoileal intussusception was found and reduced without difficulty. Intussusception is an uncommon but important cause of postoperative intestinal obstruction. Since the typical features of intussusception are usually absent and radiology frequently unhelpful, a high index of clinical suspicion is necessary for early diagnosis and treatment to avoid strangulation and perforation.
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PMID:Postoperative intussusception in childhood: case report. 1044 51

Our patient had a history of chronic endometriosis and pelvic pain and complained of recent onset of right-sided abdominal pain, nausea, and vomiting. Transvaginal ultrasonography revealed a thick-walled mass superior and medial to the right ovary, which was thought to be an inflamed appendix. The woman was not pregnant, and the structure appeared to be anatomically separate from the uterus. Subsequent laparoscopy confirmed the diagnosis of acute appendicitis; uncomplicated laparoscopic appendectomy followed. In the setting of chronic endometriosis, other nongynecologic sources of acute pelvic pain must be considered. Surgical intervention is appropriate whenever clinical suspicion for an acute abdomen is high, and the a priori diagnosis of endometriosis should not result in operative delay.
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PMID:Transvaginal ultrasonographic identification of appendicitis in a setting of chronic pelvic pain and endometriosis. 1121 49

A 12-year-old girl presented with lower abdominal pain, nonbilious vomiting, and a severe secretory diarrhea. Infectious and noninfectious etiologies were ruled out, and she was found to have perforated acute appendicitis. It is essential to consider acute appendicitis in the differential diagnosis for secretory diarrhea and abdominal pain in the pediatric population.
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PMID:Acute appendicitis presenting as secretory diarrhea. 1203 68

We review the clinical report of 110 patients that were operated on by a laparoscopic appendectomy in our hospital since January 1992 until december 2000. In 66 patients the reason was an acute appendicitis, and recurrent abdominal pain in 44. The age of them was between 4 and 19 year old with a mean of 10.8; there were 44 males (39%) and 66 females (61%). The maximum weight was 70 kg and the minimum 15, with a mean of 41. In 23% of them vomiting was present in the postoperative period. The hospital stay was 2 or 3 days in 73% of the patients. In acute appendicitis patients 66.1% were with acute inflammation, in 29% complicated and 4.8% negative appendicitis. Of recurrent abdominal pain patients in 50% we found pathological alterations. Finally we had complications in 13% of cases. As conclusion we achieve a reduction in hospital stay, the patients and parents appreciate it, this approach allow a better exploration of abdominal cavity and in those patients with recurrent abdominal pain we obtained a clinical improve.
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PMID:[Nine years of experience with laparoscopic appendectomy in children]. 1260 80

We presented a case of a 55-year-old woman who intentionally ingested an unknown amount of carbosulfan, a carbamate insecticide. On admission, her clinical findings were coma, pinpoint pupils, hypersalivation, respiratory failure, bradycardia, and hypotension. Hertrachea was intubated after suction of secretions, and atropine was administered intravenously. After gastric lavage, multiple doses of activated charcoal were instilled through the nasogastric tube over five days (total doses of 840 g). On the fourteenth day, she developed right-lower quadrant abdominal pain, anorexia, nausea, and vomiting, and she underwent an appendectomy. On pathologic examination of the specimen, particles of activated charcoal were seen within the dilated part of the appendiculer lumen. The patient was discharged from the hospital after antidepressant therapy at the psychiatry clinic. This case documents that multiple doses of activated charcoal may be associated with acute appendicitis.
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PMID:Multiple dose-activated charcoal as a cause of acute appendicitis. 1264 71

The aim of our study was to further improve the preoperative diagnosis of acute appendicitis in children and adolescents. All diagnostic parameters from the patients' medical history (duration and quality of abdominal pain, stool behaviour), the laboratory (leukocytes, C-reactive protein), the clinic (defense, tenderness on percussion, nausea, vomiting, dry tongue) and repeated ultrasound investigations (visualisation of the appendix, indirect signs of an inflammatory process in the appendix region) were documented prospectively and were re-assessed with regard to their diagnostic value. As an additional parameter, procalcitonin was determined. 1156 patients (593 male/563 female) with a mean age of 9.51 years (+/- 1.2 yrs) (max. 15 yrs/min. 2.3 yrs), referred to the department with acute abdominal pain, were examined. 233 (141 male/92 female; 20.1 %) of these patients with a mean age of 10.47 years (+/- 1.1 yr) had appendicitis. Based on the patients' medical history, laboratory findings, the initial clinical investigation and the initial ultrasound investigation, 173 patients (74.3 % of the later operated 233 children with appendicitis) were diagnosed with certainty. The diagnosis of 60 patients (25.7 %) of this group remained uncertain. These patients received a saline enema (Clysmol, Pharmacia & Upjohn Company) and were subjected to a second clinical and sonographic investigation after approximately four hours of parenteral fluid substitution (Ringer's lactate, Mayrhofer Pharmazeutika Company, 4 ml/kg/h). The other 923 patients (79.83 %) were discharged and were followed up as outpatients in the following days. Based on this stepwise procedure, the percentage of correctly diagnosed appendicitis could be increased to 97.4 %. The measurement of procalcitonin proved to be of no value in the diagnosis of acute appendicitis. It may be concluded that in children with abdominal pain, high diagnostic accuracy can only be achieved by a carefully combined evaluation of all individual diagnostic parameters and repeated investigations.
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PMID:Advancements in the diagnosis of acute appendicitis in children and adolescents. 1563 Jun 42

We reviewed the medical records of 62 patients with systemic small and medium-sized vessel vasculitides and gastrointestinal tract involvement followed at our institution between 1981 and 2002. This group included 46 men and 16 women (male:female ratio, 2.9), with a mean age of 48 +/- 18 years. Vasculitides were distributed as follows: 38 polyarteritis nodosa (21 related to hepatitis B virus), 11 Churg-Strauss syndrome, 6 Wegener granulomatosis, 4 microscopic polyangiitis, and 3 rheumatoid arthritis-associated vasculitis. Gastrointestinal manifestations were present at or occurred within 3 months of diagnosis in 50 (81%) patients and were mainly abdominal pain in 61 (97%), nausea or vomiting in 21 (34%), diarrhea in 17 (27%), hematochezia or melena in 10 (16%), and hematemesis in 4 (6%). Gastroduodenal ulcerations were detected endoscopically in 17 (27 %) patients, esophageal in 7 (11%), and colorectal in 6 (10%), but histologic signs of vasculitis were found in only 3 colon biopsies. Twenty-one (34%) patients had a surgical abdomen; 11 (18%) developed peritonitis, 9 (15%) had bowel perforations, 10 (16%) bowel ischemia/infarction, 4 (6%) intestinal occlusion, 6 (10%) acute appendicitis, 5 (8%) cholecystitis, and 3 (5%) acute pancreatitis. (Some patients had more than 1 condition.) Sixteen (26%) patients died.The respective 10-month and 5-year survival rates were 71% (95% confidence interval [CI], 52-90) and 56% (95% CI, 35-77) for the 21 surgical patients; and 94% (95% CI, 87-101) and 82% (95% CI, 70-94) for the 41 patients without surgical abdomen (p = 0.08). Peritonitis (hazard ratio [HR] = 4.3, p < 0.01), bowel perforations (HR = 5.7, p < 0.01), gastrointestinal ischemia or infarctions (HR = 4.1, p < 0.01), and intestinal occlusion (HR = 5.5, p < 0.01) were the only gastrointestinal manifestations significantly associated with increased mortality in multivariate analysis. For this subgroup of 15 patients, 6-month and 5-year survival rates were 60% (95% CI, 35-85) and 46% (95% CI, 19-73), respectively (p = 0.003). None of the other gastrointestinal or extraintestinal vasculitis-related symptoms, or angiographic abnormalities (seen in 67% of the 39 patients who underwent angiography), was predictive of surgical complications or poor outcome. However, prognosis has dramatically improved during the past 30 years, probably owing to better management of these more severely ill patients, with prompt surgical intervention when indicated, and the combined use of steroids and immunosuppressants.
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PMID:Presentation and outcome of gastrointestinal involvement in systemic necrotizing vasculitides: analysis of 62 patients with polyarteritis nodosa, microscopic polyangiitis, Wegener granulomatosis, Churg-Strauss syndrome, or rheumatoid arthritis-associated vasculitis. 1575 41

An unusual cause of acute abdominal pain simulating acute appendicitis is presented. The patient was admitted with complaints of fever, malaise, headache, nausea, vomiting, diarrhoea, and severe bleeding. Based on the clinical and epidemiological findings, a diagnosis of Crimean Congo hemorrhagic fever virus infection was suspected, and ribavirin therapy was started. While her clinical condition was improving, she experienced a sudden pain at her right lower quadrant of the abdomen. Explorative laparotomy revealed haemorrhage within the abdominal muscles. Her CCHF IgM was found to be positive.
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PMID:Crimean Congo hemorrhagic fever infection simulating acute appendicitis. 1584 39

Appendicitis has rarely been reported following solid organ transplantation and never following liver transplantation. We reviewed records of all patients who received solid organ transplants at UCLA between 1989 and 2002 and subsequently underwent appendectomy for presumed acute appendicitis. Of nearly 8000 transplant patients, 17 (nine male, eight female) subsequently underwent appendectomy for presumed acute appendicitis. Average age at appendectomy was 37 yrs (range 6-73 yrs). Organ transplants included liver (seven patients), heart (four), kidney (three), kidney-pancreas (two), and heart-kidney (one). The mean interval from transplant to appendectomy was 1064 d (16-2977). Presenting symptoms and signs included abdominal pain in 16 patients (94%); nausea and or vomiting in 15 (88%); right lower quadrant tenderness in 16; and leukocytosis (WBC > 10 000) in 13 (76%). Mean interval from presentation to appendectomy was 0.94 d (range 0-4). Computed tomography (CT) was performed in 16 patients and showed signs of acute appendicitis in 15. Open technique was used in all patients, preceded by laparoscopy in one. Pathology showed appendicitis in 15 patients (one with perforation), serositis in one, and a normal appendix in one. Mean duration of hospitalization was 7 d (range 1-20). Complications occurred in four patients (24%) and included intra-abdominal abscess requiring percutaneous drainage, ventral hernia, small bowel obstruction, and hematuria in one patient each. There were no deaths and no cases of acute rejection during hospitalization. Average length of follow-up was 712 d (range 3-2492). We conclude that appendicitis is relatively rare following solid organ transplantation. CT facilitates prompt diagnosis. The clinical presentation is similar to that of non-transplant patients, but complications are more frequent, and hospitalization is longer.
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PMID:Acute appendicitis after solid organ transplantation. 1655 58

The authors present a case of a 32 year old pregnant woman who is admitted to the Obstetric clinic in the 16th gestational week with a pain in the ileoceacal region of the abdomen and vomitting. The woman has clinical signs of acute abdomen. A clinical diagnosis of acute appendicitis was suggested. During the operation under general anesthesia was found a phlegmonous inflammation of a Mekel diverticulus with perforation as well as local peritonitis and a catharal inflammation of the appendix. The appendix and the Mekel diverticle were removed during the operation. No comlications were observed during the post operative period. No fetal distress was observed during and after the operation Three months later the same patient was admitted to the obstetric clinic in the 32nd gestational week with a diagnosis Threatened premature delivery in ml VIII status post resection of a Mekel diverticle and appendectomy. The patient had pain to the right of the umbilicus and vomiting. The labor was induced and a viable premature infant was born. Two days after delivery there was again a clinical symptoms and signs of an acute abdomen due to ileus. A strangulation of the terminal ileum was found due to adhesions A Debridman and a lavage were performed No complications were observed during the postoperative period. The authors discuss the difficulties which might ensue when the diagnosis acute abdomen is made in a pregnant woman
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PMID:[A case report of two incidents of acute abdomen in a woman during pregnancy and in the early puerperium]. 1663 7


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