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

Acute appendicitis is the most frequent disease in children population that requires an urgent surgical intervention. Only 2% of operated children belong to the group younger than 3 years. Yet, 77% are school children. Appendicitis in young children is characterized by: atypical clinical course, late diagnosis, high percentage of perforations, and high level of mortality and morbidity rates. The commonest symptoms are: vomiting, undefined abdominal pain, and high temperature. Abdominal distention and diffuse abdominal tenderness are the most frequent signs during examination. Our analysis (1991-2000) included all patients younger than 3 years who were hospitalized in Clinic for Pediatric Surgery Nis with diagnosis of the acute appendicitis. Out of 2533 patients with disease, 58 (2.3%) were younger than 3 years, 23 were girls (39.7%) and 35 were boys (60.3%). Perforated appendicitis was found in 55 (94.8%) of 58 children. Thirty five (60.5%) patients were previously treated. Complications developed in 36 (62.1%) cases: purulence (58.3%), dehiscence (22.3%), abdominal wall abscess (13.8%), and ileus (5.6%). Acute appendicitis is very specific condition that needs high attention by all doctors engaged in pediatric health care. Our recommendation is "to admit and observe" by using the physical examination in all suspected cases. Sometimes, even sedation may be used for better palpation results.
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PMID:[Acute appendicitis in the first three years of life]. 1697 6

We report on a six-year prospective study to determine the presentation and outcome of acute abdominal TB at Komfo Anokye Teaching Hospital. Between January 1998 and December 2003, material for biopsy including resected bowel was taken from all cases of acute abdomen, which at laparotomy were suspected as one or other form of abdominal TB. TB-positive cases were then retrospectively analysed for clinical presentation and outcome of surgical treatment. There were 96 histologically proven cases of abdominal TB, 60 in women and 36 in men. Seventy patients (72.9%) were admitted as acute intestinal obstruction with acute abdominal pain, vomiting, constipation, distension and fluid levels on abdominal X-ray. Twenty-two (22.9%) patients were admitted as acute diffused peritonitis - with generalized abdominal tenderness, guarding and rebound - and four (4.2%) as acute appendicitis. There were 74 emergency bowel resections (77% resection rate) for 34 ileocaecal masses, 16 strictures, 10 perforations and 14 adhesions, with a mortality of 4.2%. Previous series from our subregion have reported similar emergency resection mortality rates for other abdominal conditions. All the patients received postoperative anti-TB therapy. This paper notes that acute intestinal obstruction is the most common acute presentation of abdominal TB in our environment. The results of emergency resection compare favourably with resection for other acute abdominal conditions.
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PMID:Case series of acute presentation of abdominal TB in Ghana. 1703 7

We report 12 patients [5 males, mean age 28 years (SD 4.6)] presenting with clinical features suggestive of acute appendicitis who were later diagnosed as having dengue fever (DF). Seven were admitted to hospital by surgeons and then referred to physicians due to thrombocytopenia (one of them following appendicectomy). Five were admitted to medical wards and then referred to surgeons due to abdominal pain. The mean time from onset of fever to abdominal pain was 2.2 d (SD 0.9). Clinical features included: right iliac fossa tenderness in 12 patients, rebound tenderness in nine, vomiting in nine, erythematous rash in eight, arthralgia/myalgia in eight, headache in six, diarrhea in three and palatal petechiae in three. All patients had C-reactive protein <12mg/l, and DF was confirmed serologically. Leucocytopenia and thrombocytopenia occurred by the third or fourth day of illness in all patients. Seven had free fluid around the appendix on abdominal ultrasound. The mean duration of abdominal symptoms and signs was 1.8 d (SD 1.3). DF may present with features suggestive of acute appendicitis in dengue-endemic areas. A carefully obtained history, clinical examination and a full blood count done on the third or fourth day of illness may help to differentiate DF from acute bacterial appendicitis.
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PMID:Dengue fever mimicking acute appendicitis. 1736 95

Ovarian vein thrombosis (OVT) is a rare cause of abdominal pain that may mimic a surgical abdomen. The differential diagnosis of OVT includes acute appendicitis, endometritis, pelvic inflammatory disease, pyelonephritis, nephrolithiasis, tubo-ovarian abscess, and ovarian torsion. The complications of OVT, including sepsis and pulmonary embolism, are significant. Diagnosis relies on a careful examination of the radiographic findings. This diagnosis should be considered not only in postpartum patients but also in women with pelvic inflammatory disease, recent abdominal surgery, malignancy, or known hypercoagulable state. In this report we present a case of OVT in a 29-year-old woman presenting with 3 days of sharp left-sided abdominal pain, nausea, and vomiting after bilateral salpingectomy. We then discuss the epidemiology, pathophysiology, and clinical management of OVT.
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PMID:Ovarian vein thrombosis: a rare cause of abdominal pain outside the peripartum period. 1819 26

This study has been performed in the Emergency center, Clinical centre of Serbia, during the period 01.03.2007-01.09.2007. We performed this study on 57 patients with diagnosis suspected for acute appendicitis (ages 16-70). Parameters that make the Alvarado score are the following: migration of pain, anorexia, nausea or vomiting, right lower abdominal quadrant tenderness, rebound tenderness in right iliac fossa, elevated temperature, leukocytosis, shift to the left of neutrophils. The aim of the work is to evaluate the Alvarado scoring system in diagnosis of the acute appendicitis. With all the patients Alvarado score has been determinate preoperatively, and diagnosis was confirmed by intraoperative finding and histopatological examination of the removed appendix. All the patients with score 7 or more were surgically managed. Specificity (positive predictive value) was 92.59 % in males and 76.67 % in females. The negative appendectomy rate was 7.41 % with the males and 23.33 % with the females. The values of the Alvarado score are significantly higher in the patients with acute appendicitis, compared with the patients of the other diseases. With the application of the Alvarado scoring system we can decrease postoperative morbidity and mortality.
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PMID:Evaluation of the Alvarado score in the diagnosis of acute appendicitis. 1851 62

Abdominal pain is common feature of Henoch-Schonlein purpura, which may mimic appendicitis, leading to unnecessary laparotomy. Accordingly, the diagnosis must be confirmed by ultrasonography or computed tomography scan before laparotomy is performed. The authors report a case of simultaneous occurrence of Henoch-Schonlein Purpura and gangrenous appendicitis in an 18 year-old boy. The patient was admitted with abdominal pain, cramps, and mild dehydration. He also complained of small reddish purple on his lower limbs, bilateral knee pain, low-grade fever, as well as bloody stools. The symptoms subsided completely. Eight days later, he returned with nonbloody, nonbilious emesis, abdominal cramps, and right lower quadrant abdominal tenderness. Abdominal ultrasound evaluation was performed to rule out an intussusception but demonstrated appendiceal dilatation with a possible appendicolith without any evidence of intussusception. A laparotomy was undertaken, and appendectomy was performed for gangrenous appendicitis. Simultaneous occurrence of Henoch-Schonlein purpura and acute appendicitis is rarely observed. Clinical features of the patients may mislead the clinicians, resulting in delayed diagnosis or misdiagnosis. The use of ultrasonography and computed tomography scan would confirm the diagnosis before surgery.
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PMID:Gangrenous appendicitis in a child with Henoch-Schonlein purpura. 1897 Sep 18

Our study on acute appendicitis in adults aimed to report current data in Yaounde, Cameroon. This retrospective study included 323 patients, with 185 men against 138 women (sex ratio: 1.37). Mean age was 28.3 years old. Incidence was of 4.6%. Symptoms appeared within a delay of 3 to 4 days and consisted of the triad: abdominal pain (97.5%), vomiting (44%) and anorexia (39.9%). 99.7% of the patients presented with hyperthermia whereas defence on palpation in the right iliac fossa was noted in 307 patients. Rectal examination was evocative in 92.7% of the cases. Hypemeutrophilia was found in 84.9% of the patients. Plain abdominal radiography (PAR) orientated the diagnosis in 74.3% of cases; echography was very useful in abscesses (6,5%). 96.7% of the patients underwent surgery within an average time of 48 hours. McBurney incision was performed in 232 cases. Appendice in the inner latero caecal position was predominant in 243 cases. In seven cases (2.2%), appendice was normal; 2 Meckel's diverticula were discovered (0.6%). We carried out 309 anterograde appendectomies, 317 irvaginations of the appendicular root and 14 epiplooplasties. 302 histological exams were performed; catarrhal appendicitis were ranking first: 167 cases. Morbidity reached 14.2% dominated by sepsis (71.7%). The mortality rate was 0.6%. A better diagnostic approach together with a better sensitisation of the population may shorten surgical delays inducing a decrease of morbidity of acute appendicitis in Cameroon.
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PMID:[Current clinical features of acute appendicitis in adult in Yaounde, Cameroon]. 1919 8

Cysts of the omentum are rare and most frequently discovered in children. These cysts may cause abdominal distension, pain, or vomiting. Omental cysts with right lower quadrant pain are found even more rarely in adults. We describe a 44-year-old male who had a 2-day history of abdominal pain localized in the right lower quadrant. Before surgery, acute appendicitis with intra-abdominal abscess was suspected, but during the operation, an infected cyst of the omentum, adjacent and adherent to the redundant transverse colon, was found to have been causing these symptoms. Despite the fact that cysts of the omentum have been reported rarely, the operator should be aware that the cyst is a benign entity and the surgical strategy should be different from that for malignancy. We should keep the possibility of omental cyst in mind to avoid unnecessary bowel resection and potentially harmful inappropriate treatment.
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PMID:Inflammatory omental cyst adjacent to the transverse colon mimicking appendicitis in an adult patient. 2004 Apr 64

Meckel's diverticulum is the most prevalent abnormality of the gastrointestinal tract seen in approximately 2% of the population. Diagnosing complicated diverticulum is difficult, for its capacity to mime multiple disorders such as appendicitis, ulcer disease, enterocolitis, Chron disease, sigmoid diverticulitis, cholecystitis, and it should be considered in all patients with unexplained chronic abdominal pain, nausea, vomiting, gastrointestinal bleeding, unexpected cause of intestinal obstruction or acute abdomen. Herewith we provide an illustrative presentation, emphasizing the difficulties in preoperative diagnosis of complicated Meckel's diverticulum and underlining the nonspecific nature of the subjective and objective findings. Both cases were admitted to our clinic with acute abdomen diagnoses--first case as a intestinal obstruction and in second case was acute appendicitis. Laparatomy ascertain that the cause of symptoms was the complicated Meckel's diverticulum.
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PMID:[Complicated Meckel's diverticulum in adult pathology]. 2018 76

The aim of this study was to investigate the relationship between the frequency of common signs and symptoms and the histopathologic findings of resected appendix to identify factors that might be useful for judging the necessity for surgery in patients with acute appendicitis. The association of preoperative clinical characteristics, including age, sex, physical findings, gastrointestinal symptoms, body temperature, and white blood cell count, with histopathologic findings of the appendix was evaluated in 128 patients, who underwent appendectomy for clinical symptoms of acute appendicitis. The frequency of periumbilical pain as the initial symptom was significantly high in patients with catarrhal appendicitis (P < 0.01 versus those with phlegmonous appendicitis, P < 0.01 versus those with gangrenous appendicitis), and vomiting occurred less frequently in these patients (P < 0.05 versus those with phlegmonous appendicitis, P < 0.01 versus those with gangrenous appendicitis). A history of periumbilical pain and vomiting was useful for judging the necessity of appendectomy.
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PMID:Profile of signs and symptoms in mild and advanced acute appendicitis. 2048 Aug 44


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