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

Dobrava-Belgrade hantavirus infection mimicked acute appendicitis in a patient suffering from hemorrhagic fever with renal syndrome in Hungary. The 27-year-old man was admitted to the local hospital with severe abdominal pain localized mainly at the right lower quadrant of the abdomen and with fever, nausea, vomiting and bloody diarrhea. Based on these findings supported by computerized tomography acute perforated appendicitis was suspected and an explorative laparatomy was performed, which did not confirm the diagnosis. Next day he developed acute oliguric renal failure raising the possibility of hantavirus infection. Specific serum IgG and IgM antibodies against hantavirus were identified, and by molecular methods the presence of Dobrava-Belgrade virus was proven. This report describes a rare clinical manifestation of hemorrhagic fever with renal syndrome (HFRS), and shows that HFRS might be difficult to diagnose especially when symptoms mimick those of an acute abdominal inflammation.
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PMID:Dobrava-Belgrade hantavirus infection mimics acute appendicitis. 2107 78

Pseudomyxoma peritonei is a rare progressive disease. Patients commonly present with a picture of acute appendicitis or with increasing abdominal girth. We present a case of a 71 year old man who presented with right iliac fossa pain, fever and vomiting. His abdominal examination revealed right iliac fossa mass which was confirmed radiologically. Diagnostic laparoscopy showed jelly like material along with a right iliac fossa mass. The aspirate was negative for malignancy initially. Due to persistance and progression of his disease he underwent right hemicolectomy. Histopathological diagnosis showed moderately differentiated adenocarcinoma of the cecum Duke's C2.
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PMID:Psuedomyxoma peritonei secondary to adenocarcinoma of the cecum. 2135 34

This is a case of a 34 years old male Hispanic patient with history of AIDS who presented to the ER with severe right lower quadrant abdominal pain of three days of evolution, associated with fever, chills, nausea, vomiting, watery diarrhea, weakness and general malaise. Acute appendicitis, Clostridium Difficile Colitis and Ischemic Colitis were the most important clinical conditions to consider in the differential diagnosis. Abdominal CT with IV contrast demonstrated thickening of the ascending colonic wall a finding highly suggestive of a transmural inflammatory necrotizing colitis of infectious etiology. Broad-spectrum antibiotic therapy, cancidas and ganciclovir were started with mark clinical improvement. IgG antibodies against CMV were elevated. Typhlitis is a serious illness that affects patients with impairment in immunity. It is important to include it in the differential diagnosis of an HIV/AIDS patient that presents with RLQ pain and fever. Contrast enhanced CT-Scan is mandatory to establish the diagnosis and to differentiate typhlitis from other intra-abdominal pathologies. Therapy needs to be individualized.
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PMID:Right lower quadrant abdominal pain in an immunocompromised patient: importance for an urgent diagnosis and treatment. 2169 4

Acute appendicitis presents typically with periumbilical pain that in a few hours settles at the right lower quadrant of the abdomen. Atypical presentations are common but association with acute scrotum is an extreme rarity. A 30-year-old fisherman presented at a rural medical facility with a 2-day complaint of severe pain at the right hemiscrotum followed about 24 hours later with mild diffuse abdominal pain. There was associated mild fever and nausea but no vomiting. There were no urinary symptoms and no recent sexual exposure. Initial physical examination revealed mild generalized tenderness worse at the right lower quadrant but the scrotum was not remarkable, and cremasteric sign was negative. He was admitted as a case of acute abdomen for close observation. Abdominal and scrotal ultrasound scan were normal. By the second day of admission, pain became marked at the right lower abdomen with associated vomiting. There was also marked tenderness at the right lower quadrant with rebound. A diagnosis of acute appendicitis was thus made and appendicectomy done after proper workup. The abdominal and scrotal pain stopped after surgery and the patient was discharged on the seventh postoperative day. Patients with unusual abdominal and scrotal pain should be admitted and closely observed and evaluated to prevent unnecessary scrotal exploration or negative appendicectomy.
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PMID:Acute appendicitis masquerading as acute scrotum: a case report. 2181 59

Appendicitis is the most common abdominal emergency. While the clinical diagnosis may be straightforward in patients who present with classic signs and symptoms, atypical presentations may result in diagnostic confusion and delay in treatment. Abdominal pain is the primary presenting complaint of patients with acute appendicitis. Nausea, vomiting, and anorexia occur in varying degrees. Abdominal examination reveals localised tenderness and muscular rigidity after localisation of the pain to the right iliac fossa. Laboratory data upon presentation usually reveal an elevated leukocytosis with a left shift. Measurement of C-reactive protein is most likely to be elevated. The advances in imaginology trend to diminish the false positive or negative diagnosis. Radiographic image of faecal loading image in the caecum has a sensitivity of 97% and a negative predictive value that is 98%. In experienced hands, ultrasound may have a sensitivity of 90% and specificity higher than 90%. Helical CT has reported a sensitivity that may reach 95% and specificity higher than 95%. Despite all medical advances, the diagnosis of acute appendicitis continues to be a medical challenge.
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PMID:Diagnosis of acute appendicitis. 2234 55

We present a child with both acute appendicitis and torsion of the right testis presenting at the same time. Testicular torsion possibly occurring due to vomiting in acute appendicitis so far has not been reported in the literature.
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PMID:Simultaneous acute appendicitis with right testicular torsion. 2252 57

Multiple magnet ingestion during childhood may result in emergency situations. A single magnet may be discharged with intestinal peristalsis, but multiple magnets may stick together and cause significant intestinal complications. Here we present a case with intestinal perforation due to ingestion of multiple magnets and metal pieces. An eight-year-old girl presented with abdominal pain and vomiting. She had abdominal tenderness and defense on the physical examination. Abdominal X-ray showed air and fluid levels. Metallic images were not considered at first as important in the diagnosis. Abdominal ultrasonography was reported as acute appendicitis. During the abdominal exploration, the appendix was normal, but there were dense adherences around the ileum and cecum. After adhesiolysis, intestinal perforations were seen in the cecum and 15 and 45 cm proximal to the cecum. Magnet and metal pieces were present in the perforated segments. Wedge resection and primary repair was performed. There were no postoperative complications, and she was discharged on the postoperative fifth day. Pediatric surgeons should be aware of the complications of multiple magnet ingestion. If the patient has a history of multiple magnet ingestion, follow-up with daily abdominal X-rays should be done, and in cases where magnets seem to cluster together or if acute abdominal signs develop, surgical exploration should be considered.
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PMID:[Intestinal perforation due to multiple magnet ingestion: a case report]. 2279 31

Cystic fibrosis (CF) is an inherited disease of the secretory glands caused by mutations of the cystic fibrosis transmembrane regulator (CFTR) gene. The clinical manifestations of CF are repetitive lung infections, biliary cirrhosis, pancreatic abnormalities, and gastrointestinal disorders. We report a 21-year-old Taiwanese man with CF who had abdominal pain for 2 days. The diagnosis of CF had been confirmed by peripheral blood analysis of the CFTR gene 5 years before admission. He presented to the emergency department with nausea, vomiting, abdominal distension, and crampy abdominal pain, which is atypical for acute appendicitis. The physical examination and a series of studies revealed intestinal obstruction, but acute appendicitis could not be ruled out. After conservative treatment, together with empiric antibiotics, the refractory abdominal pain and leukocytosis with a left-shift warranted surgical intervention. A diagnostic laparoscopy revealed a swollen, hyperemic appendix, a severely distended small intestine, and serous ascites. The laparoscopic procedure was converted to a laparotomy for open disimpaction and appendectomy. He was discharged on the eighth postoperative day. The histologic examination of the appendix was consistent with early appendicitis. In conclusion, acute abdominal pain in adult CF patients is often associated with intestinal obstruction syndrome. The presentation of concurrent appendicitis may be indolent and lead not only to diagnostic difficulties, but also a number of therapeutic choices.
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PMID:Acute appendicitis mimicking intestinal obstruction in a patient with cystic fibrosis. 2308 94

After abdominal muscle exercises a young man suffered from upper abdominal pains and vomiting. The pain moved to the lower abdomen and the abdominal wall hardened. Clinical picture and laboratory findings were in agreement with acute appendicitis, and the patient was operated. Unexpectedly the small intestine and the ascending colon appeared almost entirely gangrenous upon gridiron incision, and the surgical incision was widened. An extensive internal herniation was revealed, with the small intestine having protruded through the sigmoid mesentery, causing a disturbance of the blood circulation and necrosis of the bowel. Swift and sufficient resection of the bowel saved the patient's life.
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PMID:[Peculiar "appendicitis" turning out to be an internal hernia]. 2334 83

This paper describes a case of ovarian metastasis from lung carcinoma along with its diagnostic challenges, clinical management, and review of the literature. A 49-year-old woman was admitted to our emergency department with complaints of abdominal pain and vomiting. A laparoscopic appendectomy was performed due to acute appendicitis, and a unilateral oophorectomy (left side) via laparoscopy was performed due to the detection of an ovarian mass. Immunohistochemical staining of the ovarian mass revealed that it was reactive to cytokeratin-7 (CK-7) but negative for CK-20. The immunohistochemical and pathological features of the tumor indicated an ovarian metastasis of non-small-cell lung cancer. The patient underwent chemotherapy and was followed up by the oncology department. Her postoperative regular followup of 6 months showed that her condition was stable with no recurrence. The management of female patients with acute abdominal pain and pelvic masses should consist of a multidisciplinary approach to include the diagnosis of any distant organ metastasis.
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PMID:Ovarian metastasis from lung cancer: a rare entity. 2363 11


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