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)

Seven cases of the Curtis-Fitz-Hugh syndrome diagnosed over a six month period are reviewed with particular reference to the widely ranging modes of presentation. All presented as acute surgical emergencies but unlike other series, right upper quadrant pain was the presenting symptom in only one case. Right upper quadrant pain nonetheless, featured to a variable extent in all cases, being relatively shortlived in three. Conditions mimicked included left renal colic, acute appendicitis, pulmonary embolism, acute cholecystitis, chronic cholecystitis and urinary tract infection. In five cases symptoms dated back to a difficult or complicated termination of pregnancy and in one case a hysterectomy had been performed twelve years previously at which time the patient had documented evidence of pelvic inflammation. Diagnosis was made laparoscopically and all symptoms responded satisfactorily to a four week course of tetracycline.
 ...
PMID:Curtis-Fitz-Hugh syndrome: the new mimicking disease? 294 32

Periappendicitis, a variant of appendicitis, is histologically diagnosed in only about 5% of appendices removed for presumptive acute appendicitis. We herein describe a boy with periappendicitis whose clinical presentation was that of left renal colic and partial left midureteral obstruction. Appendicitis not infrequently simulates right ureteral colic. However, to our knowledge appendiceal inflammation never has been reported to stimulate left ureteral colic. Also, complications of appendicitis are known to cause right ureteral obstruction (rarely bilateral) but have not been reported to cause solitary left ureteral obstruction. We found no previously reported case of solitary left ureteral obstruction from appendiceal inflammation or of periappendicitis causing a serious urologic complication.
 ...
PMID:Periappendicitis presenting as left renal colic. 744 12

The symptoms of right-sided renal colic mimic sometimes acute appendicitis. A prospective comparative study of 188 patients with ureteral stone and 188 patients with acute appendicitis was performed to evaluate the features of differential diagnosis. Appendicitis caused more often nausea (81 vs 11%), fever and localized pain in the McBurney (97 vs 59%) than renal colic. The patients with ureteral stone had tenderness in 16% in the right lower quadrant. The mean values of C-reactive protein (41 mg/l) and blood leukocytes (14 x 10(9)/l) were elevated in appendicitis, but not in renal colic (14 mg/l and 10 x 10(9)/ l). Urinanalysis revealed red cells in 92% of ureteral stones compared with 26% in appendicitis. Only one of 188 patients with appendicitis was first misdiagnosed to have renal colic. A mistake of appendicitis for ureteral stone is clinically rare occurring only once or twice per year in the hospital where 700-800 emergency appendectomies are annually performed.
 ...
PMID:A chance of misdiagnosis between acute appendicitis and renal colic. 893 24

In the past decade alternatives to urography have been proposed for the study of patients with renal colic. In 1992 it was suggested to replace urography with KUB and ultrasonography. In 1993 the combination of KUB and ultrasonography followed by urography in unresolved cases was proposed and, in 1995, it was suggested to replace urography with unenhanced helical CT (UHCT). This article illustrates the contribution of UHCT to the study of patients with renal colic and analyses advantages and shortcomings of the technique compared with other diagnostic approaches. Diagnostics of the patient with renal colic is based on the detection of direct and indirect signs which allow identification of not only the calculus, with a sensitivity of 94-100% and accuracy of 93-98% according different authors, but also other signs that can serve to guide patient management and evaluate long-term prognosis. Unenhanced helical CT has the capability to detect extraurinary abnormalities which present with flank pain and mimic renal colic. The examination technique affects the quality of the images and therefore diagnostic accuracy as well as the dose to the patient. With regard to setting parameters, the choice of thickness and table feed should be guided by numerous factors. Multiplanar reconstruction is indicated in the study of the entire ureter course to identify the exact site of the calcification for the urologist to perform an evaluation similar to that obtained by urography. Many authors consider UHCT to be a valuable tool for suggesting the best therapeutic approach. Among these there are also urologists. The evaluation is based on the stone detection, its size and level in the urinary tract. Cost analysis shows that the cost of UHCT is equal to or inferior to the cost of urography. With regard to the dose, different data are reported in the literature. A high pitch (more than 1.5) and a thin collimation (3-mm thickness) are good compromise between quality and dose which can be compared to the dose of normal urography. What is to be done if helical CT is not available? If helical CT is not available, plain film plus ultrasonography should be considered. This approach does not solve all the cases; in unresolved cases urography is indicated. It should also be noted that US has a good sensitivity in detecting other conditions such as biliary lithiasis, acute pancreatitis, acute appendicitis and abdomino-pelvic masses which are responsible for pain that mimics renal colic. In conclusion, IVU should not have any more the priority in investigating the patients with renal colic. Helical CT should be the first choice in imaging a patient with renal colic. If this technique is not available, plain film and ultrasonography should be considered adding urography in unresolved cases.
 ...
PMID:Present-day imaging of patients with renal colic. 1186 8

The differential diagnosis of left lower quadrant abdominal pain in an adult man includes, among others, sigmoid diverticulitis; leaking abdominal aortic aneurysm; renal colic; epididymitis; incarcerated hernia; bowel obstruction; regional enteritis; psoas abscess; and in this rare instance, situs inversus with acute appendicitis. We report a case of situs inversus totalis with left-sided appendicitis and a brief review of the literature. There were several subtle indicators of total situs inversus present that were missed by the physicians and surgeons who initially evaluated the patient prior to surgery. Computed tomography scan with contrast, however, revealed the diagnosis immediately, and treatment was successfully initiated.
 ...
PMID:Left lower quadrant pain of unusual cause. 1126 11

We present 15 cases of acute appendicitis in ten boys and five girls (age 3-15 years) with cardinal symptomatology coming from the urogenital tract, who were treated in our departments. All the patients presented with right renal colic, dysuria, frequency and urinary retention. The symptoms were attributed to an ongoing appendix inflammatory process in close proximity to the right distal ureter and urinary bladder. All the patients were successfully operated, and postoperative courses were uneventful. As the present patient group is the largest reported to date, a classification of the pathophysiology in relation to the clinical presentation is proposed.
 ...
PMID:Urological symptoms of acute appendicitis in childhood and early adolescence. 1277 91

Several conditions can clinically mimic renal colic. We assessed the accuracy of non-contrast-enhanced helical CT and of ultrasonography (US) in offering an alternative explanation for flank pain. In a 3-year period, 181 patients with acute flank pain underwent US and non-contrast-enhanced helical CT in a blinded sequence. Their efficacy in detecting both alternative causes of pain and additional findings unrelated to the pain was assessed in 160 cases with a confirmed diagnosis. An alternative cause was found in 23 cases (14%). US gave 4 false-negative results (1 acute appendicitis, 1 ovarian cyst torsion, 1 diverticulitis, and 1 papillary necrosis) and 2 false-positive results (1 acute pyelonephritis and 1 diverticulitis), with a 78% sensitivity and a 98% specificity for nonlithiasic causes. CT gave 5 false-negative results (1 complicated ovarian cyst, 1 pleuritis, 1 epididymitis, 1 acute pyelonephritis, and 1 papillary necrosis) and 1 false-positive (1 simple ovarian cyst described as a complicated lesion), resulting in a 74% sensitivity and a 99% specificity for diagnosing alternative causes. There were 130 additional US findings in 68 patients and 151 additional CT findings in 77 patients. A wide spectrum of findings can be identified in subjects imaged for flank pain. Non-contrast-enhanced helical CT and US have comparable accuracy in diagnosing causes other than stone disease.
 ...
PMID:Acute flank pain: comparison of unenhanced helical CT and ultrasonography in detecting causes other than ureterolithiasis. 1529 May 74

Results of treatment of 17 patients aged from 27 to 82 years with acute inflammation of omental processes (OP) are analyzed. The majority of them were hospitalized on day 1-3 from the beginning of the disease. In 9 cases inflammation was in the right half of the colon, in 7 -- in sigmoid colon (which in 3 patients was located in the right iliac area). In right-sided location of inflammation clinical picture looks like acute appendicitis. In some patients mainly in left-sided location of the inflammation the disease looks like renal colic, perforation of colon or peritonitis. Acute pathology of OP was suspected only in one case. All the patients underwent surgery. In 8 of them necrosis was revealed, in 7 -- phlegmonous inflammation of one OP, in 2 -- inflammatory infiltration without destruction. Surgery comes to removing of affected OP, which was supplemented with appendectomy in 9 cases. There were no complications and lethal outcomes. Problems of diagnosis and surgical treatment of acute inflammation of OP are discussed.
 ...
PMID:[Acute inflammation of omental processes of the colon]. 1624 85

There has been a substantial increase in the use of computed tomography (CT) and magnetic resonance imaging (MRI) in pregnancy and lactation. Among some physicians and patients, however, there are misperceptions regarding risks, safety, and appropriate use of these modalities in pregnancy. We have developed a set of evidence-based guidelines for the use of CT, MRI, and contrast media during pregnancy for selected indications including suspected acute appendicitis, pulmonary embolism, renal colic, trauma, and cephalopelvic disproportion. Ultrasonography is the initial modality of choice for suspected appendicitis, but if the ultrasound examination is negative, MRI or CT can be obtained. Computed tomography should be the initial diagnostic imaging modality for suspected pulmonary embolism. Ultrasonography should be the initial study of choice for suspected renal colic. Ultrasonography can be the initial imaging evaluation for trauma, but CT should be performed if serious injury is suspected. Pelvimetry now is used rarely for suspected cephalopelvic disproportion, but when required, low-dose CT pelvimetry can be performed with minimal risk. Although iodinated contrast seems safe to use in pregnancy, intravenous gadolinium is contraindicated and should be used only when absolutely essential. It seems to be safe to continue breast-feeding immediately after receiving iodinated contrast or gadolinium. Although teratogenesis is not a major concern after exposure to prenatal diagnostic radiation, carcinogenesis is a potential risk. When used appropriately, CT and MRI can be valuable tools in imaging pregnant and lactating women; risks and benefits always should be considered and discussed with patients.
 ...
PMID:Guidelines for computed tomography and magnetic resonance imaging use during pregnancy and lactation. 1866 32

The dilemma of acute non-traumatic abdominal pathologies in the pediatric population depends on the age of the patients and symptoms. Surgical etiologies in patients younger than 2 years of age include intussusception, pyloric stenosis, malrotation and midgut volvulus. In older patients, considerations become closer to differential etiologies in adults including acute appendicitis. Ultrasound and fluoroscopic examinations remain the mainstay for diagnosis that may even be therapeutic such as contrast/air enemas in intussusception reduction. There is an increasing role for CT in appendicitis and renal colic especially in assessing complications; however, it is less favored because it incurs radiation to the patient. This article summarizes the imaging approach to pediatric patients with acute abdominal pathologies presenting to the emergency department, and how imaging is instrumental in guiding diagnosis and treatment, with emphasis on radiation safety, in the context of providing typical imaging findings of each pathology in this pictorial review.
 ...
PMID:Imaging Acute Non-Traumatic Abdominal Pathologies in Pediatric Patients: A Pictorial Review. 3155 65


1 2 Next >>