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

Twenty-four pregnant women with acute appendicitis received exploratory laparotomy during an 8-year period. Abdominal pain accompanied with nausea and vomiting were the most common symptoms. Abdominal tenderness and rebounding pain were the most reliable physical signs. Leukocytosis with WBC count greater than 15,000/cu mm and granulocytes greater than 87% and prolonged symptomatic duration were indications that appendiceal perforation might have occurred. A McBurney's incision and spinal anesthesia were preferred for appendectomy during pregnancy. In cases of uncomplicated appendicitis, tocolytic agents and antibiotics were not routinely used. Premature labor occurred in 21% of patients during postoperative period.
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PMID:Appendicitis during pregnancy. 263 59

This retrospective study of 132 patients less than 12 years of age with Appendectomy done for Acute Appendicitis showed histological confirmation in 106 patients (80.3%) and a "negative appendix" rate of 19.7%. The appendix was perforated in 31 patients (23.5%). In those patients with confirmed Acute Appendicitis, males predominate (1.7 males: 1 female) and the peak incidence was in those 9 years of age or more. Abdominal pain was present in all patients except a 13 month old infant. Abdominal tenderness was also elicited in all patients except one. Fever was present in 83 patients (78.3%), vomiting in 82 patients (77.4%) and diarrhoea in 19 patients (17.9%). There were 2 deaths in this review, giving a mortality rate of 1.9%. Postoperative complications include wound infection (13.2%), pelvic abscess (0.9%), ileus (0.9%) and adhesion obstruction (0.9%).
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PMID:Acute appendicitis in Singapore children--some clinical aspects. 263 19

In a review of 22 years of clinical experience, we found seven previously healthy children with primary peritonitis. The diagnosis was made at laparotomy in all patients. Their symptoms included diffuse abdominal pain, fever, vomiting, and diarrhea. Abdominal tenderness was maximal in the right lower quadrant in five children, which led to confusion with the diagnosis of acute appendicitis. Streptococcus pneumoniae was identified as the etiologic agent in three patients and group A beta-hemolytic Streptococcus in one patient. The remaining three patients all had prior antibiotic therapy, and peritoneal fluid cultures were sterile. All children had a prompt response to treatment with antibiotics and recovered without complications. Long-term follow-up (4 1/2 to 15 years) was available for three patients; all three remained healthy.
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PMID:Primary peritonitis in previously healthy children. 638 16

Fifty-four cases of acute appendicitis were studied prospectively within a period of 11 months spanning between February-September, 1991 and December, 1991-February, 1992. The mean age was 25.4 years with a range of 8-70 years. Ninety percent of the patient were between 11-40 years of age. Male patients accounted for 54% of the cases. Students and civil servants accounted for 68%, while artisans and traders accounted for remaining cases. Low abdominal pain was present in all cases, loss of appetite in 77.7%, and previous history of abdominal pain in 76%. Abdominal tenderness was present in all the patients, rebound tenderness in 77.7%, guarding in 81.5% and Rovsings sign in 50%. In 12 cases (22%) the diagnosis was incorrect 8 of which were female patients. In 9.3% there was perforation. Wound infection and wound dehiscence occurred in 20.4% and 7.4% of the cases respectively. It is concluded from this study that acute appendicitis is commonly encountered in private Hospital, clinical course and postoperative outcome are not different from what obtained in major medical establishments.
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PMID:Acute appendicitis: a prospective study of 54 cases. 819 59

Acute appendicitis in pregnancy is the most common non-obstetric complication warranting emergency laparotomy. A retrospective study of 52 pregnant patients who underwent laparotomy for suspected acute appendicitis between June 1982 and June 1995 revealed a histopathological diagnosis in 29 (56%) patients. The hospital incidence for acute appendicitis in pregnancy was 0.09% (1 in 1102 deliveries). There were 10 (19%) patients who presented in the first trimester, 31 (60%) second trimester, 8 (15%) third trimester and 3 (6%) patients in the puerperium. Abdominal pain in the right lower quadrant was the most common presenting symptom. Abdominal tenderness and rebound tenderness were the most common physical signs, although the latter was less marked in late pregnancy. Preoperative laboratory investigations were equivocal in reaching a decision for surgical intervention. Laparotomy was performed within 24 hours of onset of symptoms in 67% of patients. Perforation of the appendix was found in 4 (14%) patients, all of whom had symptoms exceeding 24 hours. Wound infection occurred in 4 (9.6%) patients, 3 of whom had a perforated appendix. There were 2 (9%) fetal losses among the patients with negative laparotomies. Five (17%) other fetuses were lost in the group with diseased appendix, three of these were in patients with perforated appendix. There was no maternal death in the study.
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PMID:Acute appendicitis in pregnancy. A review of 52 cases. 902 94

The clinical picture of regional enteritis was reviewed in 98 cases collected from five hospitals in the City of Edmonton. There was no apparent racial prevalence, although only one case was reported among Indians and Eskimos. More than one-half had their onset between the ages of 11 and 30 years. Men were more commonly affected than women. The onset in 44 patients was acute and closely mimicked acute appendicitis. Twenty-eight patients had had abdominal surgery prior to the onset of symptoms. Major symptoms were abdominal pain, diarrhea and weight loss. Abdominal tenderness, fever and abdominal mass were the most consistent physical signs. The most valuable diagnostic procedure was radiological examination of the bowel. Complications were largely confined to the gastrointestinal tract. In the majority of cases, surgery was the ultimate form of therapy.
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PMID:REGIONAL ENTERITIS: DISEASE PATTERENS AND MEDICAL MANAGEMENT. 1418 59

The diagnosis of appendicitis in children can be difficult. Misdiagnosis may result in empirical treatment with antibiotics. The aim of this study was to determine whether initial treatment with antibiotics hindered subsequent diagnosis of appendicitis. Retrospective review of 311 children treated for appendicitis between 1999 and 2004. Patients were divided into two groups: Group 1: (n = 45) received antibiotics prior to a definitive diagnosis of appendicitis. Group 2: (n = 266) did not receive antibiotics prior to a diagnosis of appendicitis. Group 1 patients were significantly younger and more likely to be female than in group 2. Abdominal tenderness was less marked and there was a greater reliance on radiological investigations in patients receiving antibiotics. C-reactive protein and pre-operative temperature were significantly higher in group 1 patients compared to group 2. The perforation rate and complication rate were significantly greater in group 1. The commonest misdiagnoses were urinary tract infection and respiratory infection. Initial misdiagnosis results in significant delay before appendicectomy. This study shows that the clinical signs of acute appendicitis can be masked by prior treatment with antibiotics. The diagnosis of acute appendicitis must be considered and, if necessary, excluded in all children seen with abdominal pain who have recently been treated with antibiotics.
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PMID:Delayed diagnosis of appendicitis in children treated with antibiotics. 1673 26