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

Four cases of primary torsion of the greater omentum are reported. The most common clinical picture in this condition mimics acute appendicitis. Primary torsion with spontaneous derotation of the greater omentum may be an important cause of right iliac fossa pain of obscure origin. Scrutiny of the omentum during negative appendiceal exploration is extremely important. Treatment is excision of the twisted, infarcted omentum.
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PMID:Primary torsion of the greater omentum. Case report. 233 Jul 96

The skin temperature in the right and left iliac fossae was recorded in 100 patients who were referred with a provisional diagnosis of acute appendicitis. This was not found to be a reliable aid in diagnosis of acute appendicitis nor an indicator to the need for surgery in patients with right iliac fossa pain.
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PMID:Is the hot appendix really hot? 829 Apr 31

Serum alpha-interferon levels were analysed in 50 consecutive children admitted with right iliac fossa pain. Serum alpha-interferon levels were significantly raised in 33% of children without acute appendicitis when compared to 5.7% of children with histologically proven acute appendicitis and 9% of normal controls. This interesting phenomenon needs further investigation. A larger series may show it to be of clinical use in non-specific abdominal pain in childhood.
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PMID:Serum alpha interferon in children with right iliac fossa pain. 818 88

Young women with right iliac fossa pain are commonly referred to general surgeons as possible acute appendicitis. The differential diagnosis that includes pelvic visceral disease may be very difficult to determine clinically, especially when the history and physical signs are equivocal. We believe that diagnostic accuracy may be improved by eliciting precisely the site of abdominal pain. Right-sided low inguinal pain may be referred from the female pelvic viscera in the same way as testicular pain may be referred to the groin, as these viscera derive their autonomic nerve supply from the T10-L2, mainly T12-L1, spinal segments in both sexes. There are no previous reports of the value of the symptom of right-sided low inguinal pain in differentiating pelvic visceral disease from acute appendicitis in young women. This paper reports a prospective study of the discriminant value of this symptom in such patients.
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PMID:Right-sided low inguinal pain in young women. 919 21

One-third of all cases of abdominal pain and a quarter of cases of right iliac fossa pain urgently admitted to hospital leave hospital with no precise diagnosis. Based on a series of 400 patients hospitalised for right iliac fossa pain, comprising 107 cases with no identified aetiology, this prospective study was designed to assess the medium-term outcome of these patients, with or without surgical exploration. 67 cases were reviewed at five years. No major diagnosis was missed. Over this 5-year period, 30 patients (45%) experienced another episode of abdominal pain. Among the third of patients (21 cases, 31%) reviewed for another episode of right iliac fossa pain, 7 were readmitted to hospital, with 5 operations, for histologically confirmed acute appendicitis in 3 cases (5% of the series). The patient and his attending physician must be informed of the nonspecific diagnosis established during the first hospitalisation. There is no significant evidence to suggest a psychological component in the recurrent nature of the pain. Cancer must be formally excluded in patients over the age of 50. When surgical exploration is performed, nowadays by laparoscopy, appendicectomy is recommended. This procedure does not decrease the risk of recurrent pain, but confirms the real absence of histopathological abnormality and decreases the number of subsequent hospitalisations.
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PMID:[Outcome of nonspecific right iliac fossa pain syndromes]. 995 Oct 94

The aim of this study is prospectively to evaluate the serum C-reactive protein (CRP) and interleukin-6 (IL-6) levels in detection of acute appendicitis in patients with right iliac fossa pain. Data were collected in prospective manner on 102 consecutive patients with right iliac fossa pain. Laparotomy was performed for suspected acute appendicitis for 55 of the 102 patients, of whom 49 patients had appendicitis, 6 patients non-appendicitis (NA), and the other 47 patients had nonspecific abdominal pain (NSAP) and they did not undergo operation. Among those with appendicitis 31 had acute appendix (AA), 8 had gangrenous appendix (GA), and 10 had perforated appendix (PA). The WBC and CRP the mean (SEM) values were significantly different in AA, GA, and PA groups compared with NSAP and NA groups (P < 0.05). Although the mean IL-6 levels were significantly different only in PA group than the others groups (P < 0.05). The sensitivity and specificity of serum CRP measurements were calculated as 96% and 87%, respectively whereas these were 33% and 83% for IL-6 levels for the diagnosis of the acute appendicitis. As a result, measurement of the CRP levels and WBC have an additional diagnostic value on the diagnosis of the acute appendicitis but determination of IL-6 levels which added to the test combination of WBC and CRP, the sensitivity for the diagnosis of the acute appendicitis was not changed whereas the specificity was decreased to 66%.
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PMID:Diagnostic value of interleukin-6 and C-reactive protein in acute appendicitis. 1096 43

Schistosomiasis is a widely prevalent disease in the world and usually involves the gastro-intestinal and urinary tract. The involvement of the female genital tract has been well-established in S. haematobium infections and is rare with S. japonicum infections. This case involves a Filipino female who was admitted to the University Hospital Kuala Lumpur for right iliac fossa pain and was diagnosed initially as acute appendicitis. Ultrasound showed a multi-septated pelvic cyst leading to a provisional diagnosis of ovarian torsion. Intraoperatively a right parovarian cyst was detected and removed. Histology revealed a congested cyst wall with areas of haemorrhage with several viable and calcified eggs of S. japonicum measuring 85 microns x 62 microns. Within the cystic cavity blood admixed with eggs were seen. Confirmation was carried out by using the indirect haemagglutination (IHA) test. This is a first report of upper genital schistosomiasis mimicking an ovarian tumour.
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PMID:Upper genital schistosomiasis mimicking an ovarian tumour. 1120 Jul 20

In cases of clinically suspected acute appendicitis, the rate of negative laparoscopic exploration ranges from 8 to 15%. In that situation, should we remove an apparently normal appendix or should we leave it in place? If there is no evidence of another cause to explain the acute right iliac fossa pain, it seems reasonable to proceed with an appendicectomy even if the appendix looks normal, because the rate of re-operation for recurrent symptoms is up to 6% and an endo-appendicitis which is defined as inflammation of the appendicular mucosa can be present in 11% to 26% of the cases. Anyway, the therapeutic decision is also influenced by the discussion between the physician and the patient before operation as well as by his past medical history. Good information about the risks and advantages of removal and nonremoval of an apparently normal appendix must be given.
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PMID:Should every patient undergoing laparoscopy for clinical diagnosis of appendicitis have an appendicectomy? 1265 83

Recurrent appendicitis is defined when patients with recurring similar right iliac fossa pain had acute appendicitis confirmed at the time of operation and the pain completely subsided after surgery. We conducted a retrospective study on our patients with appendicitis. There were 290 patients with appendicitis over a two-year period and 33 patients (11%) had reported recurring pain prior to the presentation. Majority had one prior episode but 15% had multiple episodes of right iliac fossa pain. Fifty-eight percent of the episode occur within six months of the presentation. We conclude that recurrent appendicitis should be considered as a differential diagnosis in patients with recurrent right iliac fossa pain.
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PMID:Recurrent appendicitis as a cause of recurrent right iliac fossa pain. 1497 75

Exploratory laparoscopy has been used since 1910 and is one of the new tools for diagnosing appendicitis on a routine basis. It can be looked upon as "semi-invasive" in comparison to on one hand ultrasonography/CT/MRI and on the other open laparotomy. According to the literature, mostly in retrospective studies, laparoscopy might reduce the frequencies of unnecessary appendectomies in 20-30 percent and an accuracy of diagnosis of appendicitis of 95-99 percent. This means that laparoscopy has a sensitivity of 92 percent in diagnosing acute appendicitis, including all cases of mucosal inflammation only. This means, however, that about one in 11 appendicitis is missed and it is still a question as to whether an appendix that looks normal at laparoscopy for acute right iliac fossa pain should be removed, or whether if it is not removed, there is a risk of missing an early case of appendicitis later leading to perforation and peritonitis? Mucosal inflammation obviously can never be determined in the appendix is left in place. However, a summery of available data seems to favour that it is distinctly uncommon that explorative laparoscopy misses any acute appendicitis that requires appendectomy. If there are cases of acute appendicitis not requiring appendectomy can only be known in prospective studies. A Cochran review was published in early 2002 and analysed 45 randomized trials, 39 of which had been carried out in adults, comparing both therapeutic and diagnostic outcomes of patients undergoing open or laparoscopic surgery for suspected appendicitis. Diagnostic outcomes favoured the laparoscopic approach in that both the negative appendectomy rate and "the frequency of an unestablished diagnosis" were reduced, most significantly in women in their reproductive years. However, in the conclusion the authors sounded a note of caution about the quality of some of the research data they had analysed, and recommended that more blinded studies be performed. Because there is a belief that laparoscopic appendectomy is less likely to cause intraperitoneal adhesions than open surgery, they also recommended longer follow-up studies to assess the relative incidences of obstruction due to adhesions resulting from the two techniques. Therefore, the conclusion can be drawn that in all equivocal cases laparoscopy is better than laparotomy as the initial step in year 2003. However, there is still a lack of data comparing non-invasive modern techniques such as ultrasonography and CT with laparoscopy, and the value of laparoscopy after the best available ultrasonography or CT.
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PMID:Exploratory laparoscopy at suspicion of acute appendicitis. Review. 1521 97


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