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

To determine the sonographic features of uncomplicated acute diverticulitis of the cecum and ascending colon, the sonographic findings in 534 patients who presented with right lower quadrant pain were reviewed. Of these, 18 patients had uncomplicated acute diverticulitis of the cecum and ascending colon. The diagnosis was confirmed by surgery (one patient), clinical course (17 patients), CT (eight patients), or contrast enema (11 patients). On sonography, a round or oval focus of varying echogenicity, which protruded from a segmentally thickened colonic wall and was surrounded by a hyperechoic area, was seen in all 18 patients. These were hypoechoic foci (12 patients), hypoechoic foci with internal strong echoes (three patients), and echogenic shadowing foci with surrounding hypoechoic bands (three patients). Extraluminal gas (one patient) and thickening of lateroconal fascia (six patients) were seen also. Findings of enlarged appendix, frank abscess, and ascites were absent. All patients, including the one who had laparotomy, were successfully treated medically for diverticulitis. Of 515 patients without diverticulitis, in only one patient with acute appendicitis did sonography show a hypoechoic protruding focus. Our experience indicates that the major sonographic finding in patients with uncomplicated acute diverticulitis of the right colon is a hypoechoic round or oval focus protruding from a segmentally thickened colonic wall.
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PMID:Uncomplicated acute diverticulitis of the cecum and ascending colon: sonographic findings in 18 patients. 211 52

The appendectomy-rate in the Federal Republic of Germany is decreasing. German surgeons have begun to refuse appendectomy if there are no signs of acute inflammation. Preoperative assessment of patients with right lower quadrant pain has acquired new significance. The authors report on 2 years of experience with routine use of high-resolution ultrasonography in 669 cases of suspected acute appendicitis. Only 101 patients (= 15.1%) turned out to be suffering from acute appendicitis. Ultrasonography evaluation was found to have a sensitivity of 84.2%, a specificity of 96.8% and an overall accuracy of 94.9%. Ultrasonography was also useful in detecting mimicking diseases of acute appendicitis. Sonography should help to rule out severe disease in the frequent cases of functional abdominal pain.
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PMID:[Sonography in suspected appendicitis: a decisive factor in diagnosis and therapy? Results of a prospective study of 669 patients]. 216 Jun 81

A 7-year-old boy developed rhabdomyolysis with a peak creatine phosphokinase level of 261,400 IU/L after his appendectomy. These abnormalities occurred following a 2-3-day illness consisting of upper respiratory tract symptoms, fever, and abdominal pain mimicking acute appendicitis. At the time of operation, a normal appendix was removed, and mesenteric lymphadenitis was noted. The myoglobinuria and elevation of creatine phosphokinase were transient, and the patient remained asymptomatic. We review various causes of right lower quadrant pain and rhabdomyolysis and address the roles of malignant hyperthermia and infectious agents. The possible cause of the phenomena observed in this patient is discussed.
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PMID:Asymptomatic rhabdomyolysis of unknown etiology. 224 93

Crohn's disease limited to the appendix is uncommon. The disease may mimic acute appendicitis with fever, leukocytosis, right lower quadrant pain, and occasionally a palpable mass. When Crohn's disease affects the appendix, it typically has a longer clinical period in which the patient has symptoms than do most cases of acute appendicitis. The most common preoperative diagnoses are acute appendicitis and appendiceal abscess. A review of the literature is presented along with our experience in three additional cases of Crohn's disease limited to the appendix. We suggest that Crohn's disease be included in the preoperative differential diagnosis and that extensive intraoperative examination of the gastrointestinal tract be made in any case of suspected appendicitis that has had a protracted preoperative course.
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PMID:Crohn's disease of the appendix. 240 47

We have reported a case of hematoma of the rectus abdominis muscle resulting from prophylactic subcutaneous heparin therapy. The resultant right lower quadrant pain mimicked acute appendicitis. Because the use of prophylactic heparin is so prevalent in the hospital, it is important to be aware of this potential complication, which may be preventable by proper injection technique.
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PMID:Hematoma of the rectus abdominis muscle: a complication of subcutaneous heparin therapy. 295 22

Appendiceal disease can be acute, acute recurrent, or chronic. Acute appendicitis is the most common form. Acute recurrent appendicitis is more common than chronic appendicitis. In children the clinical manifestations of appendicitis are variable. Patients who have an appendicolith usually develop appendicitis, often with perforation. A case is presented of 3-year follow-up of a patient with an appendicolith and acute recurrent appendicitis. The literature about appendicoliths is reviewed. In the appropriate clinical setting, a history of prior episodes of similar right lower quadrant pain does not preclude the diagnosis of appendiceal disease. Awareness of the less common forms of appendicitis is important so that appropriate treatment is not delayed.
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PMID:Acute recurrent appendicitis with appendicolith. 305 84

Two hundred and fifty consecutive patients with suspected appendicitis were examined with graded compression sonography. The initial diagnostic criterion for appendicitis was visualization of a noncompressible appendix; this was later modified to include the dimensions of the visualized appendix. The appendix was visualized in 91 of 250 patients (36%). Five adult patients with sonographically visible appendixes that were 6 mm or less in maximal diameter had either benign clinical follow-up (three patients) or a histologically normal appendix removed at surgery (two patients). However, two patients with appendixes measuring 6 mm in diameter and multiple appendicoliths had surgically confirmed acute appendicitis. Of 84 patients with visible appendixes measuring greater than 6 mm in maximal diameter, 78 had surgically confirmed acute appendicitis. In the remaining six, symptoms resolved spontaneously, and no surgery was required. In the absence of compelling clinical findings or an appendicolith, adult patients with maximal appendiceal diameters of 6 mm or less should undergo a period of close observation rather than immediate surgery. A diagnosis of appendicitis can be made in adult patients with persistent right lower quadrant pain and a visualized appendix greater than 6 mm in diameter.
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PMID:Acute appendicitis: sonographic criteria based on 250 cases. 328 53

Isolated ischemic necrosis of the cecum is an infrequently described entity. We report three cases seen at our institution within a three-year period. All three patients had been hospitalized for congestive heart failure in the past, but none was in failure at the time of the most recent hospitalization. All three patients presented with clinical and laboratory findings consistent with acute appendicitis. At surgery the cecum was ischemic in each case, while the appendix and the remainder of the intestine appeared normal. There was no evidence of major vascular occlusion or embolization at the time of original operation. We propose that the cecum, like the splenic flexure, is a "watershed area," with poor blood supply relative to that of the adjacent intestine. While cecal ischemia has been described in association with a variety of clinical entities, we propose a newly recognized association with poor myocardial function. In such patients, isolated ischemic necrosis of the cecum should be considered in the differential diagnosis of right lower quadrant pain.
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PMID:Isolated ischemic necrosis of the cecum in patients with chronic heart disease. 646 94

Perforation of a Meckel's diverticulum by a sharp object often presents with subtle nonspecific abdominal findings. A 53-year-old man had features resembling acute appendicitis and right ureteral obstruction. At laparotomy a wooden toothpick was found perforating a Meckel's diverticulum. The diagnosis of complicated Meckel's diverticulum should be considered when there is typical right lower quadrant pain or the patient is known to have ingested a sharp foreign body. The mortality resulting from perforation is low. The authors discuss other complications of Meckel's diverticulum.
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PMID:Perforation of a Meckel's diverticulum by a foreign body. 682 11

Segmental infarction of the greater omentum is an unusual cause of acute abdominal pain in children. Over 30 years at the Hospital for Sick Children in Toronto, this entity was encountered nine times. All children complained of right lower quadrant pain. They were tender in that area and were thought to have acute appendicitis. At operation, the appendix was found to be normal in all and an area of infarcted omentum was identified as the cause of the acute illness. Torsion of the infarcted omentum was noted in four cases. Excision of the omentum was curative.
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PMID:Segmental infarction of the greater omentum: a cause of acute abdomen in childhood. 685 Apr 35


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