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

Preoperative total and differential leucocyte counts were made in 225 children with acute appendicitis, 50 children with a normal appendix and 100 children with acute abdominal pain which resolved without any therapy. When adjusted to age, neutrophilia in 96 per cent, 30 per cent and 32 per cent and leucocytosis in 41.8 per cent, 4 per cent and 3 per cent was noted in the respective groups, the levels being significantly higher in the acute appendicitis group than in the other two groups. Among children with appendicitis, infections were observed in 62.8 per cent of the group with leucocytosis and in 13.7 per cent of the group with a normal leucocyte count; the difference is statistically significant. It is suggested that in acute appendicitis neutrophilia supports the diagnosis and leucocytosis indicates the prognosis. The rate of infection increases as the total leucocyte count rises above the upper normal limit. The difference of opinions on the significance of leucocyte counts in acute appendicitis is discussed.
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PMID:Leucocyte counts in the diagnosis and prognosis of acute appendicitis in children. 51 64

The unusual clinical course of three cases of dilatation of ureters and renal pelvises in pregnancy was reported. The presenting symptom in each case was acute abdominal pain, which was at first attributed to other surgical or obstetric emergencies like premature separation of placenta, acute appendicitis and acute hydramnion.
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PMID:Hydroureter and hydronephrosis of pregnancy presenting as acute obstetric or surgical emergencies. 109 May 56

Chest and abdominal radiograms are most helpful in evaluating acute abdominal pain in children. When basilar pneumonia is found the likelihood of associated appendicitis is slim. Evidence of appendicolithiasis on abdominal films secures the diagnosis of acute appendicitis and should prompt the surgeon to early operative intervention, since the threat of appendiceal perforation is great. Barium enema is safe and informative when obscure clinical presentation or associated illness exists. The likelihood of appendicitis is great when the appendix fails to fill at the time of barium enema. Complete filling of the appendix excludes the possibility of acute appendicitis.
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PMID:Radiologic aids in the diagnosis of appendicitis in children. 118 26

Twelve children with acute abdominal pain, which was suspected of being acute appendicitis, were subsequently found to have lower lobe pneumonia. Diagnostic barium enema or operative exploration failed to demonstrate any appendiceal abnormality. The abdominal symptoms and the ileus subsided soon after the initiation of antibiotic therapy. Contrary to common belief, it was observed that left-sided pneumonia is capable of mimicking appendicitis almost as frequently as right-sided pneumonia. Since the likelihood of acute appendicitis accompanying pneumonia is small, operative intervention is rarely indicated and should be undertaken only after careful and intensive investigation.
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PMID:Basilar pneumonia simulating acute appendicitis in children. 126 2

A case of actinomycosis of the abdomen ten years after surgery for acute appendicitis is reported. The patient, a 2 1/2 years old girl at the time of operation, presented with acute abdominal pain ten years after appendectomy. Computed tomography (CT) showed a mass in the region of the right psoas muscle. Fine needle aspiration revealed pus which on culture was found to contain Actinomyces israeli. Since surgery is a well known probable cause of abdominal actinomycosis, we must assume the appendectomy and the formation of the actinomycotic abscess to be related. Discovery of an abdominal mass even years after violation of the gastrointestinal tract should arouse suspicion of an abscess involving these otherwise infrequent pathogens.
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PMID:[Abdominal actinomycosis. Actinomycotic abscess 10 years after appendectomy]. 141 25

Over a 3-year period nine patients (mean age of 43 years) with acute abdominal pain and unsuspected abdominal neoplasms were referred for graded compression sonography to rule out appendicitis. Six of the nine patients had right lower quadrant neoplasms involving the cecum, terminal ileum, iliacus muscle, or iliac lymph nodes. However, in three patients neoplasm was noted outside the right iliac fossa involving the liver, right kidney, and upper abdominal mesentery. This study underscores the fact that in patients without sonographic evidence of acute appendicitis, a survey of the upper abdomen and right flank should routinely be performed in addition to scanning the right iliac fossa and pelvis. In patients more than 50 years of age neoplasm must also be kept in mind in the differential diagnosis of appendicitis.
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PMID:Graded compression sonography of abdominal neoplasms mimicking acute appendicitis. 142 42

The authors used color Doppler ultrasonography (US) to evaluate 33 children with suspected appendicitis and found locally increased blood flow in all of 10 patients with appendicitis or periappendiceal abscess; the studies were normal in 16 patients without appendicitis. The gray-scale sonographic results were concordant in all 26 of these patients. In two other patients with presumptive mesenteric adenitis and in one patient with a hemorrhagic ovarian cyst at gray-scale US, color Doppler imaging showed no increased perfusion and aided in confirming the absence of a significant inflammatory process. In four other children, color Doppler US clarified gray-scale sonographic findings that might have been confused with complicated appendicitis and aided in the diagnosis of other causes of acute abdominal pain. These findings indicate that color Doppler US is a useful adjunct to gray-scale US in evaluating children with suspected acute appendicitis.
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PMID:Appendicitis in children: color Doppler sonography. 811 55

The presentation, operative management and final diagnosis were reviewed in 28 patients with AIDS (27 men and one woman) who underwent emergency laparotomy. On clinical and radiological examination, six patients showed features of toxic megacolon, five patients had small bowel obstruction, six patients had localized peritonitis and three had perforated viscus with generalized peritonitis. The most common disease processes were acute colitis in seven patients (associated with cytomegalovirus (CMV) infection in six), intra-abdominal lymphoma in five patients, acute appendicitis in five patients (associated with CMV infection in two), and atypical mycobacterial (MAI) infection in four patients. Two perioperative deaths occurred; one in a patient with acute pancreatitis and a second with generalized peritonitis. Later deaths were due to progression of AIDS, and patient survival at 1 month, 3 months and 6 months was 89 per cent, 64 per cent and 48 per cent, respectively. Lower operative mortality than in previously reported series may be due to earlier intervention in CMV toxic megacolon. Surgery, however, conferred less benefit in patients with acute abdominal pain from MAI infection or lymphoma. With careful patient selection, emergency laparotomy may achieve worthwhile palliation in patients with AIDS.
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PMID:Emergency laparotomy in patients with AIDS. 131 Jun 34

The ability to improve surgical decision-making in the acute abdomen using selective laparoscopy is now established. When the decision to operate is uncertain laparoscopy not only identifies those patients who do not require laparotomy, but also reveals those who need surgery which might otherwise have been delayed. Furthermore, the high error rates in diagnosing acute appendicitis in young women provides overwhelming support to the current view that all women with suspected appendicitis should undergo laparoscopy before appendicectomy, irrespective of clinical 'certainty'. Improvements in the management of the acute abdomen can also be achieved by other techniques such as computer-assisted diagnosis (McAdam et al, 1990) and peritoneal cytology (Stewart et al, 1988), and a combination of these with selective laparotomy would be appropriate. Initial patient assessment using a structured proforma would appear to be one of the most significant factors in the improvement of diagnostic accuracy associated with the use of computers (Gunn, 1976), and their combination with a policy of selective laparoscopy has been shown to be beneficial (Paterson-Brown et al, 1989). The ability to detect which patients are likely to benefit from laparoscopy by performing peritoneal cytology first (Vipond et al, 1990) has been shown to be helpful in reducing the number of patients who undergo a 'negative laparoscopy' (Baigrie et al, 1990). It is now time for laparoscopy to return to the bosom of general surgery from where it was conceived almost a century ago. When it does, as the developments in laparoscopic cholecystectomy would predict it will, so surgeons in training must take the earliest opportunity to become as familiar and proficient with the technique as their gynaecological colleagues have done, even if this means attending the gynaecological operating lists to do so. It is only then that the undoubted benefits of laparoscopy will be spread more widely in general surgery and particularly for the patient with acute abdominal pain.
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PMID:The acute abdomen: the role of laparoscopy. 183 86

From 1984 to 1989 78 patients over the age of 60 years were operated on acute appendicitis. Compared to appendicitis in younger people these older patients showed 3 times longer an interval between the first appearance of symptoms and their contact to the doctor, or surgical treatment. As result of this longer period appeared the high perforation rate 53.8%. In this group of patients with perforation the complication rate was 4 times higher than the intraoperative and histologically confirmed acute appendicitis. From these facts results a mortality rate of 4%. In the retrospective evaluation was also seen that there was no conclusion between the laboratory parameters, the physical symptoms and the degree of the inflammation of the evidence of perforation with local or diffused peritonitis. The inclusion of appendicitis in the differential diagnosis of acute abdominal pain in older people offers the chance of an earlier surgical treatment, so reducing the risk of postoperative complication and mortality.
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PMID:[Appendicitis in the aged]. 204 17


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