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

This preliminary communication describes the initial results of a further special study investigating the disease spectrum and clinical presentation in a total of 1080 children admitted to hospital with acute abdominal pain (677 from the Children's Hospital, Sheffield, England, and the remaining 403 from hospitals in Paris, Oslo, Copenhagen, and Deventer). The disease spectrum in children differs radically from that in adults, well over 90% of cases being due to either acute appendicitis or non-specific abdominal pain (NSAP). The clinical presentation of both appendicitis and NSAP was found to differ from that in older age groups. These findings imply clearly that the use of the existing OMGE database for computer-aided diagnosis--using data drawn from cases of all ages--may not be optimal in children. A fresh database (using only children's data) was therefore created and tested. Its sensitivity for appendicitis was equivalent to that of inexperienced clinicians (79.6% versus 77.3%). The computer's specificity (over 70%) was higher than that of clinicians (52.7%). The findings also re-emphasise the value of disciplined data collection, and the implications for teaching are discussed.
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PMID:Acute abdominal pain in children. 304 47

The torsion and infarction of an accessory spleen must be considered as a rare cause of acute abdominal pain in childhood. It can be accompanied by acute diffuse or localised abdominal pain and it could also appear to be an acute appendicitis or an intussusception. The ultrasound examination helps to narrow down the possible differential diagnoses.
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PMID:[Accessory spleen torsion. Clinical picture, sonographic diagnosis and differential diagnosis]. 305 66

Differentiating acute appendicitis from other causes of acute abdominal pain in children frequently remains unsatisfactory. To determine whether initial historical and physical examination findings might predict final diagnoses, 246 patients with complaints of nontraumatic and nonrecurrent acute abdominal pain were studied. All were between three and 18 years of age and had presented to a hospital-based pediatric emergency department. Each family was telephoned an average of 5.1 days after the visit to determine the patient's subsequent clinical course; operative notes and pathology reports were reviewed for patients receiving surgery. Of these patients with acute abdominal pain, both fever and vomiting were present in 18 of the 24 who eventually had diagnoses of appendicitis, compared with 49 of 222 patients with other final diagnoses (P less than 0.01, with negative predictive value 0.97, sensitivity 0.75, and specificity 0.78, but positive predictive value only 0.27). The duration of the pain at presentation and the frequency of other symptoms (eg, diarrhea, dysuria, anorexia, and lethargy) were unrelated, however, to final diagnosis, as was the duration of the pain and whether abdominal tenderness initially was localized or generalized. Nonruptured appendicitis was generally indistinguishable from ruptured appendicitis preoperatively, by both duration and symptoms. Boys were found more likely to have appendicitis (with or without rupture) than girls (18/118 or 15%, vs. 6/128 or 5%, P less than 0.05). In conclusion, fever and vomiting were noted at presentation more frequently in children with appendicitis than in children with other causes of acute abdominal pain.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Diagnosing appendicitis in children with acute abdominal pain. 318 19

This presentation reports the experience of the surgical house staff and registrars at Middlesbrough General Hospital who used a desk-top computer system to support their clinical diagnosis of acute abdominal pain. The results cover a two year period and are compared with a baseline period of one year. Substantial benefits followed the introduction of the computer-aided diagnostic support system; increased diagnostic accuracy of the whole surgical team, reduction in negative laparotomy rates, earlier surgical intervention for acute appendicitis, reduction in the number of cases of perforated appendicitis and more efficient use of resources. The reasons for these improvements include more thorough collection of data, use of common terminology and an educational element provided by detailed feedback from the computer system.
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PMID:Computer aided diagnosis of acute abdominal pain at Middlesbrough General Hospital. 353 83

Acute suppurative infection of the sacroiliac joint can mimic the acute abdomen. Experience with a patient who had exploratory laparotomy for acute appendicitis prompted a review of the literature, which indicated that 12.6% of patients with pyogenic sacroiliitis have acute abdominal pain. A high index of suspicion is necessary to establish this diagnosis.
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PMID:Pyogenic sacroiliitis: another imitator of the acute abdomen. 372 68

The high negative exploration rate in patients with suspected acute appendicitis is the main compelling reason to improve the accuracy in managing patients with acute abdominal pain. In this article, data from a prospective study on a group of patients undergoing an acute appendectomy were used to devise a scoring system for the purpose of differentiating between the patients with an acute appendicitis and those found to have a normal appendix at operation. The results show that by using the scoring system described, 30% of the unnecessary appendectomies could have been avoided. These findings show the potential value of this method. The results of the prospective study were compared with the results of a retrospective study on the same group of patients demonstrating a significant difference and hence the unreliability of retrospective studies.
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PMID:Scoring system for computer-aided diagnosis of acute appendicitis. The value of prospective versus retrospective studies. 390 8

Omental infarction may be much more common than the number of cases reported in the literature would imply. The condition should be considered in the differential diagnosis of acute abdominal pain. A thorough search for it should be made in patients whose findings at laparotomy are not consistent with the preoperative diagnosis (usually acute appendicitis), especially when serosanguineous fluid is found in the peritoneal cavity. Treatment is excision of infarcted omentum to prevent formation of adhesions with obstructive and septic complications.
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PMID:Infarction of the greater omentum. Elusive cause of acute abdominal pain. 396 Jul 96

Appendicitis is not the only common cause of acute abdominal pain in childhood. Almost equally common is an acute episode which in its early stages resembles acute appendicitis but which subsides without treatment in 24 to 48 hours. The clinical features of this syndrome are contrasted with those of appendicitis. The two conditions cannot always be distinguished on clinical grounds, leading to admission to hospital for observation and the finding of a normal appendix in 14% of operations for suspected appendicitis. Reasons are given for abandoning attempts to diagnose acute mesenteric adenitis at the bedside.
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PMID:Acute abdominal pain in childhood, with special reference to cases not due to acute appendicitis. 576 46

Campylobacter jejuni Skirrow biotype 1, Lior serotype 8 was isolated from the appendix of an 11-year-old boy who had a 6-h history of acute abdominal pain. Histological diagnosis on the appendix section was early acute appendicitis. Dilute carbol fuchsin stain and indirect fluorescent antibody test performed on the appendix section also revealed the presence of Campylobacter sp. The patient developed a significant bactericidal antibody titer of 1,024, providing substantial clinical evidence of the pathogenicity of the isolate. This case indicated that not only may abdominal pain caused by Campylobacter enteritis mimic appendicitis, but the organism may actually be recovered from the infected appendix.
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PMID:Isolation of Campylobacter jejuni from an appendix. 635 36

By 1982, the central analysis team of this on-going multinational survey had received a total of 8,723 cases for analysis and had accepted 8,480. In all some 23 centres in 15 countries, involving over 200 doctors had participated in this survey. A common protocol was used for data collection; around 98% of all possible data was recorded (using pre-circulated definitions) and analysed via a computer-aided system in Leeds, England. As before, the most common surgical diagnosis was acute appendicitis (2336 of 8,480 cases, 27.5%) followed by acute cholecystitis (800 cases, 9.4%). The construction of a worldwide database of information about 6.097 patients is described--as is its use both in diagnosis and in teaching. Particular attention is given to the construction of a computer program which allows medical students to compare their impression of acute abdominal pain with 'reality' as evidenced in these 6,097 patients. As regards additional cases, particular stress has been laid on acquisition of material from countries outside Europe and North America. Series from Mexico (893 patients) and Thailand (311 patients) are discussed in detail, and the implications for future work are reviewed.
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PMID:The O.M.G.E. Acute Abdominal Pain Survey--progress report, 1982. 637 50


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