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

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

99mTc-PIPIDA scans were obtained in three patients with acute abdominal pain. The appearance of the scans suggested partial common duct obstruction. Two patients underwent surgery. One had acute appendicitis and the second had infarction of the distal ileum. In both cases, the gallbladder and biliary tract were normal. The third patient had been treated with morphine, which is known to increase biliary tract pressure and may cause contraction of the sphincter of Oddi. An ultrasound study of the gallbladder was normal and all symptoms resolved within 24 hours. Subsequently, three additional patients without biliary disease have been seen who had similar hepatobiliary scans. All three had received meperidine prior to the study. It is concluded that acute abdominal disease or the administration of morphine sulfate or meperidine can result in a scan pattern suggesting partial distal common duct obstruction in the absence of gallbladder or biliary tract disease.
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PMID:Abnormal 99mTc-PIPIDA scans mistaken for common duct obstruction. 708 93

In a prospective study of 230 patients followed up for 5 years after hospital admission for acute non-specific abdominal pain, 21 patients (9 patients) could not be traced, and 11 (5 percent) had died. Only one death was related to symptoms from the first admission. Of the remaining 198 patients, 77 percent were healthy and free of any symptoms during the observation period. Fourteen patients (7 percent) had been hospitalized once more due to acute abdominal pain; 5 had acute appendicitis. The others had diagnosed recurrences of nonspecific abdominal pain. Sixteen percent complained of continuing of intermittent abdominal symptoms, mainly of benign colonic or gynecologic origin, while malignant disease developed in 1 percent (or 4 percent of patients over 50 years of age). It is concluded that control of these patients is generally unnecessary, but when symptoms recur further examinations, especially for colonic or gynecologic disease, should be carried out. In patients over 50 years old, the possibility of malignant disease should be kept in mind.
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PMID:Prognosis of acute nonspecific abdominal pain. A prospective study. 711 75

From January to March 1980, a consecutive sample of 50 children admitted to hospital with acute abdominal pain provisionally diagnosed as appendicitis but who recovered spontaneously without a specific physical diagnosis was studied. The instruments used were a standardized parental interview and Rutter A(2) and B(2) questionnaires which are designed as screening devices to explore levels of emotional adjustment in children. A comparison was made with 43 children (controls) matched for sex and age from the same schools. Forty children suffering from acute appendicitis were studied in the same way. A significantly increased number of children in the nonspecific group obtained abnormal scores on the Rutter Scales compared with the control group (P less than 0.025). An unexpectedly large number (31%) of boys suffering from acute appendicitis obtained abnormal scores on the Rutter Scales. Postal follow up three months following discharge from hospital indicated that 8 (16%) of the nonspecific group were incapacitated to the extent of missing school. During the study, 15 children had a normal appendix removed at operation. Seven of them showed a significant degree of maladjustment.
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PMID:Hospital admissions for abdominal pain in childhood. 713 74

The authors report what they believe is the first report in the English literature of acute inflammation of ectopic pancreatic tissue in a Meckel's diverticulum. A 29-year-old man presented with acute abdominal pain and a clinical diagnosis of acute appendicitis was made. Laparotomy revealed a normal appendix and a Meckel's diverticulum with gross inflammation at the distal end. Microscopic examination showed acute inflammation limited to ectopic pancreatic tissue in the wall of the diverticulum. Fat necrosis was present. The possible pathophysiologic mechanisms are discussed.
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PMID:Acute inflammation of pancreatic tissue in a Meckel's diverticulum. 713 21

A 40-year-old woman presented with acute epigastric pain with vomiting. Within 24 hours, the pain spread to the right periumbilical region. Tc-99m disofenin hepatobiliary scan failed to demonstrate the gallbladder on a 60-minute view. The presumative diagnosis of acute cholecystitis was thought to be confirmed on this basis by the patient's physicians. However, a 75-minute view demonstrated filling of the gallbladder. In hepatobiliary scanning for acute abdominal pain, delayed views (2 to 24 hours) are recommended when the gallbladder is not visualized on the 60-minute view. If the gallbladder is visualized, cystic duct obstruction can be excluded and diagnoses such as pancreatitis, acalculous cholecystitis, and acute appendicitis should be investigated.
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PMID:Hepatobiliary scan with delayed gallbladder visualization in a case of acute appendicitis. 720 Aug 46

The role of clinical and computer based decision in the diagnosis of acute appendicitis in the elderly was studied in connection with the Research Committee of the World Organization of Gastroenterology (OMGE) survey of acute abdominal pain. A total of 220 patients over the age of 65 years presenting with acute abdominal pain were included in the study at the Central Hospital of Savonlinna and at the University Hospital of Tampere. Twenty-two preoperative clinical history variables, 14 clinical signs and three tests were evaluated in a single variable and multivariate analysis to find the best combination of predictors of acute appendicitis in the aged. In order to sum up the contributions of independent diagnostic factors, a diagnostic score (DS) was built: DS = 2.81 x (rectal digital tenderness; 1 = yes, 0 = no) + 2.54 x (rigidity; 1 = yes, 0 = no) + 2.06 x (renal tenderness; 1 = no, 0 = yes) + 2.33 x (bowel sounds; 1 = normal, 2 = absent/abnormal) - 8.13. The sensitivity of preoperative clinical decision in detecting acute appendicitis in the aged was 0.79 with a specificity of 0.92, an efficiency of 0.90 and usefulness index (UI) of 0.56. At a cut-off level of -2.78 the DS reached a sensitivity of 0.84 in detecting acute appendicitis with a specificity of 0.87, an efficiency of 0.87 and UI of 0.68. When the patients with a DS value between -2.78 and -0.45 were considered as non-defined (n = 28, follow-up required before the decision to operate), the sensitivity of the computer-aided diagnosis in detecting acute appendicitis in the elderly was 0.77 with a specificity of 0.97, an efficiency of 0.96 and UI of 0.57. In the elderly patients where a leucocyte count was available (n = 157), location of pain, rectal digital tenderness and leucocyte count predicted significantly acute appendicitis. At a cut-off level of -2.62 the DS reached a sensitivity of 0.81 in detecting acute appendicitis with a specificity of 0.92, an efficiency of 0.91 and UI of 0.59. When the patients with a DS value between -2.62 and 0.06 were considered as nondefined (n = 12, follow-up required before the decision to operate), the sensitivity of the computer-aided diagnosis (leucocyte count available) in detecting acute appendicitis in the elderly improved to 0.86 with a specificity of 0.94, an efficiency of 0.93 and UI of 0.69. In our study the diagnostic scoring system for the elderly performed well considering the simple nature of its structure.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Acute appendicitis in patients over the age of 65 years; comparison of clinical and computer based decision making. 796 Feb 9

Our retrospective study aims at defining the influence of ultrasonography on the management of acute abdominal pain in a pediatric population. This technique appears to be essential in the diagnosis of intussusception and thus, should be recommended in all cases of acute abdominal pain in the population at risk for this disorder. On the other hand, ultrasonography only plays a minor role in the management of the other diseases we observed, especially in acute appendicitis.
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PMID:[The role of ultrasonography in abdominal pain in children in the emergency room]. 796 62

Acute appendicitis is the most common cause of acute abdomen requiring surgical intervention. The clinical diagnosis of acute appendicitis is not always easy due to variable symptomatology, particularly at the onset. The contributions of history-taking and physical examination in the diagnosis of acute appendicitis was studied in connection with the Research Committee of the World Organization of Gastroenterology (OMGE) survey of acute abdominal pain. Especially the suitability of diagnostic parameters in the construction of an expert system for automatic decision making was studied. The results clearly show that it is possible to construct an expert system for automatic decision making in the diagnosis of acute appendicitis.
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PMID:Parameters for a knowledge base for acute appendicitis. 805 50

The role of clinical and computer-based decisions in the diagnosis of acute appendicitis was studied in connection with the survey of acute abdominal pain by the Research Committee of the World Organization of Gastroenterology (OMGE). One thousand three hundred and thirty-three patients presenting with acute abdominal pain were included in the study. Twenty-two preoperative clinical history variables, 14 clinical signs, and 3 tests were evaluated in a multivariate analysis to find the best combination of independent predictors of acute appendicitis for males and females. Independent predictors of acute appendicitis in males were tenderness, previous abdominal surgery, rebound, rigidity, location of pain at diagnosis, guarding, and body temperature. To sum up the contributions of the most significant diagnostic factors, a diagnostic score (DS) was built. When the male patients with a DS value between -2.00 and -0.48 were considered nondefined (n = 75, follow-up required before deciding to operate), the sensitivity of the computer-aided diagnosis in detecting acute appendicitis in males was 0.95, with a specificity of 0.89 and an efficiency of 0.91. In males whose leucocyte count was available (n = 476), previous abdominal surgery, leucocytosis, location of pain at diagnosis, tenderness, rigidity, rebound, guarding, rectal digital tenderness, and body temperature predicted significantly acute appendicitis. The DS reached a sensitivity of 0.94 (the cut-off level was -1.74), with a specificity of 0.80 and an efficiency of 0.84. (ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Sex-specific diagnostic scores for acute appendicitis. 812 77


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