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

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.
Radiology 1992 Sep
PMID:Appendicitis in children: color Doppler sonography. 811 55

The authors present a retrospective analysis of 465 pediatric laparoscopic appendectomies. The ages of these patients ranged from 3 to 16 years, with a mean age of 10 years. The diagnosis of acute appendicitis was based on one or more of the following: the initial or repeated physical examination, abdominal radiographs, leukocyte blood count, and ultrasonography. On gross examination, 90% of appendices appeared inflamed, while on microscopic examination, 93% showed evidence of acute inflammation. There was a 3.6% incidence of minor intraoperative incidents and a 3.0% postoperative complication rate with 1.3% of patients requiring a subsequent laparotomy or repeat laparoscopic procedure. There were no deaths. The advantages of laparoscopic appendectomy include easy and rapid localization of the appendix, regardless of its location, the ability to explore the entire abdominal cavity through the same laparoscopic portals used for appendix removal, the ability to lavage completely the contaminated peritoneal cavity, a reduction in the incidence of intraperitoneal abscesses, and a probable reduction in postoperative adhesions. In addition, laparoscopic appendectomy is associated with less cutaneous scarring and a more rapid return of intestinal function and normal activities. In our experience, these results are better than those obtained with classical surgery.
Surg Laparosc Endosc 1991 Sep
PMID:Laparoscopic appendectomy in children: report of 465 cases. 166 97

The successful application of laparoscopic surgery to gallbladder disease and acute appendicitis has encouraged clinical investigators to develop this technology further in an attempt to manage other pathologic disorders of the gastrointestinal (GI) tract. After gaining experience with various laparoscopic skills while performing clinical biliary tract surgery, appendectomy and then in a controlled animal laboratory, a pilot program for laparoscopic colonic surgery was initiated. Twenty patients with ages ranging from 43 to 88 years (mean age of 57 years) underwent laparoscope-assisted colon resection. In nine patients, a right hemicolectomy was performed and a sigmoid colectomy in eight. A low anterior resection, Hartman's procedure, and abdominal perineal resection were each performed in one patient. Indications for surgery were large villous adenomas or adenocarcinoma in 12, diverticular disease in 5, sigmoid endometrioma in 1, cecal volvulus in 1, and inflammatory bowel disease in 1. Eighty percent of patients were able to tolerate a liquid diet on the first postoperative day and 70% were discharged within 96 h eating a regular diet and having normal bowel movements. There were three operative complications: a 3 unit postoperative bleed managed without surgery, one patient developed marked edema of the rectosigmoid anastomosis requiring decompression with a rectal tube, and one individual with metastatic colon cancer was operated on for a mechanical small bowel obstruction 7 days after the initial laparoscopic surgery. Although laparoscope-assisted colonic surgery may still be considered a procedure in evolution, we feel that in time it has the potential to be as popular as laparoscopic cholecystectomy.
Surg Laparosc Endosc 1991 Sep
PMID:Minimally invasive colon resection (laparoscopic colectomy). 168 89

The incidence of acute appendicitis has been reported to vary substantially by country, geographic region, race, sex, season, and occupation, but the reasons for this variation are unknown. We evaluated several risk factors for appendicitis by analyzing data from hospital discharge abstracts on all cases of acute appendicitis treated surgically in nonfederal hospitals in California from 1983 to 1986 (N = 102,546). Comparison of age and sex-specific incidence rates for four racial/ethnic groups (white, Hispanic, black, and Asian/other) revealed rates in blacks and the Asian/other group one-half or less of the rates for whites and Hispanics between the ages of 5 and 29 years. Incidence rates in males were higher than rates in females in all racial/ethnic groups for most ages (RR = 1.1-1.7). Seasonal variation in incidence was modest. Peak rates occurred in July, August, and September, and the lowest rates occurred in December. Hypotheses about the etiology of appendicitis must account for substantial racial/ethnic, gender, age variation, and modest seasonal variation in the incidence.
Epidemiology 1991 Sep
PMID:The epidemiology of acute appendicitis in California: racial, gender, and seasonal variation. 174 78

The incidence of hospital and posthospital wound complications was studied in 236 patients, residents of Zelonograd, who underwent operation for acute appendicitis. The material was collected at City Hospital No. 3 and four out-patient clinics of Zelenograd. The incidence of suppuration of the surgical wound in the hospital period was 13.1%, that of nonpurulent complications was 9.3%, and the total incidence of the wound complications was 22.4%. In the posthospital period additional suppuration of wounds was encountered in 23.3% of patients, nonsuppurative wound complications in 17.1%, and the total incidence of posthospital wound complications was 40.3%. The frequency of rehospitalization was 5.5%, the incidence of postoperative hernias was 0.9%. The economical loss due to the development of wound complications in 236 patients operated on for acute appendicitis came up to 56,120 roubles.
Khirurgiia (Mosk) 1991 Sep
PMID:[Complications of wound healing after appendectomy. Medical and economic aspects]. 175 33

The paper reports a case of intestinal malrotation in an adult patient with an anomalous location in the left hypochondrium of the cecum and vermiform appendix. The patient underwent explorative laparotomy for peritonitis due to acute appendicitis. Following a review of the literature, the anomaly was classified in embryological terms as a union defect during the third developmental stage of the umbilical loop. Attention is focused on the importance of an exact knowledge of the embryology of intestinal rotation in order to avoid technical surgical errors. In conclusion, the value of giving the patient precise iconographic documents is stressed in order to inform the surgeon who may have to operate on the patient's abdomen in the future.
Minerva Chir 1991 Sep 15
PMID:[Intestinal malrotations in the adult]. 175 38

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.
Baillieres Clin Gastroenterol 1991 Sep
PMID:The acute abdomen: the role of laparoscopy. 183 86

A male aged 57 years with acute appendicitis was found to have ST elevations in the EGG (precordial V1-V3 leads) suggesting acute myocardial infarction. The ECG returned to normal postoperatively. The patient showed no signs of ischaemic heart disease and the exercise test and myocardial scintigraphy were found to be normal.
Ugeskr Laeger 1991 Sep 23
PMID:[ST elevation in a patient with a healthy heart and acute appendicitis]. 194 92

A clinical study on cefuzonam (CZON), a new parenteral cephalosporin antibiotic, was performed in 22 patients with acute appendicitis. CZON in a dose of 1 g was administered by intravenous bolus injection or intravenous drip infusion for 60 minutes. In the appendices, concentrations of CZON were 0.066-21.7 micrograms/g in normal or slight catarrhal cases, 0.173-11.7 micrograms/g in moderate phlegmous cases and 0.116-12.1 micrograms/g in serious gangrenous perforated cases. The concentration of CZON in appendixes was not directly proportional to the degree of pathological change of inflammation. 6 patients with acute peritonitis due to perforated appendicitis were treated with CZON of 2 g/day for 5-10 days. The clinical effect was good in 5 cases, fair in 1 case of the above 6. The clinical efficacy rate was 83%. Side effects were not notable in the patients.
Jpn J Antibiot 1991 Sep
PMID:[Clinical studies on cefuzonam for acute peritonitis due to perforated appendicitis. Tissue concentration and clinical efficacy]. 196 Aug 60

One hundred patients with suspected acute abdominal inflammation were imaged at 0.5, 2-3, 4-6, and 24 hours after the administration of Tc-99m HMPAO labeled autologous leukocytes. Scan findings were retrospectively compared with final diagnosis, serum C-reactive protein (CRP), and antibiotic treatment. Clinical findings were confirmed with surgery, barium enema, or sigmoidoscopy in 61 patients, and diagnosis was based only on clinical findings in 13 patients. In 26 patients, symptoms subsided before a final diagnosis was made. Tc-99m leukocyte images were positive in 45 of the 61 patients with a confirmed diagnosis, including all patients with acute cholecystitis (N = 4) and inflammatory bowel disease (N = 8). They were also positive in nineteen out of 25 patients who had acute colonic diverticulitis and in 6 out of 7 who had intra-abdominal abscesses. Abnormal activity was found in patients with colonic carcinoma, small bowel infarction, and acute appendicitis. Abnormal activity was visualized in 0.5-hour images in all but one of the positive cases. With the exception of two postoperative cases, malignant lymphoma, and a liver abscess, a CRP level of greater than 75 mg/L was associated with positive image findings. Antibiotic treatment did not affect imaging findings. Imaging with Tc-99m labeled leukocytes appears to be valuable for detecting and localizing abdominal inflammation, and three-phase imaging during the first 4-6 hours is recommended. In some cases, 24-hour images may be useful for distinguishing small bowel from large bowel inflammation.
Clin Nucl Med 1990 Sep
PMID:Tc-99m labeled leukocytes in imaging of patients with suspected acute abdominal inflammation. 220 80


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