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

Retained barium may lead to acute appendicitis. This should be kept in mind when a patient has an abnormality of the gastrointestinal tract, as retained barium seems to increase the risk.
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PMID:Acute appendicitis and barium enema. 273 57

The etiology of cecal diverticulitis remains unclear. The majority of diverticula are solitary and probably false and may be the result of the same degenerative process seen in the more common left-sided diverticulosis. A minority are true diverticula and may be of congenital origin. Cecal diverticulitis is clinically indistinguishable from acute appendicitis although patients with cecal diverticulitis tend to be older (average age, 40 years), have a longer duration of symptoms, and present less often with nausea and vomiting. In patients with previous appendectomy and in those with more indolent symptoms, barium enema may be helpful in making the diagnosis. If nonoperative treatment is chosen, careful follow-up with air contrast barium enema and colonoscopy should be carried out. The majority of patients require surgery and two types of cecal diverticulitis are encountered at laparotomy. The usual type, accounting for two thirds of cases, is easy to recognize, has an inflamed projection from the cecal wall, and is dealt with by a limited local diverticulectomy. Some authors advocate nonsurgical treatment for this first group of patients. Incidental appendectomy is advocated to avoid confusion should symptoms occur postoperatively. The hidden variant presents as a large, indurated phlegmon and is difficult to distinguish from a perforated cecal carcinoma. With the hidden variant, right hemicolectomy is the surgical treatment of choice and carries a 1.4 percent mortality.
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PMID:Cecal diverticulitis. A review of the American experience. 330 72

Whether barium retained in the appendix can be a cause of acute appendicitis is debatable. We describe a 40-year-old man who developed nonspecific right abdominal pain 7 weeks after a barium enema, which proved to be normal. On abdominal film a distended appendix containing barium was seen, and at laparotomy acute appendicitis was present. Thus far, 26 cases of "barium appendicitis" have been reported. On the basis of the relevant literature and the cases collected, it is appropriate to draw the following conclusions: 1) With present knowledge it is not possible to state whether retained barium plays any etiologic role in the development of subsequent uncomplicated acute appendicitis. 2) If a later appendicitis does supervene, it carries a high risk of being complicated; barium seems to be responsible for the complication. 3) The longer the interval between the barium study and the subsequent appearance of acute appendicitis, the higher will be the risk of complications.
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PMID:Barium appendicitis: fact or fancy? Report of a case and review of the literature. 330 23

A concentric ring appearance of the cecal mucosa on a barium enema is a distinctive but nonspecific radiographic finding that has been termed the vortical, whirlwind, or coiled-spring sign. It can be caused by inversion of a postappendectomy stump and transient intussusception of the intact appendix in asymptomatic patients. The sign has also been reported with mucoceles, carcinoma, and endometriosis of the appendix, but there has been little mention of it in connection with acute appendicitis. The records of 18 patients with a coiled-spring sign and nonfilling of the appendix were reviewed. Acute appendicitis was proven in 14 of 18. In five of these 14, this sign was the only finding accompanying nonfilling of the appendix. On review of 53 cases of pathologically proven acute appendicitis studied by preoperative barium enema, 14 had a coiled-spring sign. The coiled-spring sign is nonspecific but can be produced by acute appendicitis, where it may be the only positive sign accompanying nonfilling of the appendix.
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PMID:Coiled-spring sign of the cecum in acute appendicitis. 348 8

One hundred seventy consecutive patients with clinical suggestion of acute appendicitis were studied by ultrasound (US) with the examiner using the graded compression technique. In 14 patients, the only US findings consisted of enlarged mesenteric lymph nodes in combination with mural thickening of the terminal ileum. This was consistent with the findings at surgery in four patients and with the results of barium studies in seven patients. In nine of 14 patients, stool cultures were performed, eight of which were positive for Yersinia enterocolitica. None of these 14 patients finally proved to have appendicitis. In a patient with acute pain in the right lower quadrant whose appendix cannot be visualized sonographically and whose US findings consist of enlarged mesenteric lymph nodes and mural thickening of the terminal ileum, the diagnosis is probably mesenteric adenitis and acute terminal ileitis. Appendectomy should be avoided in this condition.
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PMID:Mesenteric adenitis and acute terminal ileitis: US evaluation using graded compression. 353 38

A case is presented of acute appendicitis in a 50-year-old man with unsuspected carcinoma of the right colon. This association is emphasised as acute appendicitis is an important marker of colonic carcinoma in the older age group. The value of doing routine barium enema examination in these patients after appendicectomy is discussed. Further unusual features of this carcinoma were radiographically visible calcification and spread into the right kidney.
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PMID:A complicated case of appendicitis. 373 8

The barium enema is a safe and useful diagnostic modality in the evaluation of patients with suspected acute appendicitis. Complete appendiceal filling with barium virtually excludes this diagnosis. Frequently positive diagnostic information is obtained. Only 1 study in the literature documents the frequency of normal appendiceal filling by barium enema. The authors utilized the single-contrast technique. We recorded the frequency of normal appendiceal filling with the double-contrast technique and then compared our data with the previously published study to determine if there is a significant clinical disadvantage to the double-contrast technique when acute appendicitis is a diagnostic consideration.
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PMID:Appendiceal filling by double-contrast barium enema. 394 69

Cecal diverticulitis, is not a common disease, frequently congenital, becoming clinically evident between the second and the fourth decade. The diagnosis of cecal diverticulitis is often controversial since the signs and symptoms simulate an acute appendicitis or an appendicular abscess. Moreover, during surgery, sometimes it appears like carcinoma of the cecum. Barium enema is the only clinical test useful for a correct diagnosis before surgical procedure, but in the case of an acute appendicitis this test is normally not performed. The surgical treatment is, when possible, diverticular resection associated with cecal appendix resection. In doubtable or technically hazardous cases it is sometimes necessary a right hemicolectomy. Mortality and morbidity for minor procedures are negligible, whereas for right hemicolectomy they range between 3,7% and 11% according to different Authors.
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PMID:[Diverticulitis of the cecum]. 623 38

Barium enema examination is a well known and useful adjunctive technique for the diagnosis of acute appendicitis when its clinical presentation is atypical. The combination of a mass effect on the cecum and nonfilling of the appendix have been considered virtually pathognomonic radiographic findings. These appearances on barium enema examination may also be encountered in patients with small-bowel obstruction, acute enterocolitis, pelvic hemorrhage and adhesions, and pelvic inflammatory disease. In three of five cases, these radiographic findings contributed to the decision to perform laparotomy, at which a histologically normal appendix was removed. The value of the barium enema examination in suspected but atypical acute appendicitis must be tempered by the recognition that occasionally other diseases with acute presentations produce similar findings.
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PMID:Nonspecificity of barium enema findings in acute appendicitis. 661 Mar 41

A simplified radiographic procedure was utilized in children with suspected acute appendicitis in an effort to improve diagnostic accuracy. Children with suspected appendicitis were given 6 oz of barium by mouth, and follow-up posteroanterior, and oblique radiographs of the abdomen were obtained 6 to 12 hours after barium ingestion. Appendicitis was not seen in 63 children with complete appendiceal filling. An 8 percent incidence of appendicitis was seen with partial appendiceal filling. A 42 percent incidence of appendicitis was noted in 110 children with nonvisualization of the appendix, and an 86 percent incidence of appendicitis was noted where there was a mass effect on the cecum. The advantages and disadvantages of the barium swallow have been discussed. By utilizing the barium swallow as a diagnostic adjunct, an overall 95 percent accuracy rate in the diagnosis of acute appendicitis was achieved over a 4 1/2 year period.
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PMID:Use of the barium swallow in the diagnosis of acute appendicitis. 663 74


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