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

Diverticulitis of the right colon is a relatively uncommon disease that usually mimics acute appendicitis. Most patients are operated on early, and a barium enema is not commonly obtained. Five cases with barium studies are presented. In four of the five cases an intramural mass effect and evidence of involvement of the colonic wall were present. Diverticula of the right colon were found in all five patients. If the diagnosis is made without surgery, medical therapy is usually successful.
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PMID:Diverticulitis of the right colon. 669 55

Barium is occasionally retained in the appendix after radiographic examinations of the gastrointestinal tract, and its significance has been debated for many years. This report details three cases in which barium was present in the appendix at the time of acute appendicitis. Review of these three cases and 13 cases previously reported suggests that retained appendiceal barium may be significant when it exists in either of two patterns. In patients with appropriate symptoms, a barium appendicolith has the same significance as a calcified appendicolith, strongly suggesting a diagnosis of appendicitis. Barium outlining a dilated appendical lumen also suggests appendicitis in the appropriate clinical setting. The significance of retained barium in the appendix in asymptomatic patients remains uncertain.
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PMID:Significance of retained barium in the appendix. 677 9

The significance of prolonged retention of barium in the appendix in an asymptomatic patient has been debated. Four patients, with retained barium in the appendix for several months after gastrointestinal barium studies, who then developed acute appendicitis, are reported and analyzed. Thirty-one patients who retained appendiceal barium longer than 72 hr after radiographic examination of the gastrointestinal tract were followed for over 1 year. No patient developed appendicitis. Five patients underwent abdominal surgery for other indications and there was no evidence of appendicitis. In 11 patients, who had abdominal radiographs 6 days to 4 months after detection of appendiceal barium, the barium had disappeared. The connotation of the term "barium appendicitis" as initially reported is questioned. Preliminary data in this report suggest that no causal relationship exists between prolonged retention of barium and future acute appendicitis and that normal appendices can expel barium in variable time periods. Etiologic connotation between prolonged appendiceal barium retention and future acute appendicitis should be erased. Retained barium in the appendix can be used as an acid in the precise radiographic diagnosis of acute appendicitis.
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PMID:Retained barium n the appendix: diagnostic and clinical significance. 697 65

We report a case of acute appendicitis with perforation associated with retained appendiceal barium. Abnormally retained barium may lead to appendicitis and this should be kept in mind when a barium-filled appendix is seen in an asymptomatic patient. Routine follow-up films on all patients whose appendix fills with barium are not recommended.
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PMID:Barium appendicitis. 707 50

Appendicitis remains the most common intraabdominal indication for surgery in children. Recently, barium enema has been helpful in increasing the accuracy of diagnosis in difficult cases. Experience with 202 barium enemas in children with abdominal pain entertaining the diagnosis of acute appendicitis revealed some of the problems encountered in using this procedure as a diagnostic tool. Of the 66 children who underwent surgery, there were 32 children who were felt to have a positive barium enema and 31 of these turned out to have acute appendicitis. In the group that had negative barium enemas, there were 3 false negatives and 2 of these children had early perforations by the time of their surgery. The third group were equivocal barium enemas and they pointed out the difficulty in obtaining a normal barium enema in a child who does not have appendicitis. It was felt that the use of barium enema as an adjunct was helpful especially if it were positive, but a negative barium enema could not be relied upon to delay surgery in the child with right lower quadrant peritoneal signs.
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PMID:Pitfalls in the use of barium enema in early appendicitis in children. 725 33

The diagnosis of acute appendicitis is generally based on clinical and laboratory findings. In 1/3 of the cases, acute appendicitis presents atypically and, consequently, the contribution of the radiologist becomes necessary. Conventional radiologic methods, i.e. plain abdominal film and barium enema, generally yield aspecific and indirect information. In contrast, the modern methods of cross-sectional imaging, i.e. sonography and Computed Tomography (CT), allow to identify, directly and accurately, the inflammation of appendix and periappendiceal tissues. We report our experience with 25 cases of surgically confirmed adult acute appendicitis studied with abdominal CT examination. CT was usually performed with contiguous 5-mm-thick scans and with oral and intravenous contrast agent administration. CT showed abnormal appendix (72% of cases), pericecal or periappendiceal inflammatory infiltration (68%), phlegmon (20%), appendicoliths (16%), abscess (12%). CT was diagnostic for appendicitis in 21 cases (84%) and suggestive of it in 4 cases (16%). CT is an interesting diagnostic alternative to US in the assessment of clinically questionable cases of appendicitis. Furthermore, it is the method of choice in the analysis of complicated appendicitis and in the percutaneous management of periappendiceal abscesses.
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PMID:[Diagnostic value of computerized tomography in acute appendicitis in adults]. 764 31

The diagnosis of acute appendicitis is usually made from the history and physical examination. Recently, abdominal ultrasonography (US), laparoscopy, computerized tomography (CT), and barium enema (BE) have been used in the preoperative evaluation of patients with presumed appendicitis in order to improve the diagnostic accuracy. However, the usefulness of these tests in verifying the diagnosis of appendicitis has not been established. We reviewed the medical records of 203 patients who underwent appendectomy. One hundred patients were surgically treated before 1984 (group I) and 103 patients underwent surgery after 1988 (group II). Patients in group II were more likely to have preoperative US, laparoscopy, CT, or BE (24 in group II versus 3 in group I, p < 0.05). When groups I and II were compared, the rates of perforation (27% versus 20%), normal appendectomy (8% versus 11%), and the interval between admission and operation (12.2 hours versus 10.7 hours) and length of hospitalization (5.0 days versus 5.1 days) were not significantly different. We concluded that although adjunctive testing may be beneficial in selected patients, its routine use in patients suspected of having appendicitis cannot be advocated at present.
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PMID:Impact of adjunctive testing on the diagnosis and clinical course of patients with acute appendicitis. 827 45

A child with the suspected diagnosis of atypical acute appendicitis underwent a diagnostic barium enema. The study was complicated by perforation with leakage of a large amount of barium into the peritoneal cavity. The complex hospital course that resulted has prompted us to reevaluate the barium enema in the diagnosis of appendicitis and review the literature for contraindications. We conclude that this particular complication is extremely rare and that barium enema still has a part to play in some patients where the clinical diagnosis is uncertain.
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PMID:Perforation associated with barium enema in acute appendicitis. 841 56

At the end of the eighties, Doppler equipment added to conventional ultrasonography a new dynamic dimension. On the basis of radiological (US, CT, barium studies), clinical, biological, surgical and/or pathological correlations in 30 cases, the following considerations were emphasized. In case of intestinal obstruction, viability of the obstructed segment is compromised when Doppler parietal flow remains undetectable. In Crohn's disease or ulcerative colitis, as well as in acute appendicitis, presence of Doppler parietal flow throughout the affected thickened segment indicates an acute condition; similarly, abnormally high mean portal velocity (30-48 cm/sec; normal: 15 +/- 7 cm/sec), and abnormally low resistive index in the superior mesenteric artery (0.58-0.78; normal: 0.908 = 0.026) are detected. In colonic diverticulitis, similar characteristics can be observed, but are subtle and usually predominant at the mesenteric side of the affected segment in moderate diverticulitis. These abnormal Doppler findings disappear with successful therapy.
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PMID:[Contribution of Doppler sonography in inflammatory pathology of the large bowels]. 864 80

Nine patients (six females and three males), median age = 27.5 years (range 13-36) with caecal diverticulitis are presented. All underwent surgery with a suspected diagnosis of acute appendicitis. Per-operative diagnosis was possible in five cases, two cases were thought to have other benign pathology, but malignancy could not be excluded in the remaining two cases. Local excision was carried out in five cases, a right hemicolectomy was performed in the rest. Histology showed true diverticuli in eight cases, severity of the inflammation made it difficult to comment on the ninth case. Postoperative barium enema was carried out in six cases, which showed no further diverticuli in the colon. We conclude that preoperative diagnosis of caecal diverticulitis is difficult, and that true solitary caecal diverticuli present in a younger age group than the false caecal and ascending colon diverticuli and that they are probably congenital in origin.
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PMID:True caecal diverticulitis. 877 6


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