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

The incidence of appendiceal diverticulosis in pathologic specimens is 0.004-2.1%. Diverticular disease of the appendix is classified as congenital (true) or acquired (false). The clinical presentation differs from that of acute appendicitis. The average age is older, the pain is often intermittent, and while localized in the right lower abdominal quadrant, is of longer duration. No further treatment besides appendectomy is needed. Since a high rate of perforations, peritonitis and lower gastrointestinal bleeding have been reported as complications, it is recommended that in those with an incidental finding of diverticula of the appendix during surgery, that appendectomy be performed. It is not recommended to perform prophylactic appendectomy when diverticula of the appendix are found on barium enema.
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PMID:[Diverticular disease of the appendix]. 915 23

Appendicovesical fistula is a rare complication of acute appendicitis in children that is difficult to diagnose preoperatively. A 21-month-old boy with signs and symptoms of recurrent urinary tract infections underwent abdominal ultrasonography, computed tomography (CT), barium enema examination, and cystography, none of which was sufficient to establish a diagnosis; an appendicovesical fistula was demonstrated by laparoscopy. The patient underwent open appendectomy, with resection of the fistula through a small incision, and has recovered without complications.
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PMID:Laparoscopic diagnosis of appendicovesical fistula in a pediatric patient. 919 94

The appendiceal abscess is a common complication of acute appendicitis and usually is located in the right lower quadrant of the abdomen. An epigastric appendiceal abscess has never been reported at an unusual location. We experienced an unusual case of a 49-year-old man with an epigastric appendiceal abscess. Initially, this abscess was suspected to be a pancreatic abscess. Abdominal CT scan and barium enema demonstrated a hyperrotated cecum with an appendiceal abscess in the left upper quadrant of the abdomen. An gastroscopy revealed a small fistula-like lesion with purulent coating at the bulging posterior gastric wall. The abscess resolved spontaneously. We believe that the abscess drained into the stomach through a small fistula between the stomach and abscess cavity. There was no recurrence for over 6 months.
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PMID:Epigastric appendiceal abscess with spontaneous drainage into the stomach. 1046 30

Primary epiploic appendagitis (PEA) is a rare benign self-limiting inflammatory process of the colonic epiploic appendices. Patients present with acute abdominal pain, often misdiagnosed clinically as acute appendicitis or diverticulitis. Computed tomography (CT) scan findings of this condition are characteristic and can confidently suggest the diagnosis avoiding unnecessary barium enemas and colonoscopy, biopsy, or surgery.
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PMID:Primary epiploic appendagitis: a report of two cases. 1127 84

An unusual case of sliding inguinal hernia complicated by stercoral appendicular fistula as a result of acute appendicitis was reported in a 3-month-old boy. A diagnosis was made using barium enema. Elective appendectomy and narrowing of the internal ring using a purse-string suture were carried out safely via a right transverse infraumblical incision. Postoperative follow-up was uneventful.
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PMID:A patient with an unusual complication of sliding inguinal hernia: Stercoral appendiceal fistula. 1198 13

The age peak for acute appendicitis is between 10 and 20 years. Although older persons more rarely develop appendicitis, in the group of over-45-year-olds the perforation and mortality rates are appreciably higher. The reason for this is the fact that in the elderly, the symptoms are often veiled, so that the diagnosis is delayed. A particular role in this connection is played by pain killers and non-specific findings. In particular, however, the commonly present co-morbidity in older patients with appendicitis often leads to recalcitrant infections, and not infrequently to sepsis with a potentially fatal outcome. For the establishment of the diagnosis, therefore, a careful physical examination and thorough history-taking, together with a comprehensive laboratory work-up is essential. Imaging procedures such as X-rays of the abdomen, ultrasonography and, where indicated, such further measures as a barium enema or a CT scan may help establish the diagnosis in patients with unclear clinical symptoms, and thus prevent perforation.
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PMID:[Insidious and often fatal. Appendicitis with few symptoms in the elderly patient]. 1213 73

Several strategies have been employed to improve the accuracy of the diagnosis of appendicitis and to reduce the associated perforation rate. Because clinical algorithms have been disappointing, many physicians resort to radiological modalities. Plain abdominal x-rays are nonspecific, barium enema examination has relatively low accuracy, scintigraphy scans require considerable time and are difficult to interpret, and magnetic resonance imaging is relatively unstudied. The most promising modalities are graded compression sonography and computed tomography. In expert hands, these techniques can achieve a high degree of accuracy. Nevertheless, most published studies have been marred by methodological difficulties. Moreover, ultrasound is more useful in detecting than in ruling out appendicitis. The radiological criteria for acute appendicitis, the accuracy of various imaging modalities and the limitations of the available research are described.
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PMID:The role of radiological imaging in the diagnosis of acute appendicitis. 1217 24

Retention of barium within appendix following a gastrointestinal tract study may predispose in rare instances to narrowing of appendiceal lumen, thus contributing to development of acute appendicitis. We present the case of a 42-year-old woman in whom this sequence of events was recognized who presented with clinical signs of acute appendicitis 9 days after barium swallow test was performed. Patients must be informed increased chance for development of appendicitis in these cases and be instructed to recognize early symptoms. Surgical treatment is reserved for symptomatic patients and prophylactic appendectomy is not reccommended.
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PMID:[Appendicitis following esophagogastroduodenal study: report of a case]. 1519 63

Diverticular disease of the right colon is not common, especially in western countries. It occurs in two different clinical forms, known as the "usual" and "hidden" variants. The diagnosis is not always easy, especially in the latter variant, because sometimes barium enema and CT scan are unable to distinguish this form from cancer. The final diagnosis is only intraoperative. In our experience, from 1994 to 2004, we observed 4 cases of complicated right-sided diverticulitis. Three of these patients had symptoms mimicking acute appendicitis, such as fever and abdominal pain. Only 2 of them underwent surgical treatment consisting of a right standard hemicolectomy. The 4th patient had no inflammatory symptoms, but had a history of right-sided abdominal pain and diarrhoea. Laboratory data showed only hypochromic anaemia. Barium enema and CT scan highlighted a vegetating mass in the ascending colon causing irregular severe stenosis of the lumen and hyperdensity of mesocolic fatty tissue. Surgical treatment consisted in a right hemicolectomy. Macroscopically, the mass involved the caecum and ascending colon. Enlarged lymph-nodes were present in the thickness of the mesocolon, but not in other districts. Histological examination revealed diffuse diverticular disease complicated by perforation of many diverticula into the mesocolon.
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PMID:Diverticular disease of right colon. Clinical variants and personal experience. 1673 70

Mesenteric and retroperitoneal cysts are rare intra-abdominal tumours with an incidence of 1/140.000 in surgery departments and 1/20.000 in paediatric departments. There are no pathognomonic signs or symptoms for the cysts. In the differential diagnosis lymphangiomas, sarcomas, adenocarcinomas and intestinal duplications should be considered. Diagnostic includes abdominal computed tomography, ultrasound and MRI. Barium enema examination or intravenous pyelogram may be used in special cases. Surgical treatment is indicated also in asymptomatic patients; laparoscopic approach is the "gold standard". Laparotomic approach should be used in the cases of impossibility of total enucleation or in the cases of malignant degeneration. Complete enucleation is the treatment of choice for retroperitoneal and mesenteric cysts. If this cannot be accomplished, the alternative should be the excision of the cyst or the marsupialization. In this paper we present a case of young man with a mesenteric cyst mimicking acute appendicitis.
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PMID:[Mesenteric cyst: case report and review of the literature]. 2061 68


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