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

Between 1982 and 1989, 78 children with diarrhoea-associated haemolytic uraemic syndrome (HUS) were referred to this hospital. Most presented with abdominal pain, bloody diarrhoea and vomiting. Seven had severe gastrointestinal involvement, four of whom required resection for bowel perforation or necrosis. One also developed an oesophageal stricture, a previously unreported complication of HUS. These seven children had a high incidence of other complications including hypertension, and cerebral and pancreatic involvement. One died from severe cerebral involvement, one has a residual neurological deficit and one has residual renal impairment. Severe gastrointestinal involvement did not significantly affect the long-term outcome. Simple haematological indices helped predict severe gut involvement. Four of the 78 children had undergone appendicectomy before the diagnosis of HUS was made. The operative findings were in no case typical of primary acute appendicitis, although histological examination did confirm inflammation of the appendix in two patients. Diagnosis is difficult in early disease, but increased awareness may help prevent unnecessary appendicectomy.
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PMID:Oesophageal and severe gut involvement in the haemolytic uraemic syndrome. 177 28

The high diagnostic ability of sonography for the solid organs of the upper abdomen and the biliary and genitourinary tract is well established. The gut on the other hand has been more or less ignored by many sonographers in routine abdominal screening and evaluation of the acute abdomen. This is regrettable because sonography, like CT, is an excellent modality for assessing mural abnormalities of various origin (i.e. neoplastic, inflammatory, ischemic or hemorrhagic), as well as possible involvement of the adjacent soft tissues and solid organs. Considerable sonographic skill and "tenacity" and an adequate equipment are however indispensable to achieve high diagnostic reliability in the detection and interpretation of abnormalities of the G-I tract. Our own and other's experience suggest that the time devoted to sonographic screening of the gut is very worthwhile especially in acute clinical conditions. Acute appendicitis is one of the typical examples where sonography has found widespread acceptance. This article reviews the application of graded compression sonography in the evaluation of appendicitis, for using on technique, diagnostic criteria, and differential diagnosis.
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PMID:Sonography of appendicitis and acute diseases of the lower abdomen. 890 64

The method of extraperitonization of the blind gut cupola based on the removable monofilament sutures and drainage of the area was designed, approved in experiments in dogs (n=18) and corpses (n=14) and successfully applied in the clinic (n=25). Unlike the traditional method, the using of this one results in less impaired trophicity, LPO intensification and phospholipase activity of the tissues of regenerating structures that was the grounds of sufficiently rapid reparation process under conditions of inflammation. The proposed complex of surgical measures in patients with destructive forms of acute appendicitis complicated by the inflammatory-necrotic phenomena in the blind gut wall was shown to prevent the development of dangerous postoperative complications, incompetence of the sutures included.
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PMID:[Prophylactics of postoperative complications in destructive appendicitis and typhlitis]. 1565 97

Twelve patients operated for gastrointestinal carcinoid tumors are analyzed retrospectively. Clinically four of the cases (33%) were with signs of bowel obstruction, 4 (33%)--with signs of acute appendicitis, 3 (25%)--with signs of gastric outlet obstruction, and one (9%) with a picture of perforative peritonitis. Carcinoid syndrome was observed in two cases (17%). Five of the tumors (42%) were localized in the small intestine, 4 (33%)--in the appendix and 3 (25%)--in the duodenum. Small bowel resection was performed in 5 cases (42%), appendectomy--in 4 (33%), hemiresection of the duodenum--in 2 (17%) and duodenotomy with excision of the tumor and pyloroplasty--in one. In 2 cases liver metastases were found, and in one--multiple (3) tumors in the gut.
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PMID:[Gastrointestinal carcinoid tumors--a retrospective analysis of 12 cases]. 1570 44

A comparative assessment of effectiveness of various non-traditional and non-typical variants of appendectomy was made with using non-standard (non-classical) methods of treatment and peritonization of the vermiform stump developed by different authors for destructive forms of acute appendicitis complicated by inflammatory infiltration of the blind gut cupola and typhlitis. An analysis of results of using the proposed non-typical technical methods and techniques as well as an assessment of the authors' technique used in 43 patients suggests that the above variants of peritonization of the vermiform process stump should not be considered as competing. Each of the methods can be successfully used depending on the concrete clinical situations and for the corresponding indications as the most optimal method of choice or as an alternative of the classical variant of appendectomy in patients with acute destructive appendicitis complicated by inflammatory infiltration of the blind gut cupola and typhlitis.
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PMID:[Evolution of the methods of peritonization of the vermiform process stump in acute destructive appendicitis complicated by typhlitis]. 1656 60

The management of the normal appearing appendix during laparoscopy for right fossa syndrome remains a matter of debate when no other cause is found. Recent data suggest that the appendix modulates both the normal brain-gut axis and the pathophysiology of inflammatory bowel disease by neuro-immunological pathways. Recurrence of symptoms caused by acute appendicitis is uncommon when the appendix is left in place. The decision to remove a normal appendix should therefore not be taken lightly, but after consideration of the patient's age, medical history and expectations as well as the timing and specificity of the presenting symptoms. An overview of the relevant literature is provided with an algorithm to aid in clinical decision making.
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PMID:Management of the 'normal' appendix during surgery for right fossa syndrome: proposed clinical algorithm. 1740 92

Gastrointestinal tuberculosis (TB) is quite rare, representing only 3% of all extra-pulmonary cases. Blind gut and ileum are the most common gastrointestinal localizations, while appendix involvement is infrequent. Appendix involvement is usually related to symptoms of acute appendicitis since the caseous necrosis may lead to adhesions and surgical complications such as perforation. For this reason patients with suspected appendicular TB usually undergo surgery even without a secure diagnosis. In these cases, due to the absence of specific symptoms and signs, the diagnosis is delayed after surgery, thus resulting in a high percentage of important, and sometimes lethal, complications. Histopathological examination is often the only way to reach a diagnosis and to establish specific antibiotic therapy, while an early diagnosis could avoid surgical treatment. We report a case of appendicular TB not only for its rarity but also to discuss the difficulty in its diagnosis.
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PMID:Appendicular tuberculosis: the resurgence of an old disease with difficult diagnosis. 2010 82

Malrotation of gut is an intestinal gestational disorder which not only affects the positioning of the midgut, but also its vascular supply. It usually presents with the syndrome of bouts of colic and vomiting with little distention of abdomen and diarrhea. Though midgut malrotation is a common cause of intestinal obstruction in newborn, scant attention is given to this developmental anomaly as a cause of symptoms in adults. The development of midgut portion of alimentary canal suffers a large variety of variations. The surgical importance of abdominal situation of the portions of intestine derived from the midgut loop requires little attention. Sub-hepatic anatomical location of the appendix makes it more difficult to diagnose acute appendicitis at any age, including in older adults. Failure to recognize the nature and characteristic features of these misplacements may lead to grave errors in procedure, or to injurious prolongation of the operation. Here in we found a rare abnormality of caecum, which was present in the sub hepatic region with the absence of ascending colon during routine dissection classes for undergraduate students.
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PMID:Sub-hepatic caecum. 2417 18

Parasites are rarely associated with inflammation of the appendix. Generally, parasites cause acute abdominal pain via blocking the gut lumen. In this article, we presented a case of appendicitis where Enterobius vermicularis was detected in the surgical specimen and Taenia was detected in the stool. A 31 year old male patient was admitted to the emergency room with severe abdominal pain, which has begun two days ago. On physical examination, tenderness was positive on palpation of the right lower abdominal quadrant and the patient was operated on with the diagnosis of acute appendicitis. Histopathological examination of the patient's appendectomy material revealed numerous parts of parasites resembling Enterobius vermicularis and slight mucosal erosion. On parasitological examination of the patient's stool, Taenia eggs and adult forms were determined. Antiparasitic therapy was started with niclosamide for taeniasis and albendazole for enterobiasis. Parasitic infections can mimic acute appendicitis clinically. Radiological and laboratory findings do not help to distinguish the diagnosis of acute appendicitis. In the histopathological examination of the appendix, the findings of acute inflammation of the appendix wall may not be defined. For patients with normal histopathological examination, screening for parasites should be done, and anti-parasitic treatment should be started after appendectomy.
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PMID:[Acute appendicitis and coinfection with enterobiasis and taeniasis: a case report]. 2465 5

This literature review assesses the current knowledge about the immunological aspects of the vermiform appendix in health and disease. An essential part of its immunological function is the interaction with the intestinal bacteria, a trait shown to be preserved during its evolution. The existence of the appendiceal biofilm in particular has proved to have a beneficial effect for the entire gut. In assessing the influence of acute appendicitis and the importance of a normally functioning gut flora, however, multiple immunological aspects point towards the appendix as a priming site for ulcerative colitis. Describing the immunological and microbiotical changes in the appendix during acute and chronic inflammation of the appendix, this review suggests that this association becomes increasingly plausible. Sustained by the distinct composition of cells, molecules and microbiota, as well as by the ever more likely negative correlation between the appendix and ulcerative colitis, the idea of the appendix being a vestigial organ should therefore be discarded.
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PMID:The immunology of the vermiform appendix: a review of the literature. 2727 18


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