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

A patient over 40 years of age who complains of lower abdominal pain, constipation or diarrhea or both, and increased flatulence should be suspected of having diverticulosis. When pain becomes more severe and persistent, diverticulitis must be considered. Diagnosis depends on roentgen demonstration of the presence of diverticula. Sigmoidoscopy and barium enema study are essential to exclude coexisting disease but in diverticulitis may need to be postponed until severe local and systemic signs of inflammation have subsided. A number of diseases can simulate diverticulitis, and differential diagnosis may present considerable difficulty. Irritable colon syndrome and acute appendicitis may be indistinguishable clinically from diverticulitis. Differentiation from carcinoma is usually not difficult, but exclusion of coexistent carcinoma may be impossible except by resection. Ulcerative colitis is also easily distinguished except when, rarely, it coexists. Crohn's disease of the colon is less easily differentiated, especially in patients over 40, in whom the two diseases often coexist. Other colonic diseases, such as ischemic colitis, and pelvic inflammatory diseases usually show characteristic features which make them readily distinguishable from diverticulitis.
Postgrad Med 1976 Dec
PMID:Diagnosis and differential diagnosis of colonic diverticulitis. 103 35

According to the authors' data peritonitis developed after appendectomy in 122 of 18347 patients, operated upon for acute appendicitis, was an extremely grave complication of this lesion and the related surgical intervention. The main causes for development of postoperative peritonitis were local and diffuse peritonitis (101 cases), more rarely--technical and tactical errors made during the operation. Due to diagnostic difficulties a purposeful treatment for postoperative peritonitis was undertaken with a delay, reoperations were performed in late terms and not in every case either. The mortality due to postoperative peritonitis made 23 per cent.
Vestn Khir Im I I Grek 1975 Dec
PMID:[Causes of development of peritonitis after appendectomy]. 121 96

The authors report twenty three cases of intestinal yerseniosis revealed among 575 patients operated upon for acute appendicitis. The diagnosis was supported bacteriologically and serologically. The disease proceeded with a predominant involvement of the appendicular process. Various forms of acute appendicitis were observed. Common appendicitis was noted in 6 cases, phlegmonous--in 15, gangrenous--in 2.
Vestn Khir Im I I Grek 1975 Dec
PMID:[Appendicular form of intestinal yersiniosis]. 121 98

The carbohydrate structure sialyl-Lewis X (SLex) can function as a ligand for E-selectin, formerly known as endothelial leukocyte adhesion molecule-1 (ELAM-1). This study was performed to analyze the expression of SLex by leukocytes and other cell types in the context of inflammatory and immune processes. Human peripheral blood cells were examined by flow cytometry using monoclonal antibody CSLEX1 directed against SLex. Cell surface SLex was found in abundance on nearly all isolated polymorphonuclear leukocytes (PMN) and monocytes, and at low levels on a substantial portion (up to 40%) of natural killer cells. This moiety was expressed also on approximately 10% of peripheral blood T cells. Immunohistochemistry was performed on various human tissues involved in inflammatory or immune processes and on secondary lymphoid tissues. In acute appendicitis, endothelial cells of postcapillary venules expressed E-selectin, and most PMN, both within vessels and extravasated, expressed SLex. A substantial number of monocytes/macrophages in inflamed appendiceal, synovial, and dermal tissues also reacted with antibody CSLEX1; however, only rare tissue macrophages in uninflamed nonlymphoid sites showed expression of SLex. These observations are consistent with the concept that SLex on circulating PMN and monocytes functions as a ligand for endothelial E-selectin in the development of inflammatory reactions. SLex-positive lymphocytes also were seen, notably, T lymphocytes in inflamed skin. An unexpected finding was that the CSLEX1 antibody also reacted with venular endothelium in certain lymphoid tissues and in inflamed appendix, but not with endothelium in normal appendix. Whether the SLex antigen identified on endothelium represents de novo expression or passive adsorption remains to be determined.
Am J Pathol 1992 Dec
PMID:Expression of sialyl-Lewis X, an E-selectin ligand, in inflammation, immune processes, and lymphoid tissues. 128 20

Solitary perforated diverticulum of the right colon is a very uncommon acute disease in emergency surgery, and usually a preoperative diagnosis of acute appendicitis is performed. Five cases of solitary perforated diverticulum of the right colon are presented. Preoperative diagnostic difficulties as well as surgical procedures are discussed.
Minerva Chir 1992 Dec
PMID:[Solitary perforated diverticulum of the right colon. Five cases]. 128 58

Twelve patients who underwent laparotomy for suspected acute appendicitis were found to have Crohn's disease of the terminal ileum. Appendectomy was performed in all although in only four patients was the appendix grossly inflamed. Postoperative complications, either abscess or fistula, developed in four patients (33%). Careful investigation of the records revealed some preoperative diagnostic clues: a history of recurrent abdominal pain and/or diarrhea (83%), physical examination revealing normal temperature (50%), and laboratory results compatible with a chronic process such as microcytic anemia (33%) and hypoproteinemia/hypoalbuminemia/hypocholesterolemia (50%). As the differential diagnosis between Crohn's disease and appendicitis is difficult and the surgical approach to the appendix in the presence of Crohn's disease is controversial, we illuminate some practical points in the preoperative evaluation of these patients and deal with the question of whether appendectomy should be performed in these patients.
J Clin Gastroenterol 1992 Dec
PMID:Preoperative clues to Crohn's disease in suspected, acute appendicitis. Report of 12 cases and review of the literature. 129 36

The clinical records and the ultrasound findings of 48 patients studied because of a presumptive diagnosis of acute appendicitis in a one-year period were reviewed. Ultrasound examination was performed using graded compression and high resolution probes when acute appendicitis was suspected and the clinical history or physical examination was unclear. The ultrasound findings were correlated with the clinical course or surgical and pathological findings. This procedure was useful in the diagnosis of acute appendicitis, with 84.6% sensibility and 95.5% specificity. Predictive value for positive results was 95.7% and 84% for negative results. These figures agree with results previously communicated in the literature. It is concluded that high resolution ultrasonography is useful in the differential diagnosis of atypical acute appendicitis.
Rev Med Chil 1992 Dec
PMID:[Utility of high-resonance ultrasonography in the diagnosis of acute appendicitis]. 134 78

Hemorrhagic colitis due to Escherichia coli O157:H7 occurs sporadically but widely throughout North America. Radiographically this condition may mimic ischemic colitis, inflammatory bowel disease, acute appendicitis or appendiceal abscess. Correlation of radiologic and clinical findings is required to ensure diagnostic accuracy and avoid unnecessary surgical intervention.
Can Assoc Radiol J 1992 Dec
PMID:Hemorrhagic colitis caused by Escherichia coli O157:H7--unusual ultrasonographic and computed tomography findings. 145 Sep 77

The diagnosis of acute appendicitis can be difficult. Barium enemas, computed tomography (CT) scans, ultrasound examinations and Indium scans are used to aid in making the diagnosis with varying degrees of success. This blinded, prospective study reports the use of a Technetium 99-m Hexamethylpropyleneamineoxide (HMPAO) labelled white blood cell scan in 30 patients with suspected appendicitis. Autologous white blood counts from 25 cc of whole blood labelled with Tc-99 HMPAO were reinjected into patients. Abdominal imaging was performed at a half hour postinjection and repeated at 2 to 4 hours postinjection. A positive study showed an increased isotope uptake in the right lower quadrant. Nineteen patients had histologically proven appendicitis. Three of these patients were excluded because they were operated on before scan completion. Thirteen of the remaining 16 patients with appendicitis had positive studies (false negative rate = 19%). All patients without appendicitis had either negative scans or scans that detected other intra-abdominal diseases, such as diverticulitis, tubo-ovarian abscess, or small bowel infarction (false positive rate = 0%). Overall, this Tc-99 HMPAO study had a sensitivity of 81 per cent, a specificity of 100 per cent and an overall accuracy of 89 per cent. The 4-hour Tc-99 HMPAO WBC scan is a useful, noninvasive test for confirming the clinical diagnosis of acute appendicitis, but it may prove more valuable as a diagnostic study to rule out appendicitis in patients that have abdominal pain of unclear etiology.
Am Surg 1992 Dec
PMID:Detection of acute appendicitis by technetium 99 HMPAO scanning. 145 3

A case of torsion of the vermiform appendix is described. It is a rare cause of an acute abdomen with a clinical presentation that is indistinguishable from acute appendicitis.
Aust N Z J Surg 1992 Dec
PMID:Torsion of the vermiform appendix: a case report and review of literature. 145 12


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