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

We report a case of a leiomyosarcoma arising in a Meckel's diverticulum in a man of 90 years, with multiple ileal diverticulosis. The clinical picture was similar to acute appendicitis and diagnosis was not made until resection of an abdominal mass with histological appearance of leiomyosarcoma. 59 cases of leiomyosarcoma of Meckel's diverticulum have previously been reported in the literature. No case until now has been reported in a patient of Caribbean origin neither in association with ileal diverticulosis. Although rare, leiomyosarcoma is the commonest sarcoma of Meckel's diverticulum, and with full resection of the tumor the prognosis is very good.
J Chir (Paris) 1990 Dec
PMID:[Leiomyosarcoma of the Meckel's diverticulum and multiple diverticulosis of the ileum. Apropos of a case]. 212 5

Acute appendicitis is the most common surgical problem in pregnancy requiring emergent intervention. To establish a contemporary patient profile and formulate an effective management strategy, a retrospective review was conducted of 84 pregnant patients who underwent laparotomy with a preoperative diagnosis of acute appendicitis. Gestational stage at presentation included the first trimester in 27 patients (32%), the second trimester in 37 patients (44%), the third trimester in 13 patients (16%), and the puerperium in 7 patients (8%). Fifty-four patients (64%) had pathologically proven acute appendicitis; the incidence did not vary by trimester. Other intra-abdominal conditions were detected in 15 patients (18%). There were no significant differences between patients with positive and negative laparotomies (or among trimesters) regarding frequency of presenting symptoms and signs or laboratory results. Operation occurred within 24 hours of symptom onset in 19 of 54 (35%) instances of proven acute appendicitis. Perforation occurred in 23 of 54 patients (43%), all of whom had symptoms exceeding 24 hours (p less than 0.0005). Five instances of perinatal death and one case of extreme perinatal morbidity were associated with negative laparotomies; only one of these was attributed to operation itself. No adverse long-term maternal morbidity or mortality occurred. Wound infection developed in seven cases of acute appendicitis (six perforated) and two negative explorations. We conclude that (1) gestational physiologic changes obscure the accurate diagnosis of acute appendicitis; (2) the natural history of acute appendicitis is not affected by trimester of presentation; and (3) adverse sequelae of acute appendicitis are obviated by prompt operative exploration and prevention of appendiceal perforation.
Am J Surg 1990 Dec
PMID:Acute appendicitis in the pregnant patient. 225 15

Between October 1988 and July 1989 100 consecutive patients with suspected appendicitis were seen at the surgical clinic, University Hospital of Aachen. All patients underwent ultrasonographic examination corresponding to a prospective study protocol in order to determine the value of ultrasound for the diagnosis of acute appendicitis. The sonographic findings were correlated with the histologic diagnosis or the clinical course, respectively. We found a sensitivity of 100% for appendiceal mass, of 88% for phlegmonous appendicitis and of 25% for catarrhal appendicitis. The overall sensitivity was 49% and the overall specificity rate was 97%. The overall accuracy rate was 64%. The predictive value of a positive test was 97% and the predictive value of a negative finding was 46%. The morphologic changes during the progress of inflammation of the appendix and their sonographic visualisation were discussed. A differentiated concept was developed to integrate the sonographic findings in the therapeutic decision.
Chirurg 1990 Dec
PMID:[The value of sonography in the diagnosis of appendicitis. A prospective study of 100 patients]. 228 6

In a retrospective study 536 appendicectomized patients were analyzed, in order to identify anamnestic, clinical and laboratory findings which allow the differentiation between acute and non-acute appendicitis. 150 consecutive patients were studied prospectively, which were referred to our department with a presumptive diagnosis of acute appendicitis. Eight single criteria were found, which exhibited a significantly different frequency in acute and non-acute appendicitis. Each criterion showed a low sensitivity and specificity; a score, which was created by combination of these single criteria also had low sensitivity and specificity. We conclude that the correct indication for appendicectomy highly depends on clinical experience of the surgeon.
Chirurg 1990 Dec
PMID:[Retro- and prospective studies on the value of clinical and laboratory chemical data in acute appendicitis]. 176 Sep 61

Cancer of the colon disguised as appendicitis occurs more frequently than is generally realized and will probably be seen more often as the elderly population increases. In all patients over 40 years of age presenting with acute appendicitis, further diagnostic testing (ie, double contrast enema or colonoscopy) should be done to rule out occult cancer.
Postgrad Med 1989 Dec
PMID:Cecal carcinoma presenting as acute appendicitis. 258 58

Intraabdominal surgical disease during pregnancy can present a challenge in diagnosis and management for the obstetrician and surgeon. To examine the complications to the fetus and mother and the consequences of a delay in operative intervention, we retrospectively studied all pregnant patients over a 17-year period who had undergone abdominal surgery at one institution. A total of 92 abdominal operations were performed on 90 patients. During the same period, 41,532 deliveries occurred. One in 451 deliveries involved surgical procedures during pregnancy. Thirty-seven patients had surgery for acute appendicitis; 20 patients were operated on for ovarian abnormalities. Postoperatively, there were two maternal deaths: one from cardiac arrhythmia and the other from hepatic failure. The most common postoperative complication was premature labor (19 patients, 21 percent). In 16 of these patients, early tocolysis was begun without fetal loss. There were five fetal deaths. Forty-seven of 72 patients had term deliveries. Intraabdominal surgery during pregnancy carries an acceptable risk to the mother and fetus; complications are related to disease severity and operative delay rather than to the operative procedure itself.
Am J Surg 1989 Dec
PMID:Intraabdominal surgery during pregnancy. 173 85

In the period between 1965-1986 with a collective sum of 5369 gynecological laparotomies, the appendix was removed as a preventive measure in 1718 cases (32%). In all these cases, the recovery period proceeded without any complications. The results of the histological studies on the appendices showed an acute appendicitis in 136 cases (7.9%). In 1118 cases (65.1%) a chronic appendicitis was found, with differing severity of fibroid scarring, including total obliteration. In 96 cases (5.6%), there was evidence of carcinoid, mucocele, and endometriosis. Only 368 appendices (21.4%) were normal morphologically. The large percentage of histopathological findings confirms, that the appendix--being a rudimentary lymphatic organ--appears to be predestined for inflammatory changes. For this reason, the risk of illness and death from appendicitis remains, especially for older people. It is usually possible, to perform a prophylactic appendectomy under optimal conditions and we experienced, that this additional operation does not increase the risk to the patient. We consider, that the routine practice of the prophylactic simultaneous appendectomy during gynecological laparotomies is justified, providing, that the contra-indications mentioned are observed.
Geburtshilfe Frauenheilkd 1989 Dec
PMID:[Preventive appendectomy in gynecologic surgery. Report of 1,718 cases]. 261 43

Torsion of the vermiform appendix is a rare condition that simulates acute appendicitis. An 8-year-old girl with symptoms suggestive of acute appendicitis is reported. At operation the appendix was found to be twisted 72 degrees and was resected.
Harefuah 1989 Dec 01
PMID:[Torsion of the appendix in a child]. 262 Aug 79

A study is presented of the etiological structure and proportion of salmonellosis among a wide group of intestinal diseases in an industrial city. The highest incidence was in June-August. The leading factors of infection transmission was food. Salmonella typhimurium was the main etiological pathogen. Different clinical forms were noted, the gastroenterological variant being observed in 50% of patients. Severe course was reported of the diseases when complicated by acute appendicitis, drug-induced allergy.
Vrach Delo 1989 Dec
PMID:[Characteristics of the course of salmonellosis]. 262 94

Twenty-four pregnant women with acute appendicitis received exploratory laparotomy during an 8-year period. Abdominal pain accompanied with nausea and vomiting were the most common symptoms. Abdominal tenderness and rebounding pain were the most reliable physical signs. Leukocytosis with WBC count greater than 15,000/cu mm and granulocytes greater than 87% and prolonged symptomatic duration were indications that appendiceal perforation might have occurred. A McBurney's incision and spinal anesthesia were preferred for appendectomy during pregnancy. In cases of uncomplicated appendicitis, tocolytic agents and antibiotics were not routinely used. Premature labor occurred in 21% of patients during postoperative period.
Changgeng Yi Xue Za Zhi 1989 Dec 20
PMID:Appendicitis during pregnancy. 263 59


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