Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085693 (acute appendicitis)
 3,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Torsion of an epiploic appendix is seldom diagnosed preoperatively because of the difficult differential diagnosis with other diseases causing acute abdominal pain, particularly appendicitis. The classic McBurney approach overlooks many infarcted epiploic appendixes. The use of diagnostic laparoscopy in acute abdominal pain can show an infarcted epiploic appendix to be at the origin of pain. Four patients were admitted for acute abdominal pain and moderate tenderness in lower quadrants and were operated on for suspected acute appendicitis. In all cases laparoscopy found the torsion of an epiploic appendix, which was resected, and a normal cecal appendix. Postoperative course was uneventful. In case of acute abdominal pain in the lower quadrants of suspected appendiceal origin, laparoscopy should be routinely performed not only in women but also in men to avoid overlooking other intraperitoneal diseases that can be the cause of symptoms.
Surg Laparosc Endosc 1997 Dec
PMID:A rare laparoscopic diagnosis in acute abdominal pain: torsion of epiploic appendix. 943 25

A retrospective study was performed after introduction of the laparoscopic technique in patients with suspected appendicitis to validate it in comparison with conventional open appendectomy. A series of 103 patients with suspected acute appendicitis were included. In 51 consecutive patients, a diagnostic laparoscopy was performed, and, if needed, an appendectomy was carried out. Fifty-two consecutive patients underwent conventional appendectomy. The primary intention of the laparoscopy was diagnostic, but if the patient was found to suffer from appendicitis, a laparoscopic appendectomy was performed. Eight (16%) patients in the laparoscopic group had a healthy appendix that was left in place. Eleven (22%) patients in this group were converted to open appendectomy. There was no significant difference between the groups concerning age, sex, or diagnosis at the time of the operation, and there was also no significant difference in the postoperative hospital stay or complication rate between the groups. The postoperative need for analgesia was lower (p < 0.01) and the operation time was longer (p < 0.0001) in the laparoscopic group than the group that underwent open surgery. It can be concluded that the greatest benefits of the laparoscopic technique are that it causes less trauma, the diagnostic accuracy is better, and the cosmetic result is superior to that after a conventional operation. This is all at the price of a longer operation time.
Surg Laparosc Endosc 1997 Dec
PMID:Appendicitis: laparoscopic versus conventional operation: a study and review of the literature. 943 26

Benign cecal ulcer is a rare lesion, usually diagnosed during operation for suspected acute appendicitis or peritonitis of unknown origin. In the past, right hemicolectomy was recommended as the treatment of choice because of the difficulty in differentiating malignant lesions from benign cecal ulcers. However, in recent reports a more conservative approach has been suggested, consisting of selective colectomy followed by frozen section biopsy. This approach is aimed at preventing unnecessary excision of the colon and conserving the ileocecal valve. We present a 47-year-old woman operated for right lower quadrant peritonitis, believed to be due to acute appendicitis. On exploration, a biopsy-proven benign cecal ulcer was found and resected.
Harefuah 1997 Dec 01
PMID:[Surgical approach to benign cecal ulcer]. 945 87

The assessment and diagnosis of abdominal pain in childhood continues to be a clinical challenge. We audited the presenting symptoms and signs in a consecutive series of 447 children presenting to a paediatric surgical unit in an attempt to quantify the value of particular symptoms and signs in differentiating acute appendicitis (AA) from non-specific abdominal pain (NSAP). The onset of pain in the centre of the abdomen and radiation of pain was not sufficient to differentiate between NSAP and AA. Progression of pain, nausea, vomiting, anorexia and diarrhoea were significantly more common in children with AA (P < 0.01). Similarly, facial flushing, tachycardia (pulse > 100 beats/min), guarding and rebound tenderness were significantly more common in children with AA (P < 0.001). Knowledge of this quantitative data could help clinicians adjust the weighting given to the presence of a particular symptom or sign in children with acute abdominal pain.
J R Coll Surg Edinb 1998 Dec
PMID:The diagnostic value of symptoms and signs in childhood abdominal pain. 999 Jul 85

Acute appendicitis is a common condition, accounting for substantial number of hospital days in all institutions and giving rise to considerable adverse economic and social consequences in the postoperative period. Laparoscopic appendicectomy offers several advantages over the open procedure. Diagnostic accuracy is improved. Postoperative morbidity, in particular wound infection, is reduced, as is postoperative pain, and cosmesis is improved. Discharge from hospital is hastened, as is return to normal activity and work. Surgical technique is detailed, including the approach to specific clinical scenarios such as perforated and retrocaecal appendicitis. The utilization of ultrasonically activated dissection for laparoscopic removal of the appendix is explained. The implications of laparoscopic appendicectomy for surgical training are discussed.
Semin Laparosc Surg 1995 Dec
PMID:Laparoscopic Appendicectomy. 1040 Oct 92

We report an unusual case of acute appendicitis caused by a mucinous cystadenoma of the cecum obstructing the lumen of the appendix. At laparoscopic appendectomy, an inflamed appendix was identified and resected. Subsequent histologic evaluation of the appendiceal base revealed mucin lakes. After discovery of a cecal mass at colonoscopy, the patient underwent definitive right hemicolectomy for treatment of a benign mucinous cystadenoma of the appendix.
Surg Endosc 1999 Dec
PMID:Mucinous cystadenoma of the cecum missed at laparoscopic appendectomy. Pitfalls in laparoscopy. 1059 74

BACKGROUND: This study was designed to determine whether Helicobacter pylori forms part of the normal microenvironment of the appendix, whether it plays a role in the pathogenesis of acute appendicitis, and whether it is associated with increased expression of inducible nitric oxide synthetase (iNOS) in appendicular macrophages. METHODS: Serology for H. pylori was performed on 51 consecutive patients undergoing emergency appendicectomy. Appendix samples were tested for urease activity, cultured and stained for H. pylori, graded according to the degree of inflammatory infiltrate, and probed immunohistochemically for iNOS expression. RESULTS: The mean age of the patients was 21 (range 7-51) years. Seventeen patients (33 per cent) were seropositive for H. pylori but no evidence of H. pylori was found in any appendix specimen. However, an enhanced inflammatory cell infiltration was observed in seropositive patients (P < 0.04) and the expression of macrophage iNOS in the mucosa of normal and inflamed appendix specimens was increased (P < 0.01). CONCLUSION: H. pylori does not colonize the appendix and is unlikely to be a pathogenic stimulus for appendicitis. Priming effects on mucosal immunology downstream from the foregut may occur after infection with H. pylori.
Br J Surg 1999 Dec
PMID:Nitric oxide synthetase and Helicobacter pylori in patients undergoing appendicectomy. 1063 58

This study describes how assessment and documentation of children's acute postoperative pain is managed by nurses in university hospitals in Finland. A survey was conducted of 303 nurses working in children's wards of university-affiliated hospitals, and at the same time a retrospective chart review of 50 consecutive cases of operation of acute appendicitis was carried out. Charts were analyzed by content analysis, and the results of the survey are reported with percentage distribution and nonparametric statistical calculations. The results indicate that nurses assess pain mainly by observing the child's behavior and changes in physiology. Pain measurement instruments are rarely used, and nurses do not recognize them. The documentation of pain care is unsystematic and does not support the continuity of care. There is a clear need for development of assessment and documentation practices in the studied hospitals. Future research should look at the postoperative care of pain at home as well as care in non-university-affiliated hospitals.
J Pediatr Nurs 1999 Dec
PMID:Nursing activities and outcomes of care in the assessment, management, and documentation of children's pain. 1063 55

Macroamylasemia is a condition of persistent, elevated serum amylase activity with no apparent clinical symptoms of a pancreatic disorder. In Korea, however, no such case has been reported to date. We report a case of a 17-year-old female diagnosed with macroamylasemia and acute appendicitis. One day earlier, she developed epigastric and right lower quadrant abdominal pain. She was characterized by high level of serum amylase, but normal lipase. Amylase isoenzyme analysis demonstrated increased fraction of salivary type and follow-up amylase level was persistently increased. Immunofixation disclosed the macroamylase binding with an immunoglobulin, consisting of IgA and kappa chain. The patient was treated by appendectomy, and the abdominal pain subsided.
J Korean Med Sci 1999 Dec
PMID:Macroamylasemia in a patient with acute appendicitis: a case report. 1064 49

There is increasing evidence to suggest that the potent neutrophil chemoattractant interleukin-8 (IL-8) has an important role in the pathogenesis of inflammatory bowel disease. IL-8 mediates its actions via two cell surface receptors, CXCR1 and CXCR2. This paper describes the distribution of these IL-8 receptors in the normal gastrointestinal tract and how this is modified in ulcerative colitis (UC). Paraffin-embedded colonic resection specimens were stained with monoclonal antibodies directed against CXCR1 and CXCR2 in ten cases of total UC, 16 cases of appendicitis, and 11 histologically normal sections. A semiquantitative scale of 0-4 was used to assess the proportion and intensity of positively stained cells within certain defined areas of tissue. A comparative assessment was made of the distribution of various cell populations. Dual immunostaining was used to confirm the phenotype of positively staining cells. In the histologically normal colon, the antibody against CXCR1 stained a subpopulation of macrophages deep to the epithelium and germinal centre lymphocytes. A similar pattern of staining was seen in acute appendicitis, with in addition some positively stained neutrophil polymorphs. In UC, there was up-regulation of CXCR1, with a striking increase in positively stained macrophages throughout the mucosa and of B and T lymphocytes outside the germinal centre areas. There was also intense up-regulation of CXCR1 expression by the luminal epithelium, reflected in the epithelial staining score (mean+/-SE=1.8+/-0.44 for UC cases, vs. 0.23+/-0.16 for controls and 0.25+/-0.14 for acute appendicitis). CXCR2 was only expressed on a small population of lamina propria mononuclear cells and crypt epithelial cells, with no significant differences observed between the groups. These results suggest that IL-8 may, through CXCR1, have a role beyond neutrophil recruitment in mediating the immune response in UC and that this is not merely a consequence of the acute inflammation seen in UC.
J Pathol 2000 Dec
PMID:Distribution of the interleukin-8 receptors, CXCR1 and CXCR2, in inflamed gut tissue. 1111 72


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