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

Epiploic appendagitis is a rare cause of focal abdominal pain which, depending on its localisation, can mimic a variety of abdominal diseases. We report a case of 36-year-old woman who presented with a classic signs of acute appendicitis. On examination, the obese, afebrile, and had very strong right iliac fossa tenderness and guarding. The white cell count was 12.82 x 10(9)/L, and C reactive protein count was 15.13MG/DL. She underwent emergency laparoscopic procedure after the acute appendicitis diagnosis has been established. Laparoscopic exploration of the abdominal cavity showed vermiform, no inflamed, appendix and necrotic appendix epiploica of the caecum. The treatment consisted of typical laparoscopic appendectomy and laparoscopic resection of the necrotic appendix epiploica. The patient made rapid recovery and was discharged from the hospital on second day after the operation. Histological investigation of the appendix epiploica revealed gangrenous epiploic appendage.
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PMID:Torsion of epiploic appendage mimic acute appendicitis. 2239 76

An elderly gentleman presented to our emergency with a 10-day history of right upper quadrant pain and nausea with associated tenderness on examination. His white cell counts were raised with predominant neutrophils with ultrasound evidence of a heterogeneous sub-hepatic collection, not associated with fever, diarrhoea or vomiting. He had a similar episode 3 weeks ago, which resolved with antibiotics. Initially thought to be a perforated acute appendicitis or a liver abscess a CT scan was done to further substantiate our finding. This to the contrary revealed a perforated sub hepatic appendix. Patient was treated conservatively with IV fluids and antibiotics and the sub hepatic collection was aspirated under ultrasound guidance. He responded well to treatment and made an uneventful recovery.
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PMID:Perforated sub-hepatic appendix; rare presentation of a common disease. 2733 86

Acute appendicitis is the most common surgical emergency worldwide. However, it can still present a challenging diagnosis especially in the young, elderly and those individuals of reproductive age, thus encompassing a wide spectrum of varied clinical presentations. Parasitic infections of the appendix are a rare cause of acute appendicitis. However, they must be considered in children presenting with abdominal pain. We report a case of Enterobius vermicularis infestation mimicking the features of acute appendicitis in a 10-year-old girl. This case is a cautionary reminder of the importance of considering E. vermicularis infestation in children presenting with abdominal pain, but who do not have a significantly raised white cell count or high Alvarado scores. A history of anal pruritus is the most characteristic symptom, but the parasites can cause severe abdominal pain mimicking appendicitis. Prompt recognition and a high clinical index of suspicion are required to prevent an unnecessary appendicectomy. Caution is advised when performing a laparoscopic appendectomy, as in our case, to prevent contamination of the peritoneum. This infestation is easily treatable with mebendazole.
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PMID:Enterobius vermicularis (pinworm) infestation in a child presenting with symptoms of acute appendicitis: a wriggly tale! 2898 88

Background: Early and accurate identification or exclusion of acute appendicitis is the key to avoid the morbidity of delayed treatment for true appendicitis or unnecessary appendicectomy, respectively. We aim (i) to identify potential predictive factors for positive and negative appendicectomies; and (ii) to analyse the use of ultrasound scans (US) and computed tomography (CT) scans for acute appendicitis. Materials and Methods: All appendicectomies that took place at our hospital from the 1st of January 2013 to the 31st of December 2015 were retrospectively recorded. Test results of potential predictive factors of acute appendicitis were recorded. Statistical analysis was performed using Fisher exact test, logistic regression analysis, sensitivity, specificity, and positive and negative predictive values calculation. Results: 208 patients were included in this study. 184 patients had histologically proven acute appendicitis. The other 24 patients had either nonappendicitis pathology or normal appendix. Logistic regression analysis showed statistically significant associations between appendicitis and white cell count, neutrophil count, C-reactive protein, and bilirubin. Neutrophil count was the test with the highest sensitivity and negative predictive values, whereas bilirubin was the test with the highest specificity and positive predictive values (PPV). US and CT scans had high sensitivity and PPV for diagnosing appendicitis. Conclusions: No single test was sufficient to diagnose or exclude acute appendicitis by itself. Combining tests with high sensitivity (abnormal neutrophil count, and US and CT scans) and high specificity (raised bilirubin) may predict acute appendicitis more accurately.
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PMID:A 3-Year Study of Predictive Factors for Positive and Negative Appendicectomies. 2960 42

Background: Appendiceal diverticular disease (ADD) is typically a histological diagnosis. Our paper aims to investigate the implications of ADD compared to acute appendicitis (AA). Methods: We conducted a retrospective data collection of patients who had undergone an appen dicectomy in three tertiary hospitals across Western Australia between 2009-2019 and included patients with histopathological diagnoses of ADD and AA. Results: Thirty-seven patients with ADD and forty with AA were included. The mean age in the ADD group was significantly older (p 0.001) at 50.1 compared to the AA group (37.3). The mean white cell count (WCC) in the ADD group was lower than the AA group (11x109/L vs. 13.3x109/L, p 0.001), whereas the C-Reactive Protein (CRP) level was greater, although not statistically significant. The ADD group had a greater risk of major surgery (p 0.05) and complications such as appendiceal perforation and appendiceal mass (p 0.05). Post-operative colonoscopy also demon strated a higher incidence of polyps in patients with ADD (19% vs. 2.5%, p 0.001). Conclusion: ADD frequently presents with clinical features indiscernible from AA. Our study demonstrates that ADD is associated with higher rates of appendiceal perforation, polyps and malignancy. We recommend that patients with ADD be advised to have a colonoscopy post-opera tively to rule out underlying malignancy.
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PMID:Appendiceal Diverticular Disease: A 10-year Retrospective Study of Cases from Tertiary Hospitals in Western Australia. 3261 90


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