Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0184567 (acute pain)
 3,962 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Those having chronic and recurrent appendicitis represent a small portion of patients with disorders of the appendix. We present a series of nine patients who underwent appendectomy for chronic or recurrent appendicitis at The Johns Hopkins Hospital, Baltimore, Maryland, between July 1984 and October 1992. There were seven women and two men (median age of 30 years, range of 15 to 63 years). All patients presented with pain in the right lower quadrant or lower abdomen of three or more weeks duration (mean of 16.0 +/- 8.4 months, range of three weeks to seven years), had no alternative diagnosis to account for the symptoms, had pathologic evidence of chronic inflammation or fibrosis of the appendix and had complete relief of the symptoms after appendectomy. Although the patients presented herein had clinical and pathologic evidence for recurrent or chronic appendicitis, careful review of the course of each patient before surgical referral revealed at least one episode of acute pain in the abdomen consistent with acute appendicitis managed by nonoperative means. This suggests that, while recurrent acute appendicitis and chronic appendicitis do occur, they can be avoided by the accurate diagnosis and operative management of acute appendicitis. We conclude that acute appendicitis can resolve spontaneously and recur repeatedly in the same individual; in the evaluation of a patient with abdominal pain, a history of prior similar episodes of pain should never dissuade one from considering the diagnosis of acute appendicitis, and recurrent acute appendicitis and chronic appendicitis should be considered in the differential diagnosis of recurrent pain in the lower abdomen.
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PMID:Chronic and recurrent appendicitis are uncommon entities often misdiagnosed. 814 38

The high value of laparoscopy for the diagnostic evaluation of appendicitis was established by studying 1001 women with suspected acute adnexitis and a group of 1679 woman patients presenting with chronic pain of unknown origin in the lower abdomen, sterility or the wish for sterilization, among whom a large percentage revealed abnormal appendixes or post-operative adhesion following appendectomy. Both groups underwent laparoscopy. The results allowed for setting up recommendations for the diagnostic evaluation and therapy of both acute and chronic appendicitis from the perspective of gynecological issues such as sterility, chronic or acute pain in the lower abdomen, and endometriosis.
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PMID:[Laparoscopic diagnosis and therapy of appendicitis from the gynecologic viewpoint]. 988 Aug 74