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Query: UMLS:C0423647 (iliac fossa pain)
 157 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The skin temperature in the right and left iliac fossae was recorded in 100 patients who were referred with a provisional diagnosis of acute appendicitis. This was not found to be a reliable aid in diagnosis of acute appendicitis nor an indicator to the need for surgery in patients with right iliac fossa pain.
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PMID:Is the hot appendix really hot? 829 Apr 31

A prospective, controlled study was conducted to determine whether a selective policy of diagnostic laparoscopy could reduce the number of unnecessary normal appendectomies in patients with acute right iliac fossa pain. The cohort consisted of patients admitted with acute right iliac fossa pain by the emergency department. Of 102 patients in the study group, 28 subsequently required a diagnostic laparoscopy when a definite diagnosis could not be reached after 8 to 12 hours of observation. Of these, only 18 had inflamed appendices, which were removed. In the rest of the patients (10), the appendices were normal and unnecessary laparotomies were avoided. In the control group, wherein equivocal cases were laparotomized after a similar period of observation, there was a normal appendectomy rate of 15.7 percent (P < 0.05). There was no significant difference in the incidence of perforation between the control and study groups. Diagnostic laparoscopy in equivocal cases could thus significantly reduce the number of unnecessary appendectomies without compromising on the rate of perforation.
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PMID:Diagnostic laparoscopy: reducing the number of normal appendectomies. 834 67

Serum alpha-interferon levels were analysed in 50 consecutive children admitted with right iliac fossa pain. Serum alpha-interferon levels were significantly raised in 33% of children without acute appendicitis when compared to 5.7% of children with histologically proven acute appendicitis and 9% of normal controls. This interesting phenomenon needs further investigation. A larger series may show it to be of clinical use in non-specific abdominal pain in childhood.
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PMID:Serum alpha interferon in children with right iliac fossa pain. 818 88

Foreign bodies found in the appendix have been reported many times. To date 254 occurrences have been documented. However, only 4 previously reported episodes involve teeth, dental restoration or dental equipment. We present a patient with a 6 month history of intermittent right iliac fossa pain following the ingestion of a gold inlay restoration, which was found at operation to be in the distal appendix. Previous reports suggest that symptoms from foreign bodies in the appendix occur in 73% of cases, and in 93% when the object is sharp. Therefore, appendicectomy is recommended when a foreign body is detected in the appendix, and particularly if it has sharp edges.
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PMID:Foreign bodies of dental origin in the appendix. 856 54

Young women with right iliac fossa pain are commonly referred to general surgeons as possible acute appendicitis. The differential diagnosis that includes pelvic visceral disease may be very difficult to determine clinically, especially when the history and physical signs are equivocal. We believe that diagnostic accuracy may be improved by eliciting precisely the site of abdominal pain. Right-sided low inguinal pain may be referred from the female pelvic viscera in the same way as testicular pain may be referred to the groin, as these viscera derive their autonomic nerve supply from the T10-L2, mainly T12-L1, spinal segments in both sexes. There are no previous reports of the value of the symptom of right-sided low inguinal pain in differentiating pelvic visceral disease from acute appendicitis in young women. This paper reports a prospective study of the discriminant value of this symptom in such patients.
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PMID:Right-sided low inguinal pain in young women. 919 21

The aim of this study was to evaluate the accuracy of different methods of demonstrating right iliac fossa peritonism in appendicitis. The methods used were cat's eye symptom (pain on going over a bump in the road), cough sign, right iliac fossa tenderness, percussion tenderness, rebound tenderness and guarding. A series of 100 consecutive patients with a median age of 25 years (range 4-81 years), presenting with right iliac fossa pain were studied prospectively; the male:female ratio was 39:61. In all, 58 patients underwent operation, 44 had appendicitis confirmed on histology. Fourteen patients had a normal appendix removed; 11 were women aged between 16 and 45 years. Cat's eye symptom and cough sign were sensitive indicators of appendicitis (sensitivity 0.80 and 0.82, respectively), but were not specific (specificity 0.52 and 0.50, respectively) and therefore inaccurate (accuracy 64%). Percussion tenderness was less sensitive (sensitivity 0.57) but more specific (specificity 0.86). Rebound tenderness proved to be sensitive (sensitivity 0.82), specific (specificity 0.89) and accurate (accuracy 86%). Thus, rebound tenderness had a positive predictive value of 86% compared with 56% and 57% for cough sign and cat's eye symptom, respectively. In the difficult diagnostic group of young women, the positive predictive value of rebound tenderness was 88% compared with 58% and 56% for cat's eye symptom and cough sign. Appendicitis remains a difficult diagnosis, particularly in young women. Rebound tenderness still has an important role to play in clinical assessment.
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PMID:Assessment of peritonism in appendicitis. 877 23

Appendicitis is the most common acute abdominal condition in Libya. Delay can result in the presentation of a patient with generalised peritonitis or an appendiceal mass. Clinical diagnosis of an appendix mass was made in 30 patients over three years at the Central Hospital: three required emergency appendicectomy within 48 hours of diagnosis, and another two had an elective appendicectomy for recurrent right iliac fossa pain two and three months after presentation, respectively. The remaining 83%, who were followed up for six months to three years (mean 15.5 months), did not require surgical intervention. An appendiceal mass should no longer be regarded as an indication for interval appendicectomy.
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PMID:Appendiceal mass: interval appendicectomy should not be the rule. 873 38

A 38-year-old man presented with acute onset of left iliac fossa pain. He had never noticed a left testis. An ultrasound scan showed a solid pelvic mass. Alfafoetoprotein and HCG were normal. Laparotomy for an acute abdomen was performed and revealed torsion of the left intra-abdominal testis. A left orchiectomy was performed. The patient made an uneventful recovery. Histology showed seminoma and carcinoma in situ. A testicular biopsy from the right testis showed no malignancy. A detailed examination of the genitalia should be part of the usual abdominal examination.
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PMID:[Intra-abdominal torsion of the testis with seminoma]. 922 89

We report a rare case of chronic appendicitis causing recurrent intussusception in a 33-year-old man who had recurrent episodes of right iliac fossa pain diagnosed clinically and confirmed by colonoscopy. This is the first known case with the rare combination diagnosed endoscopically.
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PMID:An endoscopic diagnosis of appendicular intussusception in chronic appendicitis. 926 83

A 27-year-old woman with a past history of pulmonary tuberculosis presented with right iliac fossa pain and low-grade fever. She was empirically treated for Crohn's disease despite undergoing multiple investigations that failed to provide a strongly suspected diagnosis. After 3 days of therapy, her symptomatology aggravated, and signs suggestive of intestinal obstruction developed. Placing the patient in the left lateral decubitus position before sterile draping, intracorporeal laparoscopy was performed, and Crohn's disease involving the terminal ileum but sparing its most distal 25 cm was confirmed. During the procedure, creeping mesenteric fat, a characteristic feature of Crohn's disease, was seen. Also, some adhesions in the right iliac fossa and a firm 3-cm inflammatory mass were found. Both division of mesentery along with terminal ileum resection and ileocolonic anastomosis were successfully performed intracorporeally, without need to convert to open surgery. In select cases of right iliac fossa pain in which diagnostic and therapeutic results are inconclusive or equivocal, laparoscopy can be useful to correctly diagnose and treat inflammatory bowel disorders such as Crohn's disease. Moreover, we suggest that intracorporeal laparoscopic surgery can be effective in the treatment of these conditions even in some cases with intestinal complications such as inflammatory masses and adhesions.
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PMID:Laparoscopy to correctly diagnose and treat Crohn's disease of the ileum. 961 70


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