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Results for “Appendicitis”

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PubMed1977

Acute appendicitis in association with non-obstructive carcinoma of the caecum.

A case of carcinoma of the caecum is reported, which presented as acute appendicitis, although the carcinoma did not obstruct either the lumen of the appendix or the colon. The prognosis for caecal or proximal colonic neoplasm presenting as appendicitis is poor. This is in part due to the association being missed at the initial laparotomy. It is suggested that a more aggessive attitude should be taken in the pre- and post-operative management of any patient over 50 years of age who presents with appendicitis. The difficulties of identifying a small tumour at laparotomy even if the mucosa can be palpated are emphasized.

Acute Disease↗

PubMed1975

[Phosphatase activity of the neutrophils in acute appendicitis in children].

Phosphatase activity of neutrophils was studied in 342 patients directed to the hospital with the diagnosis of acute appendicitis, and in 56 healthy children. The index of phosphatase activity of neutrophils (IPAN) was found to be considerably increased in all forms of appendicitis in childhood. An intensity of the reaction depends on the form and terms, elapsed since the disease onset. The determination of IPAN in the complex with clinical findings could be utilized for the differential diagnosis purposes in investigation of patients suspected of acute appendicitis, while in the postoperative period - for estimating a gravity of the course and prognosis of the disease.

Acute Disease↗

PubMed1979

Crohn's disease of the appendix, manifested as acute appendicitis with postoperative fistula.

Two cases are reported of Crohn's disease localized to the appendix and manifested as acute appendicitis; after appendectomy a fistula developed. In none of 18 patients with Crohn's disease reported by other authors, where the appendix was the primary site, did a fistula develop postoperatively. When the appendix is the primary site of Crohn's disease the presence of mild inflammation of adjacent organs such as the terminal ileum may be mistakenly attributed to ordinary appendicitis. If, at exploratory laparotomy performed on a tentative diagnosis of appendicitis, Crohn's disease is suspected in the adjacent intestine, it is proposed that appendectomy should be followed by at least 10 days of total parenteral nutrition to minimize the risk of a fistula developing.

Acute Disease↗

PubMed1978

[Nature of the relation of acute appendicitis morbidity to meteorological and heliogeophysical factors].

The authors analyzed 2009 appendicitis case records for the period from 1964 to 1973. In a sea climate region an evident season distribution of the apendicitis morbidity was found, with the rise of the incidence rate in January, March and April. The rise of the appendicitis incidence rate during the periods of vast fluctuations of air temperature, increase of air humidity and decrease of actual duration of sun radiance was established. The rise of the incidence of acute appendicitis was also noted during the months of a great and extremely great magnetic storms.

Acute Disease↗

PubMed1977

[External postoperative intestinal fistulae in appendicitis].

The author presents an analysis of the data obtained in 8500 patients operated upon for acute appendicitis, in 62 of them the postoperative period was complicated by intestinal fistula. It was found that the main causes of occurrence of intestinal fistulas are as follows: late terms of hospitalization and operative treatment of patients with acute appendicitis, some damage to the bowel due to inadequate access in appendectomy. The author advocates an earlier operative treatment for acute appendicitis and the use of a wide approach (transverse) in appendectomy.

Acute Disease↗

PubMed1977

Acute appendicitis associated with pregnancy, labor and the puerperium.

Eleven patients were operated on for acute appendicitis during pregnancy, in labor or during the puerperium. All patients had acute, gangrenous or perforated appendicitis. There was no fetal or maternal mortality, although three patients developed postoperative pneumonia, pelvic phlegmon or wound infection. The physical findings of appendicitis are altered by the displacement of the appendix by the uterus. The white blood counts must be interpreted with the leukocytosis of pregnancy in mind.

Acute Disease↗

PubMed1976

[Ileus due to appendicitis in the puerperium].

A report is given in a case of appendicitis after delivery in childbed. This was the third case of appendicitis within 17 657 deliveries in the gestation of the district hospital in Sangerhausen in the period from 1960 to 1975. The chronic relapsed appendicitis produced a paralytic Ileus. By using correspondent measures (infusional therapy, appendectomy, adhesion solutions) the patient could be cured without any complications. The patient feeled a Douglas-touch of pain that extended especially to the right. This was the only symptom that was noticed by the patient besides the Ileus that had been clinical well defined and secured with the help of x-ray photo.

Appendicitis↗

PubMed1979

Appendicitis and aortofemoral graft infection.

A 59-year-old man who underwent successful aortofemoral bypass had acute appendicitis at an indeterminate time in the postoperative period. Thirteen months later, a pulsatile groin mass developed. After a complicated course, it was found that infection from appendicitis had extended to the body of the graft. This unusual cause of graft infection reaffirms the importance of careful closure of the retroperitoneum over an aortic anastomosis and suggests a relationship of other intra-abdominal inflammatory processes to graft infection.

Acute Disease↗

PubMed1978

Progress of acute appendicitis: a study in children.

The results of six simple investigations are compared with the duration of the disease in 100 children with acute appendicitis. The results indicate that during the first day on which the appendix becomes inflamed the local defence mechanisms of the appendix are impaired sufficiently to allow invasion by the bacterial organisms in its lumen. This initially inflamed and subsequently infected appendix may develop in the manner indicated. Local and/or generalized complications may follow, i.e. acute appendicitis in its successive stages of development, which may be regarded as (a) inflamed, (b) infected and (c) complicated, and these changes take place at intervals of 1 day. Bacterial and faeoliths are present in the lumen of the appendix, whether inflamed or not, and it is suggested that they complicate the disease rather than being responsible for causing it.

Acute Disease↗

PubMed1979

Recurrent appendicitis: reexamination of a controversial disease.

The existence of recurrent appendicitis as a true disease entity is still disputed. The controversy surrounding recurrent appendicitis is discussed. This disease is thought to represent repeated inflammation of a nonperforated appendix. Case material supporting this concept is presented. The barium enema can provide evidence of the diseased appendix.

Adolescent↗

PubMed1976

Acute appendicitis and postoperative fecal fistula: symptoms of an unrecognized carcinoma of the colon.

This report is a retrospective evaluation of 12 case histories. All patients had been subjected to laparotomy on suspicion of acute appendicitis. The operative situations seemed to corroborate clinical expectations: an inflamed ileocecal process was assumed to be a result of performation of a gangrenous appendicitis. In three patients a primary adenocarcinoma arising from the appendiceal base was the incidental histologic finding postoperatively. In three other patients this inflammatory-looking process was related to a cecal carcinoma. In six patients a carcinoma existed unrecognized as the basic disease, these patients being subjected to intra-abdominal drainage only or in connection with appendectomy. In five instances a fecal fistula was the main persisting symptom of postoperative morbidity, in one patient even as long as two years after laparotomy. The problem in diagnostic verification of the initially unidentified carcinoma is illustrated. Attention is directed towards avoiding a false feeling of security in the presence of inflammatory manifestations in the right lower abdominal quadrant, which may misleadingly suggest a ruptured appendix.

Abscess↗

PubMed1977

Familial retrocecal appendicitis.

A family pedigree containing sixteen individuals with acute appendicitis is presented. In all but one the position of the appendix was retrocecal. In two other members explored for abdominal pain wherein acute appendicitis was not the cause, the appendix was also found to be retrocecal. The anatomic retrocecal location of the appendix in this pedigree shows a degree of uniformity that implies a common predisposing factor inherited as a simple, dominant unit-character.

Adolescent↗

PubMed1978

Acute appendicitis: efficacy of prophylactic preoperative antibiotics in the reduction of septic morbidity.

The course of 200 patients who recently underwent appendectomy at UCLA for acute appendicitis has been reviewed to determine the efficacy of preoperative systemic antibiotic prophylaxis in reducing septic morbidity after surgery. Among those with nonperforated appendicitis who were given gentamycin and clindamycin preoperatively, a reduction of infection rate from 10.2 to 5.3 per cent was found when compared with patients who received no antibiotics.

Adolescent↗

PubMed1979

Acute appendicitis during pregnancy.

Case reports (1970--1977) of thirty-five pregnant women with acute appendicitis were reviewed. Eighty-eight per cent had symptoms less than 24 hours and were operated on within 12 hours. No maternal or fetal loss occurred. Morbidity and mortality should be minimal if, when appendicitis is suspected in a pregnant woman, immediate operation is performed.

Acute Disease↗

PubMed1979

Use of the barium enema in the diagnosis of acute appendicitis and its complications.

The value of barium enema examination in diagnosing acute appendicitis in patients with equivocal findings has been confirmed by our experience with five patients. Cecal spasm, extrinsic compression of the cecum, nonvisualization of the appendix, and partial visualization of the appendix appear to be useful roentgenographic signs, either singly or in combination, in diagnosing acute appendicitis. We have had absolute pathologic correlation between the barium enema findings andthe subsequent clinical course of all the patients in whom we conducted this examination. When performed by an experienced radiologist, the barium enema examination carries no increased risk, and we have seen no complications from this procedure.

Acute Disease↗

PubMed2026

Long-term outcomes of non-operative compared to operative management of acute uncomplicated appendicitis - a systematic review and meta-analysis.

BACKGROUND: We evaluated long-term outcomes of non-operative management (NOM) versus surgical management of acute uncomplicated appendicitis. METHODS: Systematic review of studies comparing NOM versus surgery with ≥2 years follow-up. Primary outcome was long-term failure rate. RESULTS: 9/1635 studies were included (3 RCTs; 6 non-RCT studies), involving 3883 patients; 5 were in pediatric populations. Median follow-up was 33.6 (range 24-312) months. NOM pooled long-term failure rate was 38.9% (95% CI: 31.1%-46.7%), increasing to 44.4% (95% CI: 41.4%-47.4%) in RCTs. Pooled appendectomy rate after NOM was 36.3% (95% CI: 28.9%-43.7%). Incidence of appendiceal neoplasms was approximately 0.3%. Non-operative management had cost savings of €1535 (95% CI: -€1892 to -€1178) versus surgery. CONCLUSIONS: NOM of acute uncomplicated appendicitis was associated with high long-term failure rates and significant risk of subsequent appendectomy.

Humans↗

PubMed1978

Neonatal appendicitis: ischemic infarction in incarcerated inguinal hernia.

A premature 12-day-old infant with ischemic infarction of the appendix due to hernial incarceration is presented. Literature review (1901-1975) of 106 cases of acute appendicitis in the first 30 days of life permitted tabulation of some clinical aspects in 94 cases. Overt manifestations mandating surgical intervention and isolation of the inflammatory process in the inguinoscrotal region are important factors responsible for the significantly better prognosis for neonatal hernial versus intraabdominal appendicitis.

Acute Disease↗

PubMed1978

Appendicitis in the elderly.

The charts of 68 patients from 65 to 99 years of age who underwent appendectomy for appendicitis were reviewed between 1964 and 1976. Thirty-three were men and 35 women. All patients underwent appendectomy. Four patients had normal appendices. The remainder had appendicitis; 74% were ruptured. The duration of symptoms varied greatly, and was related to outcome. The mean duration was 58 hours, but both those who died and those who suffered complications had significantly longer mean duration while those who had an uncomplicated course had a shorter mean duration of symptoms. The incidence of rupture rose from 60% in those seen with symptoms less than 48 hours to 90% in those with symptoms longer than 49 hours. Delay was invariably related to delay in seeking medical treatment. In no case was the patient under the care of another physician for an extended period of time. Pain was the chief complaint in 63 patients, and was present in all. Seventy-four per cent had fever and 78% had leukocytosis. Those with normal appendices had normal white blood cell counts. Right lower quadrant tenderness was present in 80%. Thirty-nine per cent had significant additional medical problems. Most (73%) had operation within six hours of their original evaluation, and yet the overall complication rate was 34% including six deaths. Delay during evaluation did not correlate with unsatisfactory outcome as did delay in seeking medical attention. The most common complications were due to infection. In at least three of the deaths wound infection was associated with sepsis and death. Delay in seeking medical care, advanced age, and underlying problems were the most significant factors in those who died.

Age Factors↗