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At least 433 records · Page 24Linked to original sources

PubMed1997

Drain site evisceration of the appendix: report of a case.

We report herein the case of a patient in whom evisceration of the appendix occurred at the site of a drain placed in the right lower quadrant of the abdomen. Because the appendix had become adhered to the side-hole of the drain with an external diameter of 11 mm, it was pulled out attached to the drain. Consequently, the stab wound incision of the drain was extended and an appendectomy was performed under general anesthesia. Thus, drains with a small diameter should be used whenever possible, and side-holes not having any influence on the drainage should be avoided.

Appendix↗

PubMed1987

Intussusception of the appendix with a calcified fecalith.

We treated a patient with a complete invagination of the appendix which contained one large laminated calcified fecalithy. Colonofiberscopy showed a dimpling submucosal tumor, which was palpated as a bony hard tumor at laparotomy. This finding suggested that the fecalith caused an intussusception of the appendix and that such an intussusception should be suspected when there is a bony hard dimpling submucosal tumor in the cecum.

Appendectomy↗

PubMed1984

Intussusception of the appendix.

Two cases of intussusception of the appendix are reported--one caused by adenocarcinoma and adenomatous polyp and the other by an endometrioma. Appendiceal intussusception and adenocarcinoma are both uncommon entities and this is the first report of the two occurring concomitantly. Due to variable symptoms, the correct diagnosis of appendiceal intussusception has rarely been made preoperatively. Classification, symptoms, radiographic appearance, and differential diagnosis are discussed, and the authors suggest a new classification for intussusception of the appendix.

Adenocarcinoma↗

PubMedDate not supplied

Crohn's disease confined to the appendix.

Crohn's disease confined to the appendix is a rare entity, less than 50 cases having been reported. The present study reports on another 12 cases representing 6 per cent of all 194 patients operated upon for Crohn's disease in a total, unselected series. The indications for surgery were appendicitis in eight patients, appendiceal abscess in two, suspected pyosalpinx in one, and an ovarian cyst in one. The appendices were in all cases strikingly enlarged. Giant-cell granulomas, without microabscesses were detected in all but one patient. Two patients had early septic postoperative complications. Fistulization from the cecum did not occur. The median observation time after operation was 13.8 years. Since none of the patients had further manifestations of the disease, it is concluded that patients with Crohn's disease confined to the appendix have a favorable prognosis.

Adolescent↗

PubMed1988

Adenocarcinoid of the vermiform appendix. A clinicopathologic study of 20 cases.

Adenocarcinoid of the appendix is a tumor that shares the histologic features of both carcinoids and adenocarcinomas. The metastatic ability of the tumor is uncertain. Twenty consecutive cases of adenocarcinoids were compared with 88 cases of conventional appendiceal carcinoids. Metastatic tumor spread was found in six of 20 cases of adenocarcinoids, but in none of the conventional carcinoids. Metastasizing tumors were characterized by a moderate to severe nuclear atypia and a high mitotic count. These features were present in only two of the nonmetastasizing tumors, one of which was treated by hemicolectomy. Adenocarcinoids showing moderate or severe nuclear atypia, a mitotic count of two or more mitoses/10 high power fields, or spread beyond the appendix should be treated by hemicolectomy. If these features are not present, simple appendectomy is adequate.

Adenocarcinoma↗

PubMed1977

Diverticular disease of the appendix.

Diverticular disease of the appendix involves about 1 per cent of all appendices removed. Considering the large number, the subject appears to have been neglected in medical literature. Since the symptomatology is similar to that of appendicits and diverticula are frequently very small, they could go unnoticed. A comparison of 30 cases of diverticular disease and 30 cases of acute appendicitis reveals a few fine differences. The patients with diverticular disease are at least a decade older, the duration of pain in these patients is longer, and the diverticula and appendix may or may not be inflamed.

Adolescent↗

PubMedDate not supplied

An unusual malformation of the vermiform appendix simulating endometriosis: a case report with discussion of differential diagnosis.

A 48-year-old nulliparous woman with a long history of pelvic endometriosis underwent a gynecologic operation, and a swollen and indurated appendix was removed because of suspected endometriosis. Pathologic examination revealed no endometriosis, but examination of the distal appendix showed structural disorganization of its entire wall, with lack of proper differentiation of its normal coats and irregular overgrowth of fibroadipose, fibromuscular, and neural elements. Differential diagnoses, including endometriosis, carcinoid tumor and neurofibromatosis, are discussed.

Appendiceal Neoplasms↗

PubMed1988

Electron microscopic study of microfold cells (M cells) in normal and inflamed human appendix.

Electron microscopic observation was made on microfold cells (M cells) in the covering epithelium of the lymphoid follicle (dome epithelium) of the intestine. Materials consisted of ten human appendices, five of those were inflamed and obtained from children with acute appendicitis. The remainder was not inflamed macroscopically, and there was one human Peyer's patch for control. The results indicate that in the human appendix, the elevated surface type of M cells named by protruding apical cytoplasm to the lumen was more conspicuous than the depressed surface type. The latter type was named by shorter irregular microvilli than those of neighboring cells, and was present dominantly in human Peyer's patch. M cells with enfolded lymphocytes consisted of the stumpy type and the slim type in the whole shape. M cells in the inflamed appendix showed their apical cytoplasm swelling like a balloon and microfolds disappearing, and seemed vulnerable to inflammation. It is considered that the M cell surface structure changes not only in accordance with enfolded lymphocytes and the uptake of antigenic materials, but also according to the organ in which M cells are present and whether inflammation is present or not.

Acute Disease↗

PubMed1998

[Invagination of the vermiform appendix in mucinous cystadenoma].

Intussusception of the appendix vermiformis in adults is an uncommon event. The combination of a mucinous cystadenoma with an intussuscepted appendix is extremely rare. Clinical symptoms are nonspecific; in most cases the correct diagnosis is not made before surgical exploration. With the radiologic and endoscopic presentation of a polypoid lesion of the caecum, a neoplasm is often considered. Endoscopic appendectomy or disinvagination by enema have been described. Thus the definitive therapy is surgery and depends on the histological diagnosis.

Adult↗

PubMed2006

Pathology of the appendix in children: an institutional experience and review of the literature.

BACKGROUND: The appendix can be affected by a variety of congenital and acquired diseases, but acute appendicitis is the most common pathology found in the pediatric population. OBJECTIVE: This is a retrospective review of all appendectomies performed during a 2-year period at a major children's hospital with a review of the literature regarding the most common pathologic findings. MATERIALS AND METHODS: The pathology database was reviewed for appendectomy specimens, and patient medical records were evaluated to determine the age, gender, race and operative diagnosis. All slides were reviewed and the histologic findings were recorded. RESULTS: A total of 392 appendectomies were performed, including 68 incidental appendectomies and 324 performed for clinical suspicion of acute appendicitis. In 247 of the latter, acute appendicitis was confirmed histologically, and of the remainder 14 were interval appendectomies, 2 had findings suspicious for Crohn disease, 1 confirmed diverticulitis and 60 were histologically negative for appendicitis. CONCLUSION: Acute appendicitis is the most common pathologic cause of appendectomy, but various other pathologic entities are found in children. Examination of the appendix is warranted even when it appears normal on exploration.

Abdomen, Acute↗

PubMed2004

Development of the vermiform appendix during the fetal period.

This study aimed to determine the location and development of the vermiform appendix (VA) in terms of morphometry. It was carried out on 80 human fetuses that exhibited neither external pathology nor anomaly and whose gestational ages were between 10 and 40 weeks. The location of the VA and cecum was established. Total VA diameter, lumen diameter, wall thickness, serosa, muscularis and mucosa thickness were measured on microscope slides. The VA was almost always observed in the subcecal region during the fetal period. The length of the VA and the attachment length of the meso-appendix to the VA increased with the gestational age. Lymphocyte aggregation was first seen at the 17th week of the fetal period. Positive and meaningful correlation was found between gestational age and morphometric parameters of the VA. A significant difference was found between the genders in the thickness of mucosa, which was larger in girls (p<0.05). When the proximal, median and distal parts were compared, the thickness of serosa between the proximal and distal parts was also significantly different (p<0.05). The present study has revealed that the VA matures in the second trimester during the fetal period. Furthermore, the morphologic development of the VA is almost uniform from the proximal to distal part.

Age Factors↗

PubMed1997

Computed tomography of the normal appendix and acute appendicitis.

The aim of this article is to present pictorially the spectrum of appearances of the appendix and appendicitis on CT. The images presented were selected from the database of our hospitals. The various appearances of the normal appendix on CT are shown. Appendicitis can be divided into four categories on the basis of CT findings. Examples of each category are shown.

Acute Disease↗

PubMed1998

Use of the appendix to replace the choledochus.

Ten cases of choledochal cyst (CC) were treated by biliary-appendicoduodenostomy. The follow-up comprised a patient interview, ultrasonography (US), and single-proton ejected computerized tomography (SPECT) scanning. In all cases an anti-reflux submucosal tunnel was added to the distal appendico-duodenostomy; all showed an uneventful postoperative course. All the dilated intrahepatic bile ducts had normalized on B-US postoperatively. Four children under went SPECT examination; all of them had patent neo-bile ducts. In the authors' opinion: (1) Anastomosing the cecal end of the appendix to the common hepatic duct seemed more favorable than the other way around, because the cecal end could be easily trimmed to the size of the common hepatic duct, which was more or less dilated in the presence of a CC; (2) It is necessary to add a submucosal tunnel to the distal appendicoduodenostomy to achieve a more reliable anti-reflux effect; and (3) Transposing the vascularized appendix through the retro-transverse colon simplified the procedure and might reduce the risk of retroperitoneal complications if bile leakage should occur.

Appendix↗

PubMed1998

Patent omphalomesenteric duct of the vermiform appendix in a neonate: congenital appendicoumbilical fistula.

Umbilical anomalies arise from fetal structures such as the omphalomesenteric duct (OMD) or urachus or from failure of closure of the umbilical fascial ring. Persistence of the OMD may lead to several anomalies including umbilical sinus, umbilical cyst, Meckel's diverticulum, or patent OMD (POMD). A POMD is usually associated with the ileum, but rarely may be with the caecum or appendix. We describe a POMD of the vermiform appendix and discuss the possible pathogenesis and management.

Appendix↗

PubMed2000

Intussusception of the vermiform appendix: preoperative colonoscopic diagnosis of two cases and review of the literature.

Intussusception of the appendix is an uncommon condition, and the diagnosis is rarely made preoperatively. Making an accurate diagnosis before laparotomy is important in providing the optimal treatment for the patient. We present the clinical and endoscopic features of two cases of intussusception of the appendix and review the literature. Diagnosis was made preoperatively by colonoscopy in these cases and an elective appendectomy was performed. Appendiceal intussusception should be considered in the differential diagnosis of abdominal pain. Colonoscopy can be a valuable tool in establishing this diagnosis and in selecting the appropriate management.

Abdominal Pain↗

PubMed2004

Incarcerated vermiform appendix in a left-sided inguinal hernia.

We report here of a patient with an incarcerated vermiform appendix occurring in a left-sided indirect inguinal hernia. Occasionally, appendices are found in a hernial sac; however, the finding of an incarcerated vermiform appendix in an inguinal hernia on the left side is very unusual and has only been previously described once. The patient suffering this rare entity underwent appendectomy and repair of the hernia and experienced an uneventful postoperative recovery. The possibility of the presence of a situs inversus, or malrotation, as an underlying cause for the observed pathology was excluded by x-ray examination.

Aged↗

PubMed1975

Endometriosis of the appendix. Report of twelve cases and review of the literature.

Twelve cases of endometriosis of the vermiform appendix are discribed and reviewed. The incidence of 0.80 per cent is higher than has been previously reported. None of the patients displayed symptoms of acute appendicitis, however, five (42 per cent) patients had symptoms suggestive of chronic or cyclic appendicitis. Laboratory tests were nondiagnostic of this lesion. There did not appear to be a correlation between the histologic location of the endometriosis and the symptoms of chronic or cyclic appendicitis. All cases of endometriosis of the appendix were discovered as a result of incidental appendectomy.

Adult↗

PubMed1977

Penetrating injuries of the appendix.

Although rare, penetrating injuries of the appendix pose an interesting finding at laparotomy. Associated penetrating gastrointestinal injuries are common. Four additional cases of trauma to the appendix from penetrating wounds are described.

Abdominal Injuries↗