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PubMed1991

[Urinary diversion using an appendix: a report of two cases].

We report two cases of urinary diversion through an appendix. Case 1. An 81-year-old man was hospitalized with oliguria. The patient had a past history of left nephro-ureterectomy for left ureteral tumor. Ultrasound showed right hydronephrosis due to recurrence in the bladder and right ureter. A total cystectomy and partial ureterectomy were carried out, and an appendix conduit was constructed because the ureter was not sufficiently long for ureterocutaneostomy. Case 2. A 68-year-old woman with diabetic neurogenic bladder, hypothyroidism, and chronic obstructive lung disease was hospitalized with the complaint of difficulty in self-catheterization. Continent vesicostomy was carried out according to the method of Mitrofanoff using the appendix. Both patients were tubeless and without postoperative complications before discharge. Appendix conduit and Mitrofanoff operation, which can be performed by a simple surgical procedure, are considered to be applicable to poor risk cases.

Aged↗

PubMed1991

Bacteriology of the appendix and the ileum in health and in appendicitis.

The bacteriology of the ileum and the appendix in appendicitis patients with or without perforation and compared with patients who had "incidental appendectomy" was studied. Of 42 appendicitis patients, 24 (57%) of them had anaerobic bacteria in the appendix compared with two of eight (25%) with normal appendix. Anaerobes were found in the ileal aspirates of 20 of 42 (47.6%) appendicitis patients and two of eight (25%) in normal persons. This suggests that anaerobic bacteria increasingly colonize the appendix and the ileum in cases of appendicitis.

Adolescent↗

PubMedDate not supplied

[The effect of prostaglandin F2 alpha and indomethacin on the musculature of the human appendix].

In their research, the authors have tried to determine possible differences in effects of prostaglandin F2 alpha on longitudinal musculature tonus in normal and inflamed human appendix and the extent to which it is possible to react on prostaglandin effect by indomethacin. The obtained results indicate that PGF2 alpha increases tonus in human appendix musculature; however, the change is more pronounced in a normal appendix musculature. Even more, indomethacin prevents spasms caused by PGF2 alpha in musculature of both normal and inflamed appendix significantly. This indicates that, in addition to its influence on prostaglandin synthesis indomethacin also has another mechanism of activity, may be even at the level of prostaglandin receptors.

Appendix↗

PubMed1989

[Mucocele of appendix-report of three cases].

Mucocele of appendix comprises 0.07%-0.3% of the resection of appendix. Three such cases were encountered over the past four years at MMH. Tumor mass could be palpated before operation in two of our cases. The third case was found incidentally during sigmoid cancer resection. Mucocele of the appendix should be differentiated from submucosal lesion such as leiomyoma, lipoma, lymphoma in the cecum or appendiceal abscess. Recent advances of ultrasound, CAT scan as well as angiography have made correct preoperative diagnosis possible, yet literature still shows diverse opinion about its etiology (neoplastic vs. obstructive). Although most authors favor simple appendectomy for the management of this disease, some surgeons still think it should be managed aggressively with colectomy. Rupture of mucocele might result in pseudomyxoma peritonei and possibly a fetal outcome. Avoidance of iatrogenic rupture of appendix is essential. Aggressive removal of accessible masses and implants was suggested in the literature.

Adult↗

PubMed1988

The correlation between gross appearance of the appendix at appendicectomy and histological examination.

A retrospective review of patients with a preoperative diagnosis of appendicitis or thought to have appendicitis at laparotomy showed a discrepancy between the surgeons' opinion of the macroscopic appearance of the appendix and the pathologist's opinion (which was assumed to be the most accurate) in 14.5% of cases. All cases were false positive diagnoses. Using the surgeons' descriptions of the appendix at appendicectomy, a sub-group can be identified with an 80% error rate. In this group, the terms used to describe the appendix were 'mild, early, slight or moderate inflammation'. This error rate is often ignored in studies on appendicitis. We recommend that only the terms 'normal' 'inflamed' or 'gangrenous or perforated' should be used to describe the appendix. If there is any doubt, it should be classed as normal. These recommendations will improve diagnostic accuracy at operation.

Adolescent↗

PubMed1986

Coexistence of primary Crohn's disease and carcinoid tumor isolated to the appendix. A case report.

A patient is described in whom isolated Crohn's disease of the appendix was present simultaneously with isolated carcinoid tumor of the appendix. Appendectomy was the primary therapy and no recurrence of either disease has been discovered after four years of follow-up. We believe this to be the first case of its type to be reported. Crohn's disease of the appendix, carcinoid tumors of the appendix and the occurrence of gastrointestinal tumors in conjunction with Crohn's disease are all briefly discussed.

Adult↗

PubMed1978

[The first stages of the appendix development in the human embryo].

The cecoappendicular area of 14 human embryos with a length ranging from 6 to 17 mm from vertex to coccyx (28 to 48 days old; Carnegie stages 13 to 19) was studied. The appendix is not an atrophic remain of the caecum, it develops at the same time as the caecum. The first morphological anlage of the organ is observed in human embryos from 6 to 10 mm (28 to 37 days of age; Carnegie stages 13 to 16) in the form of an elevation covered with coelomic epithelium, constituted by the mesenchyme which surrounds the anlage of the caecum. In later stages, on human embryos of 11 to 16 mm (37 to 44 days of age; Carnegie stages 16 to 18), the mesoblastic anlage of the appendix is more evident, but it is not invaded by the entoblastic cells which come from the caecum on embryos of 12 to 13 mm. On embryos of about 17 mm (48 days old; Carnegie stage 19) the entoblastic anlage of the appendix has invaded the original mesoblastic anlage. The formation of the appendix by two anlage one earlier, mesoblastic, and another later, entoblastic, is similar to that of other lymphoid organs like the sack of Fabricius in birds.

Appendix↗

PubMed1976

Intussusception of the appendix caused by an adenovillous papilloma.

A case of intussusception of the appendix caused by an adenovillous papilloma in the appendix is reported. The condition was combined with acute appendicitis. The different clinical pictures are described. Due to the varied symptoms the diagnosis of intussusception of the appendix is rarely made preoperatively. The aetiology is briefly discussed. The treatment is operative with removal of the appendix or an appropriate resection.

Acute Disease↗

PubMed1988

A 25-year review of adenocarcinoma of the appendix. A frequently perforating carcinoma.

A study was undertaken to compare the age, sex, preoperative diagnosis, and operative findings of patients who had adenocarcinoma of the appendix with patients who had adenocarcinoma of the colon. The study consisted of an analysis of 316 case reports and collective reviews of adenocarcinoma of the appendix that were reported in the literature between 1960 and 1985. The mean age of patients with this disease was 57.1 years and the male-to-female ratio for adenocarcinoma of the appendix was 1.4:1. Only rarely was a malignancy suspected, as 68 percent of the patients presented with signs and symptoms of inflammatory disease of the appendix. The tumor was perforated in 55 percent of patients, making it the most frequently perforating carcinoma of the entire gastrointestinal tract. One half of these perforations were localized as abscesses. The presence of perforation did not necessarily predispose a poor prognosis. Synchronous appendiceal and other colonic neoplasms occurred in 2.7 percent of patients. Pseudomyxoma peritonei occurred as a presenting feature in 5.6 percent of patients and was generally a poor prognostic indicator. Carcinomatosis peritonei was found at initial exploration in 10.3 percent of patients and these patients rarely survived one year.

Abscess↗

PubMed1973

Mucinous cystadenoma and cystadenocarcinoma of the vermiform appendix with particular reference to mucocele and pseudomyxoma peritonei.

Ten cases of mucocele of the vermiform appendix are described. Eight cases were of mucinous cystadenoma of the appendix and six cases showed acute inflammation. Two of the six cases showed pseudoinvasion of the appendix and in a further case the appendix had perforated with extrusion of a misplaced neoplasm. Two cases were of mucinous cystadenocarcinoma and one of these was diagnosed as ;pseudomyxoma peritonei'. ;Pseudomyxoma peritonei' is a misnomer and is caused by dissemination of a mucinous cystadenocarcinoma within the peritoneal cavity. The special problems of histological diagnosis are discussed.

Aged↗

PubMed1975

[Effect of experimental inflammation of the appendix on immunogenesis].

Effects of an operation trauma and inflammation of the appendix caused by ligation of appendicular vessels on immunogenesis were studied in experiment on rabbits. A number of antibody-containing cells of plasmatic series in the blood serum and their percentage interrelation in the appendices were determined. A stimulating effect of laparotomy on the quantitative content of antibodies in the blood was established. Accelerated differentiation and restitution of the percentage interrelationship of antibody-containing cells in the appendix were noted at earlier periods as compared with controls in which similar phenomena were observed at later terms. The development of inflammation in the appendix in the majority of animals revealed itself in an increase of the antibody content in the blood at earlier periods and a decrease thereof at later periods. In the appendix the accelerated differentiation at earlier periods wes not completed subsequently by restitution of the percentage interrelationship of antibody-containing cellular forms.

Animals↗

PubMedDate not supplied

[Carcinoid tumor of the cecal appendix].

In connection with carcinoid tumor of the appendix as an incidental finding in appendectomies, we carried out revision in a period of 5 years, from 1983 through 1987, in the General Hospital of Venezuelan Institute of Social Security in San Felix, Bolivar State. We found two cases of carcinoid tumor of the appendix in 1433 appendixes that were examined by the Service of Pathology. Both cases were males patients who were admitted due to acute appendicitis. They represented 0.14% of the total appendectomies. We review on the subject and we find that the frequency is like to that published up to now. We agree with others authors in that simple appendectomy in the carcinoid tumor of the appendix is curative in tumors < 2 cm.

Appendectomy↗

PubMed1989

[Carcinoid of the appendix].

Within the framework of reflections on the extent of surgical operations in case of carcinoid of the appendix the author evaluates the size of the tumour, site of the tumour on the appendix and the presence of metastases in the appropriate lymph nodes or in remote organs. The author presents two case-histories. In the first one he demonstrates difficulties associated with evaluation of metastases of the mesenterial lymph nodes in case of mesenterial lymphadenitis concurrent with unrecognised carcinoid of the appendix. From the second case-history it is apparent that in advanced appendicitis with marked inflammatory changes of the appendix also colliquation of part of the tumour may occur and even microscopis examination does not provide information on the size of the tumour.

Adolescent↗

PubMed1989

[Carcinoma metastasis into the vermiform appendix].

Metastases into the appendix vermiformis are very rare. The authors present a case of a secondary of gastric carcinoma into the appendix vermiformis. In the patient the malignant disease was manifested with the clinical picture of diffuse peritonitis caused by perforation of the aboral portion of the appendix vermiformis at the site of the exulcerated secondary of the carcinoma. The authors give also an account of secondaries into the appendix vermiformis described in the literature.

Adenocarcinoma↗

PubMed1977

Carcinoid tumors of the appendix in children. A report of 25 cases.

Carcinoid tumors of the appendix in 25 children (21 girls, 4 boys) below 15 years corroborated the previously reported preponderance of females. 17 children were operated upon because of acute appendicitis, one because of oxyuriasis in the appendix and the remaining 7 because of diffuse recurrent abdominal pain. All the patients were subjected to appendectomy and one of them later also to right-sided hemicolectomy because of carcinoid in the margin of the resection of the appendix but not in the cecum. Despite deep infiltration of the wall of the appendix to the serosa in 9 children and lymph node metastases in one, no signs of a recurrence have been seen during follow-up of 5 to 17 years (mean 12 years).

Adolescent↗

PubMed1975

Trauma to the appendix. A report of two cases.

Only two cases of trauma to the vermiform appendix are recorded in the English literature. This report adds two more cases: one due to a penetrating bullet wound of the abdomen where tangential laceration of the appendix was the only intra-abdominal injury, the other an avulsion of the appendix from the mesoappendix resulting from blunt abdominal trauma. Preoperative diagnosis of this specific lesion could not be made. Both patients were successfully managed by appendectomy.

Abdominal Injuries↗

PubMed1988

Isolated Crohn's disease of the appendix. Two case reports and a review of the literature.

Two patients were diagnosed and treated at St Elizabeth Hospital Medical Center, Youngstown, Ohio, for isolated Crohn's disease of the appendix. Including these two patients, 75 such patients have been described in the world literature from 1953 to July 1986, to our knowledge. Crohn's disease of the appendix should be considered in patients who are in their second and third decades of life, who have pain and tenderness in the right lower quadrant of the abdomen, and whose symptoms are protracted (longer than three days) and/or recurrent. Intraoperatively, if the appendiceal wall appears hypertrophic, thickened, and chronically inflamed, a frozen section may confirm the diagnosis. Crohn's disease of the appendix is a diagnosis of exclusion. Appendectomy may be performed safely and has a low morbidity and mortality. The incidence of enterocutaneous fistula and the recurrence rate are much lower than for Crohn's disease of the small and large bowel.

Adult↗

PubMed1988

Adenocarcinoid tumor of appendix presenting as unilateral Krukenberg tumor.

We report a case of adenocarcinoid tumor of the appendix that presented initially as a unilateral Krukenberg tumor (a signet ring cell mucinous adenocarcinoma with prominent cellular stroma). The primary tumor in the appendix was discovered 10 months later at the time of a "second look" laparotomy. The ovarian metastasis showed both goblet cell elements and tubular formations with numerous argyrophilic cells, indicating that both components of these tumors may metastasize, a finding at variance with the conclusions of some authors who suggest that only the mucinous component may metastasize. Theories of histogenesis of these tumors are discussed, and 12 previously reported cases presenting as Krukenberg tumors (all bilateral) are reviewed. Because the primary tumor in the appendix may be small and easily missed, appendectomy is recommended in all patients with Krukenberg tumors when another primary site cannot be identified at the time of surgery.

Adenocarcinoma↗