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Sample records for appendicitis

  1. Appendicitis: a continuing challenge.

    Science.gov (United States)

    Pal, K M; Khan, A

    1998-07-01

    Acute appendicitis is a common surgical emergency in urban setting, of a developing country. The computerised hospital patient database at Aga Khan University Hospital, Karachi, was utilised to obtain records of all adults with a histologically proven diagnosis of acute appendicitis. A review of patients treated over a 18 month period was undertaken. One hundred and three appendicectomies were performed for acute appendicitis during this period. The diagnosis was clinical in all cases. Investigations like leucocyte count and lower abdominal ultrasound scan were used to improve diagnostic accuracy without a clear advantage. A number of routine investigations like, haemoglobin estimation and urea, creatinine, electrolyte measurements, did not provide additional information. The duration of antibiotic treatment in acute simple appendicitis was empiric and could be reduced to a single preoperative dose. Peritoneal fluid culture studies had a poor yield (26%) and results were not found to effect management in acute simple appendicitis. The routine use of Ampicillin in all cases of bacterial peritonitis needs re-evaluation, as a high incidence (73%) of resistance was seen. Studies to define the role and duration of treatment, with a single antibiotic, in acute simple appendicitis should be undertaken. Acute appendicitis is probably the most frequently considered surgical differential diagnosis at any hospital dealing with acute surgical conditions. The established treatment continues to be surgical removal of the inflamed organ. The diagnosis and decision to operate both are accepted to be based on clinical judgement, though a number of investigative manoeuvres have been described to reduce the negative appendicectomy rate. Other areas of debate are the number and length of antibiotic treatment and use of bacterial culture studies in cases of simple acute appendicitis. To analyse present practice and identify areas for study and change, a retrospective study was

  2. Operative management of appendicitis.

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    St Peter, Shawn D; Snyder, Charles L

    2016-08-01

    Appendectomy has been the standard of care for appendicitis since the late 1800s, and remains one of the most common operations performed in children. The advent of data-driven medicine has led to questions about every aspect of the operation-whether appendectomy is even necessary, when it should be performed (timing), how the procedure is done (laparoscopic variants versus open and irrigation versus no irrigation), length of hospital stay, and antibiotic duration. The goal of this analysis is to review the current status of, and available data regarding, the surgical management of appendicitis in children. PMID:27521710

  3. APPENDICITIS: YOUNG ADULTS ARE SUSCEPTIBLE

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    Somashekhar V. Hiremath

    2016-08-01

    Full Text Available CONTEXT Appendicitis is the one of the most common emergencies of the acute abdomen encountered by the clinicians; peritonitis is the common cause due to appendicular perforation. Ultrasonography of abdomen is the preferred method of diagnosis of acute appendicitis. The study is done to diagnose acute appendicitis in a tertiary care hospital to ascertain early diagnosis prevalent in this part of the country, which might differ from other studies. AIM To ascertain prevalence, presentation and management of appendicitis in this part of India in a tertiary care government hospital with provisional diagnosis of appendicitis. MATERIAL AND METHODS Cases of acute abdomen, clinical diagnosis of acute appendicitis admitted in KIMS Hospital, Hubli, a tertiary care government hospital, from January 2014 to January 2015 for materials of this study. 100 cases have been taken for study; cases included in this study are acute appendicitis, appendicular abscess; method used is USG abdomen, a simple diagnostic tool. RESULTS In present study, 100 cases of acute abdomen with clinical diagnosis of acute appendicitis were taken and laparotomy was done for 98 cases and two cases of appendicular abscess. Youngest patient was 7 years old and oldest was 65 years. Peak incidence between 11 to 30 years of age group and male to female ratio is 3:2. Postoperative wound infection was a common complication in 21 cases and retention of urine was noticed in 7 cases, and there was a death in one case due to septicaemia. CONCLUSION Acute appendicitis is a second most common indication for early laparotomy in KIMS Hospital, Hubli, first being perforative peritonitis. Acute appendicitis is common between 11 to 30 years of age group, early diagnosis and intervention is required to prevent appendicular perforation and its complications. Diagnosis of acute appendicitis is to be done in patients presenting with atypical pain, absence of vomiting does not rule out appendicitis. Anorexia

  4. Appendicitis - Multiple Languages: MedlinePlus

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    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Appendicitis URL of this page: https://medlineplus.gov/languages/appendicitis.html Other topics A-Z A B ...

  5. Scrotal absceso following an appendicitis

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    León Hernández Angélica,

    2014-07-01

    Full Text Available Appendicitis is the most common cause of acute abdomen in children; approximately one third of all cases present with appendiceal perforation at the time of surgery. Some of postoperative complications in this condition are abscesses. In unusual places such as the scrotum however, for an intraabdominal event to cause a scrotal abscess, fluid displacement requires the presence of a patent processus vaginalis. We report the case of a child with perforated appendix followed by a scrotum abscess owing to a permeable vaginal canal. The abscess was and the patient wes and treatment was performed based triple scheme antibiotics, evolving satisfactorily. Key words: appendicitis, postoperative complications, residual abscess, inguinal canal.

  6. Stump appendicitis: A rare clinical entity

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    Abhinav Kumar

    2013-01-01

    Full Text Available Stump appendicitis is one of the rare delayed complications after appendectomy with reported incidence of 1 in 50,000 cases. Stump appendicitis can present as a diagnostic dilemma if the treating clinician is unfamiliar with this rare clinical entity. We report an 18-year-old patient with Stump appendicitis, who underwent completion appendectomy laparoscopically.

  7. Ultrasonography for the acute appendicitis

    International Nuclear Information System (INIS)

    The authors analysed ultrasonography (US) findings in patients with clinical signs of acute appendicitis during a recent 7-months period. The comparative analysis between US findings and surgical-pathologic findings was performed in 193 cases who underwent surgery. There were 52 cases with a sonographically non-visible appendix whose symptoms spontaneously resolved. The inflamed appendix was visualized by high-resolution, real-time US according to the graded-compression method described by Puylaert. The following results noted: 1. Sonographically visualized 136 cases were the target-appearance appendix in 47 cases, the fluid-filled appendix in 66 cases and the irregular marginated mixed echogenic mass-like density with surrounding fluid collection in 23 cases. The appendix was not visualized by US in 109 cases. 2. Appendicitis perforation was predictable in 21 cases of 24 cases. 3. Acute appendicitis was 24 cases (59%) among 41 cases who were sonographically visualized with appendiceal wall thickening less than 3mm and 77 cases (81%) among 95 cases with wall thickening more than 3mm. 4. When the results in women were analyzed separately (n=176), the sensitivity was 86%, the specificity was 76% and the accuracy was 80%. In women, US was helpful for the differential diagnosis between acute appendicitis and other gynecologic disease. 5. In men (n=69), the sensitivity was 88%, the specificity was 67% and the accuracy was 81%. 6. The overall sensitivity was 87%, the specificity was 75% and accuracy was 80% (n=245). Graded-compression US is the examination of choice in the patients with clinical signs of acute appendicitis, particularly in women

  8. MRI features associated with acute appendicitis

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    Leeuwenburgh, Marjolein M.N. [University of Amsterdam, Department of Surgery, Academic Medical Center, Amsterdam (Netherlands); University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); Academic Medical Center, Department of Radiology (G1-223.1), Amsterdam (Netherlands); Jensch, Sebastiaan [Sint Lucas Andreas Hospital, Department of Radiology, Amsterdam (Netherlands); Gratama, Jan W.C. [Gelre Hospitals, Department of Radiology, Apeldoorn (Netherlands); Spilt, Aart [Kennemer Gasthuis, Department of Radiology, Haarlem (Netherlands); Wiarda, Bart M. [Alkmaar Medical Center, Department of Radiology, Alkmaar (Netherlands); Es, H.W. van [Sint Antonius Hospital, Department of Radiology, Nieuwegein (Netherlands); Cobben, Lodewijk P.J. [Haaglanden Medical Center, Department of Radiology, Leidschendam (Netherlands); Bossuyt, Patrick M.M. [University of Amsterdam, Department of Clinical Epidemiology, Academic Medical Center, Amsterdam (Netherlands); Boermeester, Marja A. [University of Amsterdam, Department of Surgery, Academic Medical Center, Amsterdam (Netherlands); Stoker, Jaap [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); Collaboration: on behalf of the OPTIMAP study group

    2014-01-15

    To identify MRI features associated with appendicitis. Features expected to be associated with appendicitis were recorded in consensus by two expert radiologists on 223 abdominal MRIs in patients with suspected appendicitis. Nine MRI features were studied: appendix diameter >7 mm, appendicolith, peri-appendiceal fat infiltration, peri-appendiceal fluid, absence of gas in the appendix, appendiceal wall destruction, restricted diffusion of the appendiceal wall, lumen or focal fluid collections. Appendicitis was assigned as the final diagnosis in 117/223 patients. Associations between imaging features and appendicitis were evaluated with logistic regression analysis. All investigated features were significantly associated with appendicitis in univariate analysis. Combinations of two and three features were associated with a probability of appendicitis of 88 % and 92 %, respectively. In patients without any of the nine features, appendicitis was present in 2 % of cases. After multivariate analysis, only an appendix diameter >7 mm, peri-appendiceal fat infiltration and restricted diffusion of the appendiceal wall were significantly associated with appendicitis. The probability of appendicitis was 96 % in their presence and 2 % in their absence. An appendix diameter >7 mm, peri-appendiceal fat infiltration and restricted diffusion of the appendiceal wall have the strongest association with appendicitis on MRI. (orig.)

  9. Abdominal actinomycosis mimicking acute appendicitis.

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    Conrad, Robert Joseph; Riela, Steven; Patel, Ravi; Misra, Subhasis

    2015-01-01

    A 52-year-old Hispanic woman presented to the emergency department, reporting worsening sharp lower right quadrant abdominal pain for 3 days. CT of the abdomen and pelvis showed evidence of inflammation in the peritoneal soft tissues adjacent to an enlarged and thick-walled appendix, an appendicolith, no abscess formation and a slightly thickened caecum consistent with acute appendicitis. During laparoscopic appendectomy, the caecum was noted to be firm, raising suspicion of malignancy. Surgical oncology team was consulted and open laparotomy with right hemicolectomy was performed. Pathology reported that the ileocaecal mass was not a malignancy but was, rather, actinomycosis. The patient was discharged after 10 days of intravenous antibiotics in the hospital, with the diagnosis of abdominal actinomycosis. Although the original clinical and radiological findings in this case were highly suggestive of acute appendicitis, abdominal actinomycosis should be in the differential for right lower quadrant pain as it may be treated non-operatively.

  10. Paradigm Shifts in the Treatment of Appendicitis.

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    Mak, Grace Zee; Loeff, Deborah S

    2016-07-01

    Acute appendicitis is the most common cause of emergent surgery in children. Historically, surgical dogma dictated emergent appendectomy due to concern for impending perforation. Recently, however, there has been a paradigm shift in both the understanding of its pathophysiology as well as its treatment to more nonoperative management. No longer is it considered a spectrum from uncomplicated appendicitis inevitably progressing to complicated appendicitis over time. Rather, uncomplicated and complicated appendicitis are now considered two distinct pathophysiologic entities. This change requires not only educating the patients and their families but also the general practitioners who will be managing treatment expectations and caring for patients long term. In this article, we review the pathophysiology of appendicitis, including the differentiation between uncomplicated and complicated appendicitis, as well as the new treatment paradigms. [Pediatr Ann. 2016;45(7):e235-e240.]. PMID:27403670

  11. Historical aspects of appendicitis in children.

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    Hamill, James K; Liley, Andrew; Hill, Andrew G

    2014-05-01

    Evidence of appendicitis exists from ancient Egyptian mummies but the appendix was not discovered as an anatomical entity until the renaissance in Western European literature. Much confusion reigned over the cause of right iliac fossa inflammatory disease until the late 19th century, when the appendix was recognized as the cause of the great majority of cases. Coining the term 'appendicitis' and making the case for early surgery, Fitz in 1886 set the scene for recovery from appendicitis through operative intervention. PMID:24165165

  12. Appendiceal endometriosis differentially diagnosed from acute appendicitis

    Institute of Scientific and Technical Information of China (English)

    Gastón Astroza; Victor Faundes; René Nanjarí; Marcelo Fleiderman; Carlos Rodriguez

    2010-01-01

    @@ Endometriosis is a common disease in premenopausal women involving pelvic organs specially. However endometriosis that affects the appendix is rarely seen except appendiceal endometriosis that mimics acute appendicitis. In a patient with acute appendicitis we diagnosed and operated on, histopathological examination of the appendix revealed appendiceal endometriosis which caused symptoms.

  13. Simultaneous acute appendicitis with right testicular torsion

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    Tanveer Akhtar

    2012-01-01

    Full Text Available We present a child with both acute appendicitis and torsion of the right testis presenting at the same time. Testicular torsion possibly occurring due to vomiting in acute appendicitis so far has not been reported in the literature.

  14. Appendicitis

    Science.gov (United States)

    ... tract, along with the release of hormones and enzymes, helps digest food. The appendix does not appear ... ground meats, fish, and mashed, boiled, or baked potatoes. People can talk with their health care provider ...

  15. Acute Myeloid Leukemia Presenting as Acute Appendicitis

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    Sherri Rauenzahn

    2013-01-01

    Full Text Available Appendicitis in leukemic patients is uncommon but associated with increased mortality. Additionally, leukemic cell infiltration of the appendix is extremely rare. While appendectomy is the treatment of choice for these patients, diagnosis and management of leukemia have a greater impact on remission and survival. A 59-year-old Caucasian female was admitted to the surgical service with acute right lower quadrant pain, nausea, and anorexia. She was noted to have leukocytosis, anemia, and thrombocytopenia. Abdominal imaging demonstrated appendicitis with retroperitoneal and mesenteric lymphadenopathy for which she underwent laparoscopic appendectomy. Peripheral smear, bone marrow biopsy, and surgical pathology of the appendix demonstrated acute myeloid leukemia (AML with nonsuppurative appendicitis. In the setting of AML, prior cases described the development of appendicitis with active chemotherapy. Of these cases, less than ten patients had leukemic infiltration of the appendix, leading to leukostasis and nonsuppurative appendicitis. Acute appendicitis with leukemic infiltration as the initial manifestation of AML has only been described in two other cases in the literature with an average associated morbidity of 32.6 days. The prompt management in this case of appendicitis and AML resulted in an overall survival of 185 days.

  16. Appendicitis in children: evaluation of the pediatric appendicitis score in younger and older children.

    OpenAIRE

    Salö, Martin; Friman, Gustav; Stenström, Pernilla; Ohlsson, Bodil; Arnbjörnsson, Einar

    2014-01-01

    Background. This study aimed to evaluate Pediatric Appendicitis Score (PAS), diagnostic delay, and factors responsible for possible late diagnosis in children <4 years compared with older children who were operated on for suspected appendicitis. Method. 122 children, between 1 and 14 years, operated on with appendectomy for suspected appendicitis, were retrospectively analyzed. The cohort was divided into two age groups: ≥4 years (n = 102) and <4 years (n = 20). Results. The mean PAS wa...

  17. Acute Appendicitis in Infants. A Case Report

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    Sergio Luis González López

    2013-04-01

    Full Text Available Acute appendicitis is more common in school-age children, but it rarely occurs in infants. The younger the patient, the fastest the course of the disease. In addition, there are greater risks of complications. A case of a nine-month-old infant, admitted to the pediatric hospital with fever and diarrhea, is presented. After several tests, he underwent surgery. Peritonitis caused by acute gangrenous appendicitis was diagnosed. While the patient was in the intensive care unit, he suffered a septic shock and acute multiple organ failure. As a result, he died 24 hours later. The biopsy confirmed the diagnosis of acute gangrenous appendicitis. Acute appendicitis is a disease that must be considered by doctors who treat infants with fever, diarrhea and abdominal pain related to irritability. Thus, an early diagnosis of the disease as well as the implementation of an appropriate surgical treatment can be performed.

  18. Appendicitis associated with a strangulated Littre's hernia

    OpenAIRE

    Quail, Jacob F; Romeo C. Ignacio

    2015-01-01

    A 12 year-old boy presented with right lower abdominal and groin pain. Intraoperatively, he was found to have acute appendicitis associated with a strangulated Meckel's diverticulum, or Littre's hernia. Both the appendix and Meckel's diverticulum were resected laparoscopically while the inguinal hernia was repaired four months later. We present an uncommon finding of a strangulated Littre's hernia discovered concurrently with acute appendicitis. The presentation, management and review of the ...

  19. Imaging Acute Appendicitis: State of the Art

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    Diana Gaitini

    2011-01-01

    Full Text Available The goal of this review is to present the state of the art in imaging tests for the diagnosis of acute appendicitis. Relevant publications regarding performance and advantages/disadvantages of imaging modalities for the diagnosis of appendicitis in different clinical situations were reviewed. Articles were extracted from a computerized database (MEDLINE with the following activated limits: Humans, English, core clinical journals, and published in the last five years. Reference lists of relevant studies were checked manually to identify additional, related articles. Ultrasound (US examination should be the first imaging test performed, particularly among the pediatric and young adult populations, who represent the main targets for appendicitis, as well as in pregnant patients. A positive US examination for appendicitis or an alternative diagnosis of possible gastrointestinal or urological origin, or a negative US, either showing a normal appendix or presenting low clinical suspicion of appendicitis, should lead to a final diagnosis. A negative or indeterminate examination with a strong clinical suspicion of appendicitis should be followed by a computed tomography (CT scan or alternatively, a magnetic resonanace imaging (MRI scan in a pregnant patient. A second US examination in a patient with persistent symptoms, especially if the first one was performed by a less experienced imaging professional, is a valid alternative to a CT.

  20. Synthesis of Multiester-appended and Multicarboxylic-appended Imidazolium Ionic Liquids

    Institute of Scientific and Technical Information of China (English)

    Wei Guo GENG; Xue Hui LI; Le Fu WANG; Hong Li DUAN; Wei Ping PAN

    2006-01-01

    Multiester-appended imidazolium ionic liquids were synthesized in a quatemization reaction between the imidazole derivatives carrying single or double esters and ethyl chloroacetate or bromoethane. Multicarboxylic-appended imidazolium ionic liquids were achieved from the hydrolysis of the corresponding ionic liquids. The influences of multifunctional groups on the transition temperatures and viscosity of these new ionic liquids were investigated.

  1. Evidence for eosinophil degranulation in acute appendicitis

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    Santosh G

    2008-04-01

    Full Text Available Finding of increased numbers of eosinophils in the muscle in cases of acute appendicitis has led to the hypothesis that it may have an allergic origin. This study aimed to measure the eosinophil degranulation resulting in a rise in the serum of eosinophil granule proteins that would be expected in such cases. The levels of serum eosinophil cationic protein (ECP measured by chemiluminescence assay in acute appendicitis were compared, with those of appropriate controls. Mean (95% CI serum ECP (µg/L levels were: acute appendicitis 45.3 (27.7-63.0; normal appendix 22.7 (16.0-29.3; asthma 24.2 (4.6-43.8; and healthy volunteers 13.2 (8.3-18.1. In cases of acute appendicitis, there is an inverse relationship between duration of symptoms and serum ECP. However, this was not statistically significant. Significant local eosinophil activation and degranulation occurs in acute appendicitis, enough to cause a rise in serum levels of eosinophil chemotactic protein

  2. Appendicitis in Children: Evaluation of the Pediatric Appendicitis Score in Younger and Older Children

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    Martin Salö

    2014-01-01

    Full Text Available Background. This study aimed to evaluate Pediatric Appendicitis Score (PAS, diagnostic delay, and factors responsible for possible late diagnosis in children <4 years compared with older children who were operated on for suspected appendicitis. Method. 122 children, between 1 and 14 years, operated on with appendectomy for suspected appendicitis, were retrospectively analyzed. The cohort was divided into two age groups: ≥4 years (n=102 and <4 years (n=20. Results. The mean PAS was lower among the younger compared with the older patients (5.3 and 6.6, resp.; P=0.005, despite the fact that younger children had more severe appendicitis (75.0% and 33.3%, resp.; P=0.001. PAS had low sensitivity in both groups, with a significantly lower sensitivity among the younger patients. Parent and doctor delay were confirmed in children <4 years of age with appendicitis. PAS did not aid in patients with doctor delay. Parameters in patient history, symptoms, and abdominal examination were more diffuse in younger children. Conclusion. PAS should be used with caution when examining children younger than 4 years of age. Diffuse symptoms in younger children with acute appendicitis lead to delay and to later diagnosis and more complicated appendicitis.

  3. Appendicitis During Pregnancy with a Normal MRI

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    Matthew M. Thompson

    2014-09-01

    Full Text Available Abdominal pain frequently represents a diagnostic challenge in the acute setting. In pregnant patients, the gravid abdomen and concern for ionizing radiation exposure further limit evaluation. If undiagnosed, appendicitis may cause disastrous consequences for the mother and fetus. We present the case of a pregnant female who was admitted for right lower quadrant abdominal pain. Advanced imaging of the abdomen and pelvis was interpreted to be either indeterminate or normal and a diagnosis of acute appendicitis was made on purely clinical grounds. This patient’s management and a literature review of diagnostic techniques for acute appendicitis during pregnancy are discussed. [West J Emerg Med. 2014;15(6:652-654

  4. Infectious ileocecitis--appendicitis mimicking syndrome.

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    Zganjer, M; Roic, G; Cizmic, A; Pajic, A

    2005-01-01

    The purpose of our study is to emphasize the central role of ultrasound (US) in finding the cause of abdominal pain in children. Ultrasound of the lower abdomen quadrant should be considered in all cases in which the clinical signs and symptoms are not diagnostic of appendicitis. There is a wide range of clinical syndromes and diseases which can easily be diagnosed using a high resolution ultrasound with adjunct of color and power Doppler. The spectrum of abnormalities includes appendicitis, mesenteric lymphadenitis, infectious ileocecitis, Crohn's disease, intussusception, ovarian cysts, and encysted cerebrospinal fluid. One of the most common causes of acute abdominal pain in children is acute terminal ileitis (infectious ileocecitis) with mesenteric lymphadenitis. Ultrasound is the best tool to rapidly differentiate this disease from acute appendicitis, and prevent unnecessary laparotomy (Ref. 12). PMID:16201735

  5. Can fruit seeds and undigested plant residuals cause acute appendicitis

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    Omer Engin

    2011-04-01

    Conclusions: The ratio of acute appendicitis caused by plants is minimal among all appendectomised patients, but avoidence of eating undigested fruit seeds and chewing plants well may help to prevent appendicitis.

  6. ALVARADO SCORE AND ITS CORRELATION WITH APPENDICITIS

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    Surajit

    2015-11-01

    Full Text Available BACKGROUND Acute appendicitis is the most common cause of an acute abdomen. The treatment is surgical and negative appendectomy rates are high. The Alvarado score can be used to stratify patients with symptoms of suspected appendicitis. It enables risk stratification in patients presenting with abdominal pain, linking the probability of appendicitis to recommendations regarding discharge, observation or surgical intervention. AIMS AND OBJECTIVES This study was conducted to evaluate Alvarado scoring system for diagnosis of acute appendicitis and its correlation with operative finding and histopathology. Patients presenting in the Emergency Department in primary and secondary care settings, especially in low-resource countries where emergency CT scan is not available round the clock can be benefitted from the Alvarado scoring system. MATERIALS AND METHODS The score has 6 clinical items and 2 laboratory measurements with a total 10 points. This study was conducted on 98 patients irrespective of age and sex, who attended the emergency and OPD during the course of the work with symptoms suggestive of acute appendicitis including abdominal pain, rebound tenderness, nausea, vomiting or elevated temperature with/without leukocytosis and neutrophilia, and charts were made for each of the patients. Using the scoring system for appendicitis developed by Alvarado, each chart was scored. Out of 98 patients, 7 patients with Alvarado score of ≤ 4 were treated conservatively and later discharged in stable condition. The remaining 91 patients with score of 5-6 and those with score of ≥ 7 were operated. Operative finding and later histopathological examination confirmed the diagnosis of acute appendicitis in 83 patients out of 91 who underwent appendectomy. RESULT In this study, we compared the Alvarado score of the patient recorded prior to operation with the operative finding and histopathological report. The results were statistically analysed by Student

  7. CT scan for suspected acute appendicitis

    OpenAIRE

    Widlus, David M.

    2012-01-01

    Appendicitis is common with a 7% lifetime risk for an individual in the United States. Mean age at diagnosis is 22 years old. While frequently clinically obvious, by 2006, more than 90% of patients diagnosed with appendicitis had a CT scan of the abdomen and pelvis performed. Use of CT scans has allowed a decrease in false-negative rate at appendectomy to under 10% from a rate of approximately 20% before routine use of CT scan. In addition, the rate of perforation has decreased from nearly 30...

  8. Extraintestinal heterotopic gastric tissue simulating acute appendicitis

    Institute of Scientific and Technical Information of China (English)

    Elizabeth Bender; Steven P Schmidt

    2008-01-01

    We describe the case of a 68-year-old otherwise healthy male who presented to our emergency room with signs and symptoms of acute appendicitis. Exploratory surgery revealed a normal appendix. Further examination revealed an enlarged lymph node-like mass of tissue near the appendix, in the ileocecal mesentery. This mass was removed and was found to be inflamed heterotopic gastric tissue. Although reports of heterotopic gastric tissue in the literature are common, we believe that this case represents the first report of inflamed heterotopic gastric tissue simulating appendicitis.

  9. Pitfalls in CT diagnosis of appendicitis: pictorial essay

    International Nuclear Information System (INIS)

    Despite the high diagnostic accuracy of CT for appendicitis, numerous pitfalls exist that may result in a misdiagnosis. This pictorial review outlines the potential pitfalls in the CT diagnosis of appendicitis that includes atypical position of the appendix and coexisting pathologies. Various mimickers of appendicitis and clinical dilemmas will be highlighted. Upon completion, the reviewer should have an improved ability to recognise appendicitis mimickers and identify equivocal or atypical findings.

  10. The value of hyperbilirubinaemia in the diagnosis of acute appendicitis.

    LENUS (Irish Health Repository)

    Emmanuel, Andrew

    2011-04-01

    No reliably specific marker for acute appendicitis has been identified. Although recent studies have shown hyperbilirubinaemia to be a useful predictor of appendiceal perforation, they did not focus on the value of bilirubin as a marker for acute appendicitis. The aim of this study was to determine the value of hyperbilirubinaemia as a marker for acute appendicitis.

  11. Enterobius vermicularis: A Controversial Cause of Appendicitis

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    "Gh Mowlavi

    2004-08-01

    Full Text Available Enterobiasis is undoubtedly one of the most common human helminths infections through the world, with an estimate of 1000 million cases worldwide. Although adult worms and their eggs are frequently found in inflamed appendices, but the role of the parasite in producing appendicitis in humans still remains controversial. Although acute appendicitis may occur at any age, but it is relatively rare at the extremes of age. A histopathological study of infested appendices with Enterobius vermicularis was performed in Khuzestan province, south western Iran, during 2001 to 2003. All 40 samples had surgically been removed during the emergency operations and histopathological process with (H&E staining has been performed for each. One of the main objects of this work was to collect more data about the possible role of this highly prevalent human round worm as a causative agent of appendicitis in humans, leading to different types of appendicitis in this part of the country. In this occasion over the slide examinations of the tissue sections, fewer cases than expected, with worm infested appendices were seen exclusively affected with this parasite.

  12. Acute appendicitis in pregnancy: literature review

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    Antônio Henriques de Franca Neto

    2015-04-01

    Full Text Available Introduction: suspected appendicitis is the most common indication for surgery in non-obstetric conditions during pregnancy and occurs in about one in 500 to one in 635 pregnancies per year. This occurs more often in the second trimester of pregnancy. Acute appendicitis is the most common general surgical problem encountered during pregnancy. Methods: a literature review on research of scientific articles, under the terms “acute appendicitis” and “pregnancy”, in PubMed, Lilacs/SciELO, Scopus, Cochrane Library and Uptodate databases. Results: the clinical manifestations of appendicitis are similar to non-pregnant women, however, without a classic presentation, which often occurs, diagnosis is difficult and must be supported by imaging. Discussion: clinical diagnosis should be strongly suspected in pregnant women with classic findings such as abdominal pain that migrates to the right lower quadrant. The main purpose of imaging is to reduce delays in surgical intervention due to diagnostic uncertainty. A secondary objective is to reduce, but not eliminate, the negative appendectomy rate. Differential diagnosis of suspected acute appendicitis usually includes pathologies considered in non-pregnant people. Conclusion: the imaging study of choice is ultrasound, MRI may be used when the former is not conclusive and, as a last resort, a CT scan can be performed. The treatment remains appendectomy by laparotomy, since the feasibility of video- assisted surgery in these cases remains controversial.

  13. An adult intussusception mimicking early appendicitis

    Institute of Scientific and Technical Information of China (English)

    Wei-Chun Tseng; Cheng-Ting Hsiao; Yu-Cheng Hung

    2012-01-01

    Adult intussusception is rare with variable clinical presentation. We reported a case of adult intussusception presenting with symptoms mimicking acute appendicitis. The patient presented as an abdominal pain from epigastric area with shifting gradually to RLQ. The atypical presentation of adult intussusception remains a diagnostic challenge to the emergency physician.

  14. Intrauterine contraceptive device appendicitis: A case report

    Institute of Scientific and Technical Information of China (English)

    Hao-Ming Chang; Teng-Wei Chen; Chung-Bao Hsieh; Chung-Jueng Chen; Jyh-Cherng Yu; Yao-Chi Liu; Kuo-Liang Shen; De-Chuan Chan

    2005-01-01

    Uterine perforation is one of the serious complications associated with use of the intrauterine contraceptive device (IUD). Uterine perforation by IUD can involve several neighboring organs. A case of acute appendicitis was caused by a Multiload Cu 375 IUD inserted previously.This is a rare complication and only fourteen previous cases were recorded in the literature.

  15. Cytomegalovirus appendicitis in an immunocompetent host.

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    Canterino, Joseph E; McCormack, Michael; Gurung, Ananta; Passarelli, James; Landry, Marie L; Golden, Marjorie

    2016-05-01

    Cytomegalovirus (CMV) is a common viral pathogen. Asymptomatic infection or a mononucleosis syndrome are the most common manifestations in otherwise healthy individuals. End-organ disease is rare in immunocompetent individuals. Here, we describe a case of CMV appendicitis in a patient without an immune-compromising condition. PMID:26942831

  16. Acute amebic appendicitis: Report of a rare case

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    Singh Naorem

    2010-10-01

    Full Text Available Acute appendicitis of amebic origin is considered a rare cause of acute appendicitis. We report a case of amebic appendicitis presenting with fever, severe pain in the right lower quadrant of the abdomen and rebound tenderness. Lab investigations revealed neutrophilic leukocytosis. The patient underwent appendectomy. Histopathological examination revealed numerous Entameba histolytica trophozoites in the mucosa of the appendix. Acute appendicitis of amebic origin does not appear frequently. Appendicular amebiasis can give the clinical features of acute appendicitis and should be treated accordingly.

  17. Simultaneous acute appendicitis and ectopic pregnancy

    OpenAIRE

    Ankouz Amal; Ousadden Abdelmalek; Majdoub Karim; Chouaib Ali; Maazaz Khalid; Taleb Khalid

    2009-01-01

    The acute abdomen in pregnancy is a surgical emergency. Ectopic pregnancy and appendicitis are two causes of acute abdomen in pregnancy. Difficulties in correctly identifying the cause of the pain can be hazardous to the patient and care needs to be taken in obtaining a prompt and accurate diagnosis enabling the most appropriate management. The case presented here underlies the pathogenesis of the simultaneous existence of these two conditions in a patient.

  18. Diagnosis of acute appendicitis: Current criteria

    International Nuclear Information System (INIS)

    INTRODUCTION: The aim of present paper was to identify some features related to preoperative diagnosis of acute appendicitis, according the selected variables, as well as to establish comparisons with findings from other authors. METHODS: We made a prospective, descriptive and observational study of 560 patients operated on and discharged with the histopathology diagnosis of acute appendicitis. Patients were seen in General Surgery Service of the 'Saturnino Lora' Teaching Provincial Hospital of Santiago de Cuba during year 2006. RESULTS: Among the more significant results were the predominance of young males with a mean age of 25,2 years, and the preponderance of the clinical diagnosis. Mean time of preoperative course was greater in men, and there was a predominance of gangrenous and perforated varieties, although the primacy was for the suppurative appendicitis. In the deceased ones the more severe pathologic histology ways were detected, and these were elderlies presenting with atypical clinical manifestations of disease. CONCLUSIONS: Clinical method has nowadays is of capital significance, since thorough it is possible early to diagnose this so common urgency, and to reduce the preoperative course time, whose length is cause of a unnecessary morbidity and mortality. (author)

  19. Appendicitis/diverticulitis: diagnostics and conservative treatment.

    Science.gov (United States)

    Kruis, Wolfgang; Morgenstern, Julia; Schanz, Stefan

    2013-01-01

    Appendicitis and diverticulitis are very common entities that show some similarities in diagnosis and course of disease. Both are widely believed to be simple clinical diagnoses, which is in contrast to scientific evidence. An accurate diagnosis has to describe not only the initial detection, but particularly the severity of the disease. It is based mainly on cross-sectional imaging by ultrasound (US) and computed tomography (CT). Appendectomy is the standard treatment for acute appendicitis and is mandatory in complicated cases. Antibiotic therapy is similarly effective in uncomplicated appendicitis, but long-term results are not sufficiently known. Treatment of diverticulitis is related to the disease status. Complications such as perforation and bleeding require intervention. Uncomplicated diverticulitis as graded by US or CT are subject to conservative management, in the form of outpatient or hospital care. It is an unresolved debate as to whether antibiotic treatment offers benefits. Mesalazine seems at least to improve pain. The real challenge is treatment of recurrent diverticulitis. Lifestyle measures such as nutritional habits and physical activity are found to influence diverticular disease. Besides immunosuppression, obesity is a significant risk factor for complicated diverticulitis. Whether any medication such as chronic antibiotics, probiotics or mesalazine offers benefits is unclear. The indication for sigmoid resection has changed; it is no longer given by the number of attacks, but rather by structural changes as depicted by cross-sectional imaging.

  20. Schistosomal appendicitis: Incidence in Japan and a case report

    Institute of Scientific and Technical Information of China (English)

    Tadashi Terada

    2009-01-01

    Schistosomal appendicitis is very rare in developed countries like the USA, Europe, and Japan. The author reviewed 311 pathologic archival specimens of vermiform appendix over the past 10 years. One case of schistosomal appendicitis was recognized. Therefore, the incidence of this disease was 0.32% in all appendices surgically resected in our hospital. The patient was a 41-year-old woman presenting with lower abdominal pain. She was a sailor traveling to many countries including endemic areas. Physical examination, laboratory data, and imaging modalities suggested an acute appendicitis, and appendectomy was performed under the diagnosis of ordinary appendicitis. Histologically, numerous schistosomal eggs were present in the vasculatures throughout the appendiceal walls. Some of the eggs were calcified. Stromal foreign body reaction was also recognized. The appendicitis was phlegmonous consisting of severe infiltrations of neutrophils and eosinophils. Acute serositis was also noted. Examination of feces revealed numerous eggs of Schistosoma mansoni. Clinicians should be aware of schistosomal appendicitis.

  1. Barium appendicitis: A single institution review in Japan

    Science.gov (United States)

    Katagiri, Hideki; Lefor, Alan Kawarai; Kubota, Tadao; Mizokami, Ken

    2016-01-01

    AIM To review clinical experience with barium appendicitis at a single institution. METHODS A retrospective review of patients admitted with a diagnosis of acute appendicitis, from January 1, 2013 to December 31, 2015 was performed. Age, gender, computed tomography (CT) scan findings if available, past history of barium studies, pathology, and the presence of perforation or the development of complications were reviewed. If the CT scan revealed high density material in the appendix, the maximum CT scan radiodensity of the material is measured in Hounsfield units (HU). Barium appendicitis is defined as: (1) patients diagnosed with acute appendicitis; (2) the patient has a history of a prior barium study; and (3) the CT scan shows high density material in the appendix. Patients who meet all three criteria are considered to have barium appendicitis. RESULTS In total, 396 patients were admitted with the diagnosis of acute appendicitis in the study period. Of these, 12 patients (3.0%) met the definition of barium appendicitis. Of these 12 patients, the median CT scan radiodensity of material in the appendix was 10000.8 HU, ranging from 3066 to 23423 HU (± 6288.2). In contrast, the median CT scan radiodensity of fecaliths in the appendix, excluding patients with barium appendicitis, was 393.1 HU, ranging from 98 to 2151 HU (± 382.0). The CT scan radiodensity of material in the appendices of patients with barium appendicitis was significantly higher than in patients with nonbarium fecaliths (P < 0.01). CONCLUSION Barium appendicitis is not rare in Japan. Measurement of the CT scan radiodensity of material in the appendix may differentiate barium appendicitis from routine appendicitis.

  2. Unusual perforated appendicitis within umbilical hernia: CT findings.

    Science.gov (United States)

    Arnáiz, J; Ortiz, A; Marco de Lucas, E; Piedra, T; Jordá, J; Arnáiz, A M; Pagola, M A

    2006-01-01

    We present the first imaging report of perforated appendicitis in an umbilical hernia. Computed tomography demonstrated a gas-forming abscess within an umbilical hernia and the cecum was found inside the hernial sac, with an inner relation to the abscess. Computed tomographic findings suggested appendicitis as possible diagnosis, which was confirmed at surgery. Physicians must consider appendicitis within the differential diagnosis of an abdominal abscess located near to the cecum, even at an unexpected location. PMID:16465570

  3. MRI for clinically suspected pediatric appendicitis: case interpretation

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Michael M.; Brian, James M.; Methratta, Sosamma T.; Hulse, Michael A.; Choudhary, Arabinda K.; Eggli, Kathleen D.; Boal, Danielle K.B. [Penn State Milton S. Hershey Medical Center, Division of Pediatric Radiology, Department of Radiology, Hershey, PA (United States)

    2014-05-15

    As utilization of MRI for clinically suspected pediatric appendicitis becomes more common, there will be increased focus on case interpretation. The purpose of this pictorial essay is to share our institution's case interpretation experience. MRI findings of appendicitis include appendicoliths, tip appendicitis, intraluminal fluid-debris level, pitfalls of size measurements, and complications including abscesses. The normal appendix and inguinal appendix are also discussed. (orig.)

  4. SIMULATIONS OF FLOWFIELDS AROUND UNDERWATER APPENDED BODIES

    Institute of Scientific and Technical Information of China (English)

    Huang Zhen-yu; Cheng Hong-rong; Zhou Lian-di; Miao Guo-ping

    2003-01-01

    The numerical method which is based on flux difference splitting, LU decomposition, and implicit high-resolution third-order Essentially Non-Oscillatory (ENO) scheme was constructed for the efficient computation of steady state solution to three-dimensional incompressible Navier-Stokes equations in general coordinates. The flowfields over underwater axisymmetric bodies, full-appended axisymmetric bodies and axisymetric bodies with a ring-wing duct were simulated. The method is proved to be capable of predicting the circumferential-mean velocity distribution at model scale to the accuracy of around 3% of measured values, and of predicting some details of flow features, for example, the wake harmonics.

  5. [BACTERIOLOGICAL ASPECTS OF AN ACUTE APPENDICITIS].

    Science.gov (United States)

    Zhuchenko, O P

    2016-03-01

    Peculiarities of microflora in the appendix mucosa and abdominal exudate in different morphological forms of an acute appendicitis (AA) were studied up. In accordance to the bacteriological investigations data, anaerobic, and aerobic microorganisms in AA were revealed in a monoculture and in association, more frequently--obligate anaer- obes (bacteroids) with E. coli--in 82 (80.39%) observations, staphylococcus--in 52 (50.98%), fecal streptococcus--in 19 (18.63%). With progression of inflammatory process and destructive changes in the appendix wall the quantity of bacteroids and enterobacteria have had enhanced, while the quantity of lacto- and bifidumflora-- reduced. PMID:27514082

  6. Acute appendicitis in a premature baby

    International Nuclear Information System (INIS)

    A case of acute appendicitis in a premature baby in whom diagnosis was suggested on plain films of the abdomen is presented. In this baby air in a hollow viscus suspected of being an enlarged appendix was the clue to diagnosis. The diagnostic dilemma of this rare and life-threatening condition in premature babies and newborns is underlined. The relevance of different imaging modalities and of different findings in this age group is discussed. Awareness of this rare condition and possible differential diagnosis in newborns and premature babies is stressed. (orig.)

  7. Validity of samul's paediatric appendicitis score (pas) in the diagnosis of acute appendicitis in children

    International Nuclear Information System (INIS)

    Objective: To validate the paediatric appendicitis score for the diagnosis of acute appendicitis in children using histopathology as a gold standard. Study Design: Case control study. Place and Duration of Study: Military Hospital (MH) and Combined Military Hospital (CMH) Rawalpindi, Pakistan from Dec 2009 to Jul 2010. Patients and Methods: Eighty five children 1-7year old who came to our tertiary surgical department with the chief complaint of abdominal pain of less than 7 days duration were included in the study. Paediatric appendicitis score (PAS) components including fever > 380 C, anorexia, nausea/vomiting, cough/percussion/hopping tenderness, right-lower-quadrant tenderness, migration of pain, leukocytosis > 10,000 (109/1) and polymorphonuclear - neutrophilia > 7500 (109/1) were assessed and recorded on admission, but the sum was not calculated until later and the score did not play any role in the management of the patient. The diagnosis of appendicitis was made by the trainees and consultants clinically and with the aid of routine sonography of abdomen. After appendicetomies, resected specimens were sent for histopathological examination. Pre-operative PAS, histopathology report of resected appendix were endorsed on patient's performa. A two by two table was used to determine sensitivity, specificity, positive and negative predictive values and diagnostic efficacy of PAS. Results: Sensitivity of PAS was 92.16%, specificity 88.23%, positive predictive value 92.16%, negative predictive value 88.23% and the diagnostic efficacy 90.59%. Conclusion: PAS is a highly sensitive test with fair degree of specificity in diagnosing acute appendicitis in children and its routine usage may improve the diagnostic accuracy. (author)

  8. Appendicitis Presenting Concurrently with Cecal Arteriovenous Malformation in a Child

    Directory of Open Access Journals (Sweden)

    Sahil P Parikh

    2015-09-01

    Full Text Available Acute appendicitis is a commonly diagnosed surgical problem in the pediatric population. Arterio-venous malformations (AVM of the colonic tract are rarely reported in the pediatric literature. A 13-year old boy who presented with acute appendicitis with concurrent cecal AVM is reported in whom appendectomy was done. Later on radiological investigations AVM was confirmed.

  9. Two Cases of Omental Torsion Mimicking Acute Appendicitis

    OpenAIRE

    Feeroz Alam Khan; Naeem Liaqat; Sajid Hameed Dar; Asif Iqbal Sandhu; Sajid Nayyer

    2014-01-01

    Acute appendicitis is often simulated by other entities like mesenteric adenitis, worm infestation, Meckel’s diverticulitis, urinary tract infection and rarely omental torsion. We report two cases, a 6 year old boy and an 11 year old girl, who presented with symptoms and signs of acute appendicitis but upon exploration turned out to be omental torsion.

  10. Two Cases of Omental Torsion Mimicking Acute Appendicitis

    Directory of Open Access Journals (Sweden)

    Feeroz Alam Khan

    2014-02-01

    Full Text Available Acute appendicitis is often simulated by other entities like mesenteric adenitis, worm infestation, Meckel’s diverticulitis, urinary tract infection and rarely omental torsion. We report two cases, a 6 year old boy and an 11 year old girl, who presented with symptoms and signs of acute appendicitis but upon exploration turned out to be omental torsion.

  11. Two Cases of Omental Torsion Mimicking Acute Appendicitis

    Science.gov (United States)

    Liaqat, Naeem; Dar, Sajid Hameed; Sandhu, Asif Iqbal; Nayyer, Sajid

    2014-01-01

    Acute appendicitis is often simulated by other entities like mesenteric adenitis, worm infestation, Meckel’s diverticulitis, urinary tract infection and rarely omental torsion. We report two cases, a 6 year old boy and an 11 year old girl, who presented with symptoms and signs of acute appendicitis but upon exploration turned out to be omental torsion. PMID:24834389

  12. [Change in pancreatic exocrine function in acute appendicitis].

    Science.gov (United States)

    Ivanov, Iu A

    1979-10-01

    In order to study changes in the functional state of the pancreas 1572 investigations of the blood and urine amylase, atoxylresistant lipase of the blood serum before operation were performed in different postoperative periods in 131 patients with acute appendicitis. The enzyme activity was established to increase, especially in destructive forms of appendicitis and in elderly patients.

  13. [Change in pancreatic exocrine function in acute appendicitis].

    Science.gov (United States)

    Ivanov, Iu A

    1979-10-01

    In order to study changes in the functional state of the pancreas 1572 investigations of the blood and urine amylase, atoxylresistant lipase of the blood serum before operation were performed in different postoperative periods in 131 patients with acute appendicitis. The enzyme activity was established to increase, especially in destructive forms of appendicitis and in elderly patients. PMID:505800

  14. Improving diagnosis of appendicitis. Early autologous leukocyte scanning.

    Science.gov (United States)

    DeLaney, A R; Raviola, C A; Weber, P N; McDonald, P T; Navarro, D A; Jasko, I

    1989-10-01

    A prospective nonrandomized study investigating the accuracy and utility of autologous leukocyte scanning in the diagnosis of apendicitis was performed. One hundred patients in whom the clinical diagnosis of appendicitis was uncertain underwent indium 111 oxyquinoline labelling of autologous leukocytes and underwent scanning 2 hours following reinjection. Of 32 patients with proved appendicitis, three scans revealed normal results (false-negative rate, 0.09). Of 68 patients without appendicitis, three scans had positive results (false-positive rate, 0.03; sensitivity, 0.91; specificity, 0.97; predictive value of positive scan, 0.94; predictive value of negative scan, 0.96; and overall accuracy, 0.95). Scan results altered clinical decisions in 19 patients. In 13 cases, the scan produced images consistent with diagnoses other than appendicitis, expediting appropriate management. Early-imaging111 In oxyquinoline autologous leukocyte scanning is a practical and highly accurate adjunct for diagnosing appendicitis.

  15. Unusual computed tomography findings and complications in acute appendicitis

    International Nuclear Information System (INIS)

    The objective of this article is to describe and illustrate unusual computed tomography (CT) findings in patients with acute appendicitis. We reviewed the charts of 200 patients with clinical suspicion of acute appendicitis who were submitted to abdominal CT before surgery. Patients with unusual presentation or complications were selected for illustrating the main CT findings. Unusual complications of acute appendicitis were related to anomalous position of the appendix, contiguity to intraperitoneal organs such as the liver, gall bladder, annexes and the bladder and continuous use of anti inflammatory or antibiotics during the diagnostic process. We concluded that CT is a useful diagnostic tool in patients with complicated or unusual presentation acute appendicitis. The first step towards diagnosis in these cases i to have in mind the hypothesis of appendicitis in patients with acute abdominal pain. (author)

  16. [Anaerobic-aerobic infection in acute appendicitis].

    Science.gov (United States)

    Mamchich, V I; Ulitovskiĭ, I V; Savich, E I; Znamenskiĭ, V A; Beliaeva, O A

    1998-01-01

    362 patients with acute appendicitis (AA) were examined. For microbiological diagnosis of aerobic and anaerobic nonclostridial microflora we used complex accelerated methods (including evaluation of gram-negative microorganisms in comparison with tinctorial-fermentative method of differential staining according to oxygen sensitivity of catalasopositive together with aerobic and cathalasonegative anaerobic microorganisms) as well as complete bacteriologic examination with determination of sensitivity of the above microorganism to antimicrobial remedies. High rate of aerobic-anaerobic microbial associations and substantial identity of microflora from appendicis and exudate from abdominal cavity was revealed, which evidenced the leading role of endogenous microorganisms in etiology and pathogenesis of AA and peritonitis i. e. autoinfection. In patients with destructive forms of AA, complicated by peritonitis it is recommended to use the accelerated method of examination of pathologic material as well as the complete scheme of examination with the identification of the isolated microorganisms and the correction of antibiotic treatment. PMID:9511291

  17. No Circadian Variation in Surgeons' Ability to Diagnose Acute Appendicitis

    DEFF Research Database (Denmark)

    Jørgensen, Anders Bech; Amirian, Ilda; Watt, Sara Kehlet;

    2015-01-01

    patients were included. There were no age limitations or selection in sex. RESULTS: There was no significant difference in the ability to diagnose appendicitis in day-evening hours vs night hours (p = 0.391), nor was any significant difference found on weekdays (Monday-Thursday) vs weekends (Friday...... of imaging had no effect on the ability to diagnose appendicitis. Male sex showed a higher probability of the diagnosis being appendicitis compared with other or no pathology (odds ratio: 3.094; p

  18. Study of 150 cases of acute appendicitis in children

    Directory of Open Access Journals (Sweden)

    Fallahi Gh

    1998-06-01

    Full Text Available Acute appendicitis is the most common condidition, requiring emergency operation in children. Late appendicitis is still a major sours of morbidity and potential mortality. The charts of all pediatric appendectomy patients (150 cases treated between 1367-1373 (Iranian calender in Amir Kabir Medical Center were reviewed. Mean hospital stay was 4.7 days. Mean ages of patients was 8.5 years. Male to female ratio was 1.2/1. Most common symptom was abdominal pain (100% and deep tenderness in right lower quadrant in 94.6%. Mean temprature was 37.2 and leucocytosis (more than 10000 were in the 76.3%. 14 patients had perforated appendicitis and most common pathology was acut supporative appendicitis. Accuracy of diagnosis was 96.6% and post operative pelvic abccess was 2%. Mortality occurred in one case (0.6%

  19. New synthetic strategies for xanthene-dye-appended cyclodextrins.

    Science.gov (United States)

    Malanga, Milo; Darcsi, Andras; Balint, Mihaly; Benkovics, Gabor; Sohajda, Tamas; Beni, Szabolcs

    2016-01-01

    Xanthene dyes can be appended to cyclodextrins via an ester or amide bridge in order to switch the fluorescence on or off. This is made possible through the formation of nonfluorescent lactones or lactams as the fluorophore can reversibly cyclize. In this context we report a green approach for the synthesis of switchable xanthene-dye-appended cyclodextrins based on the coupling agent 4-(4,6-dimethoxy-1,3,5-triazin-2-yl)-4-methylmorpholinium chloride (DMT-MM). By using 6-monoamino-β-cyclodextrin and commercially available inexpensive dyes, we prepared rhodamine- and fluorescein-appended cyclodextrins. The compounds were characterized by NMR and IR spectroscopy and MS spectrometry, their UV-vis spectra were recorded at various pH, and their purity was determined by capillary electrophoresis. Two potential models for the supramolecular assembly of the xanthene-dye-appended cyclodextrins were developed based on the set of data collected by the extensive NMR characterization. PMID:27340446

  20. Unenhanced MR Imaging in adults with clinically suspected acute appendicitis

    DEFF Research Database (Denmark)

    Chabanova, Elizaveta; Balslev, Ingegerd; Achiam, Michael;

    2011-01-01

    PURPOSE: The purpose of the study was to evaluate unenhanced Magnetic Resonance Imaging (MRI) for the diagnosis of appendicitis or another surgery-requiring condition in an adult population scheduled for emergency appendectomy based on a clinical diagnosis of suspected acute appendicitis. MATERIALS...... radiologists and one surgeon independent of each other and compared with surgical and pathological records. RESULTS: According to the surgical and histopathological findings 30 of 48 patients (63%) had acute appendicitis. Of the remaining 18 patients, 4 patients had no reasons for the clinical symptoms and 14...... patients had other pathology. For the three reviewers the performance of MRI in the diagnosis of acute appendicitis showed the following sensitivity, specificity and accuracy ranges: 83-93%, 50-83% and 77-83%. Moderate (kappa=0.51) and fair (kappa=0.31) interobserver agreements in the MR diagnosis of acute...

  1. Diagnostic value of procalcitonin for acute complicated appendicitis

    OpenAIRE

    Yamashita, Hiromasa; YUASA, NORIHIRO; TAKEUCHI, EIJI; Goto, Yasutomo; Miyake, Hideo; Miyata, Kanji; Kato, Hideki; Ito, Masafumi

    2016-01-01

    ABSTRACT A rapid and reliable test for detection of complicated appendicitis would be useful when deciding whether emergency surgery is required. We investigated the clinical usefulness of procalcitonin for identifying acute complicated appendicitis. We retrospectively analyzed 63 patients aged ≥15 years who underwent appendectomy without receiving antibiotics before admission and had preoperative data on the plasma procalcitonin level (PCT), body temperature (BT), white blood cell count (WBC...

  2. An unusual manifestation of acute appendicitis with left flank pain

    Directory of Open Access Journals (Sweden)

    Roland Talanow, MD, PhD

    2008-08-01

    Full Text Available The author presents a case with an unusual presentation of early appendicitis. The patient presented initially with left sided flank pain. Workup for nephrolithiasis, including non-contrast CT of the abdomen and pelvis was negative for renal stones or hydronephrosis. After discharge, the patient presented one week later in the ED with right lower quadrant pain. Contrast enhanced CT of the abdomen revealed perforated appendicitis.

  3. Unenhanced MR Imaging in adults with clinically suspected acute appendicitis

    DEFF Research Database (Denmark)

    Chabanova, Elizaveta; Balslev, Ingegerd; Achiam, Michael;

    2011-01-01

    PURPOSE: The purpose of the study was to evaluate unenhanced Magnetic Resonance Imaging (MRI) for the diagnosis of appendicitis or another surgery-requiring condition in an adult population scheduled for emergency appendectomy based on a clinical diagnosis of suspected acute appendicitis. MATERIA...... screening before the appendectomy. It may prevent unnecessary surgeries. The fast MRI examination can be adequately performed on an MRI unit of broad range of field strengths...

  4. Hydatidosis as a cause of acute appendicitis: a case report

    OpenAIRE

    Hajizadeh, Maryam; Ahmadpour, Ehsan; Sadat, Amir Taher Eftekhar; Spotin, Adel

    2013-01-01

    Acute appendicitis is considered the most common cause of emergency surgery in children and young adults. The association between parasitic infections and appendicitis has been widely investigated. Hydatidosis, a zoonotic helminthic disease caused by the larval stage of the Echinococcus granulosus, may cause illness in intermediate hosts, generally human and herbivorous animals. This disease is considered hyper endemic in northwest of Iran and is a serious public health problem. Hydatidosis p...

  5. BODIPY atropisomer interconversion, face discrimination, and superstructure appending.

    Science.gov (United States)

    Doulain, Pierre-Emmanuel; Goze, Christine; Bodio, Ewen; Richard, Philippe; Decréau, Richard A

    2016-03-25

    A strategy was developed to append sterically hindered apical pickets on both faces of the BODIPY platform to prevent stacking and aggregation. Ortho-substitution of both the meso-phenyl ring and the boron-bound catechol affords the right directionality to append pickets, achieve face discrimination, featuring two interconvertible atropisomers, and is reminiscent of the picket-fence strategy in porphyrins. PMID:26927530

  6. CT following US for possible appendicitis: anatomic coverage

    Energy Technology Data Exchange (ETDEWEB)

    O' Malley, Martin E. [University of Toronto, Princess Margaret Hospital, 3-920, Joint Department of Medical Imaging, Toronto, Ontario (Canada); Alharbi, Fawaz [University of Toronto, Toronto General Hospital, NCSB 1C572, Joint Department of Medical Imaging, Toronto, Ontario (Canada); Qassim University, Department of Medical Imaging, Buraydah, Qassim (Saudi Arabia); Chawla, Tanya P. [University of Toronto, Mount Sinai Hospital, Room 567, Joint Department of Medical Imaging, Toronto, Ontario (Canada); Moshonov, Hadas [University of Toronto, Joint Department of Medical Imaging, Toronto, Ontario (Canada)

    2016-02-15

    To determine superior-inferior anatomic borders for CT following inconclusive/nondiagnostic US for possible appendicitis. Ninety-nine patients with possible appendicitis and inconclusive/nondiagnostic US followed by CT were included in this retrospective study. Two radiologists reviewed CT images and determined superior-inferior anatomic borders required to diagnose or exclude appendicitis and diagnose alternative causes. This ''targeted'' coverage was used to estimate potential reduction in anatomic coverage compared to standard abdominal/pelvic CT. The study group included 83 women and 16 men; mean age 32 (median, 29; range 18-73) years. Final diagnoses were: nonspecific abdominal pain 50/99 (51 %), appendicitis 26/99 (26 %), gynaecological 12/99 (12 %), gastrointestinal 9/99 (10 %), and musculoskeletal 2/99 (2 %). Median dose-length product for standard CT was 890.0 (range, 306.3 - 2493.9) mGy.cm. To confidently diagnose/exclude appendicitis or identify alternative diagnoses, maximum superior-inferior anatomic CT coverage was the superior border of L2-superior border of pubic symphysis, for both reviewers. Targeted CT would reduce anatomic coverage by 30-55 % (mean 39 %, median 40 %) compared to standard CT. When CT is performed for appendicitis following inconclusive/nondiagnostic US, targeted CT from the superior border of L2-superior border of pubic symphysis can be used resulting in significant reduction in exposure to ionizing radiation compared to standard CT. (orig.)

  7. Solitary caecum diverticulitis mimicking acute appendicitis.

    Science.gov (United States)

    Hot, Semih; Eğin, Seracettin; Gökçek, Berk; Yeşiltaş, Metin; Alemdar, Ali; Akan, Arzu; Karahan, Servet Rüştü

    2015-12-01

    Solitary cecum diverticulum is a benign formation, but it can be complicated with inflammation, perforation and bleeding. Cecum diverticulitis (CD) is the most common complication of caecal diverticulum and it has the highest incidence among Asians, but it is a rare condition in the western world. The incidence of colonic diverticular disease can vary according to national origin, cultural structure and nutritional habits. CD is not common in our country, but it is an important situation because of its clinical similarity with the commonly seen acute right side abdominal diseases like acute appendicitis. Preoperative diagnosis is difficult, and hence, the actual frequency is not known. The treatment of CD can vary from medical therapy to right hemi colectomy. In this study, we presented ten CD cases on whom surgical resection was performed in our surgery unit during the last 8 years. Our purpose was to increase the awareness of surgeons about this situation, and so, make them pay attention for not having their first experience in the operating room. PMID:27054646

  8. Acute appendicitis: position paper, WSES, 2013.

    Science.gov (United States)

    Agresta, Ferdinando; Ansaloni, Luca; Catena, Fausto; Verza, Luca Andrea; Prando, Daniela

    2014-01-01

    Appendectomy is one of the most frequently performed operative procedures in general surgery departments of every size and category. Laparoscopic Appendectomy - LA - as compared to Open Appendectomy - OA - was very controversial at first but has found increasing acceptance all over the World, although the percentage of its acceptance is different in the various single National setting. Various meta-analyses and Cochrane reviews have compared LA with OA and different technical details. Furthermore, new surgical methods have recently emerged, namely, the single-port/incision laparoscopic appendectomy and NOTES technique. Their distribution among the hospitals, however, is unclear. Using laparoscopic mini-instruments with trocars of 2-3.5 mm diameter is proposed as a reliable alternative due to less postoperative pain and improved aesthetics. How to proceed in case of an inconspicuous appendix during a procedure planned as an appendectomy remains controversial despite existing study results. But the main question still is: operate or not operate an acute appendicitis, in the meaning of an attempt of a conservative antibiotic therapy. Therefore, we have done a literature survey on the performance of appendectomies and their technical details as well as the management of the intraoperative finding of an inconspicuous appendix in order to write down - under the light of the latest evidence - a position paper. PMID:24708651

  9. The diagnostic value of barium enema in acute appendicitis

    International Nuclear Information System (INIS)

    Acute appendicitis is the most common acute surgical condition of the abdomen. When the clinical presentation is atypical, barium enema has proven to be safe and useful in confirming the diagnosis and reducing the negative surgical exploration. However, the performance of barium enema in acute appendicitis has known contraindication primarily because of fear of leakage by perforation of the inflamed appendix. This study using barium enema as a diagnostic aid in acute appendicitis with atypical clinical presentation was performed to further support the previously noted efficacy and safety of this procedure. The results were as followings: 1. In case of acute appendicitis with atypical clinical presentation, the use of barium enema as a diagnostic aid increased the accuracy of diagnosis and decreased the negative surgical exploration. In women between 11 to 50 years old age, especially, it played important role differentiating appendicitis from nonsurgical acute abdomen. 2. The results of the study were 92.31% in sensitivity, 7.69% in false positive, 6.9% in false negative, and 10.26% in negative appendectomy. 3. None of case of leakage of barium by perforation of the inflamed appendix was noted, therefore, barium enema was thought to be safe as a diagnostic aid in acute appendicitis. 4. A simple partial or non filling of appendix without other associated positive finding could not exclude appendicitis, therefore, close clinical observation was necessary. 5. The positive findings of barium enema and their sensitivity were as followings: 1. Non filling of appendix: 90% 2. Partial filling of appendix: 91.7% 3. Displacement or a local impression on terminal ileum: 100%

  10. Laparoscopic management of acute appendicitis in situs inversus

    Directory of Open Access Journals (Sweden)

    Golash Vishwanath

    2006-01-01

    Full Text Available Situs inversus is often detected incidentally in adults during imaging for a acute surgical emergency. We present a case of acute appendicitis in an adult who was previously unaware about his situs anomaly. A laparoscopic approach is helpful to deal with this condition. A 40 year old man was admitted with history of acute left lower abdominal pain, with uncontrolled diabetic keto-acidosis. Clinically, he was diagnosed as acute diverticulitis with localized peritonitis. Subsequent imaging studies and laparoscopy confirmed the diagnosis of situs inversus and acute left- sided appendicitis. He successfully underwent laparoscopic appendectomy. His postoperative recovery was uneventful. Although technically more challenging because of the reverse laparoscopic view of the anatomy, the laparoscopic diagnosis and management of acute appendicitis is indicated in situs inversus.

  11. Acute Appendicitis Together with Chylous Ascites: Is It a Coincidence?

    Directory of Open Access Journals (Sweden)

    Sami Akbulut

    2010-01-01

    Full Text Available Acute chylous ascites is a rarely seen clinical picture, therefore, examination findings are often confused with acute appendicitis. To the best of our knowledge, there is no publication to date showing the occurrence of them together. This study presents the treatment plan for a 25-year-old male patient with both acute chylous ascites and appendicitis. Surgical findings were retrocaecal appendicitis, evident lymphangiectasia in the proximal segment of jejunum, and approximately 3 lt of chylous fluid. An appendectomy was performed and drainage was applied. Low-fat total parenteral nutrition (TPN and octreotide treatment were administered for 7 days postoperatively. We also present a general review of some studies on chylous ascites, which have been published in the English language medical literature since 1910.

  12. Imaging of appendicitis in adults; Bildgebung der Appendizitis beim Erwachsenen

    Energy Technology Data Exchange (ETDEWEB)

    Karul, M.; Berliner, C.; Keller, S.; Yamamura, J. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of Diagnostic and Interventional Radiology; Tsui, T.Y. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of General, Visceral- and Thoracic Surgery

    2014-06-15

    Three imaging modalities are available for the diagnosis of acute appendicitis: ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI). Transabdominal ultrasound should be the first-line imaging test. Abdominal CT is superior to US and is required immediately in patients with atypical clinical presentation of appendicitis and suspected perforation. However, low-dose unenhanced CT is equal to standard-dose CT with intravenous contrast agents in the detection of five signs of acute appendicitis (thickened appendiceal wall more than 2 mm, cross-sectional diameter greater than 6 mm, periappendicitis, abscess, and appendicolith). MRI is necessary in pregnant women and young adults. This review illustrates the principles of state-of-the-art imaging techniques and their clinical relevance. (orig.)

  13. Appendiceal diverticulitis and acute appendicitis: differences and similarities

    Directory of Open Access Journals (Sweden)

    Irene Lobo-Machín

    2014-08-01

    Full Text Available Introduction: Acute appendiceal diverticulitis is an unusual cause of acute abdomen, considered clinically indistinguishable from acute appendicitis. Material and methods: In a historic cohort study with 27 cases of appendiceal diverticulitis and 54 cases of acute appendicitis, we compared clinical characteristics, diagnostic tests and pathology findings of the two processes. Results: Mean age at presentation was lower in acute appendicitis (37.24 ± 19.98 vs. 54.81 ± 17.55 years, p < 0.001, with significant differences between men (33.33 ± 15.89 vs. 57 ± 18.02 years, p < 0.001 but not between women (41.76 ± 24.87 vs. 50.44 ± 16.69 years, p = 0.34. In the diverticulitis group, 48.15 % had leukocytosis vs. 81.48 % in the appendicitis group (p = 0.02; there was no difference in leukocyte count (13770.37 ± 4382.55 vs. 14279.63 ± 4268.59, p = 0.61. Patients with appendiceal diverticulitis had a higher incidence of appendiceal mucocele (p = 0.01 and a lower proportion of appendiceal gangrene (p = 0.03. There were no differences in appendiceal perforation or ulceration. Symptom duration before emergency department attendance (71.61 ± 85.25 hours vs. 36.84 ± 33.59 hours; Z = -3.1 p = 0.002, duration of surgery (85 ± 40 minutes vs. 60 ± 21 minutes, Z = -3.2, p = 0.001 and the presence of appendicular plastron was higher in patients with diverticulitis vs. appendicitis (8 vs. 5 patients (p = 0.01, Odds ratio 2.2. Conclusions: Appendiceal diverticulitis presents a series of clinical, epidemiological and pathological differences with respect to acute appendicitis. The former shows a more indolent course with delayed diagnosis.

  14. MRI for clinically suspected pediatric appendicitis: an implemented program

    International Nuclear Information System (INIS)

    Emergent MRI is now a viable alternative to CT for evaluating appendicitis while avoiding the detrimental effects of ionizing radiation. However, primary employment of MRI in the setting of clinically suspected pediatric appendicitis has remained significantly underutilized. To describe our institution's development and the results of a fully implemented clinical program using MRI as the primary imaging evaluation for children with suspected appendicitis. A four-sequence MRI protocol consisting of coronal and axial single-shot turbo spin-echo (SS-TSE) T2, coronal spectral adiabatic inversion recovery (SPAIR), and axial SS-TSE T2 with fat saturation was performed on 208 children, ages 3 to 17 years, with clinically suspected appendicitis. No intravenous or oral contrast material was administered. No sedation was administered. Data collection includes two separate areas: time parameter analysis and MRI diagnostic results. Diagnostic accuracy of MRI for pediatric appendicitis indicated a sensitivity of 97.6% (CI: 87.1-99.9%), specificity 97.0% (CI: 93.2-99.0%), positive predictive value 88.9% (CI: 76.0-96.3%), and negative predictive value 99.4% (CI: 96.6-99.9%). Time parameter analysis indicated clinical feasibility, with time requested to first sequence obtained mean of 78.7 +/- 52.5 min, median 65 min; first-to-last sequence time stamp mean 14.2 +/- 8.8 min, median 12 min; last sequence to report mean 57.4 +/- 35.2 min, median 46 min. Mean age was 11.2 +/- 3.6 years old. Girls represented 57% of patients. MRI is an effective and efficient method of imaging children with clinically suspected appendicitis. Using an expedited four-sequence protocol, sensitivity and specificity are comparable to CT while avoiding the detrimental effects of ionizing radiation. (orig.)

  15. Disparities in appendicitis rupture rate among mentally ill patients

    Directory of Open Access Journals (Sweden)

    Bai Ya-Mei

    2007-11-01

    Full Text Available Abstract Background Many studies have been carried out that focus on mental patients' access to care for their mental illness, but very few pay attention on these same patients' access to care for their physical diseases. Acute appendicitis is a common surgical emergency. Our population-based study was to test for any possible association between mental illness and perforated appendicitis. We hypothesized that there are significant disparities in access to timely surgical care between appendicitis patients with and without mental illness, and more specifically, between patients with schizophrenia and those with another major mental illness. Methods Using the National Health Insurance (NHI hospital-discharge data, we compared the likelihood of perforated appendix among 97,589 adults aged 15 and over who were hospitalized for acute appendicitis in Taiwan between the years 1997 to 2001. Among all the patients admitted for appendicitis, the outcome measure was the odds of appendiceal rupture vs. appendicitis that did not result in a ruptured appendix. Results After adjusting for age, gender, ethnicity, socioeconomic status (SES and hospital characteristics, the presence of schizophrenia was associated with a 2.83 times higher risk of having a ruptured appendix (odds ratio [OR], 2.83; 95% confidence interval [CI], 2.20–3.64. However, the presence of affective psychoses (OR, 1.15; 95% CI: 0.77–1.73 or other mental disorders (OR, 1.58; 95% CI: 0.89–2.81 was not a significant predictor for a ruptured appendix. Conclusion These findings suggest that given the fact that the NHI program reduces financial barriers to care for mentally ill patients, they are still at a disadvantage for obtaining timely treatment for their physical diseases. Of patients with a major mental illness, schizophrenic patients may be the most vulnerable ones for obtaining timely surgical care.

  16. Acute myelogenous leukemia and acute leukemic appendicitis: A case report

    Institute of Scientific and Technical Information of China (English)

    Po-Jen Hsiao; Shih-Ming Kuo; Jia-Hong Chen; Hsuen-Fu Lin; Pau-Ling Chu; Shih-Hua Lin; Ching-Liang Ho

    2009-01-01

    Acute myelogenous leukemia (AML) can involve the gastrointestinal tract but rarely involves the appendix.We report a male patient who had 1 year partial remission from AML and who presented with apparent acute appendicitis as the initial manifestation of leukemia relapse. Pathological findings of the appendix revealed transmural infiltrates of myeloblasts, whichindicated a diagnosis of leukemia. Unfortunately, the patient died from progression of the disease on the 19th d after admission. Although leukemic cell infiltration of the appendix is uncommon, patients with leukemia relapse can present with symptoms mimicking acute appendicitis.

  17. Oral antibiotics for perforated appendicitis is not recommended

    DEFF Research Database (Denmark)

    Alamili, Mahdi; Gögenur, Ismail; Rosenberg, Jacob

    2010-01-01

    In the majority of surgical departments in Denmark, the postoperative treatment for acute perforated appendicitis comprises three days of intravenous antibiotics. Recently, it has been proposed that such antibiotic regimen should be replaced by orally administered antibiotics. The aim of this paper...... was to give an overview of studies on acute perforated appendicitis with postoperative oral antibiotics. Five studies were found in a database search covering the 1966-2009 period. There is no evidence to support a conversion of the postoperative antibiotic regimen from intravenous to oral administration...

  18. New synthetic strategies for xanthene-dye-appended cyclodextrins

    OpenAIRE

    Malanga, Milo; Darcsi, Andras; Balint, Mihaly; Benkovics, Gabor; Sohajda, Tamas; Beni, Szabolcs

    2016-01-01

    Xanthene dyes can be appended to cyclodextrins via an ester or amide bridge in order to switch the fluorescence on or off. This is made possible through the formation of nonfluorescent lactones or lactams as the fluorophore can reversibly cyclize. In this context we report a green approach for the synthesis of switchable xanthene-dye-appended cyclodextrins based on the coupling agent 4-(4,6-dimethoxy-1,3,5-triazin-2-yl)-4-methylmorpholinium chloride (DMT-MM). By using 6-monoamino-β-cyclodextr...

  19. Imaging findings of perforative appendicitis: a pictorial review

    Energy Technology Data Exchange (ETDEWEB)

    Hopkins, K.L.; Patrick, L.E.; Ball, T.I. [Dept. of Radiology, Children' s Healthcare of Atlanta, Egleston, GA (United States)

    2001-03-01

    Appendicitis is common in children. Early diagnosis depends on recognition of characteristic signs and symptoms: right lower quadrant or periumbilical pain, localized tenderness, fever, and leukocytosis. Because these classic features may be difficult to elicit or masked by other complaints, the incidence of perforative appendicitis in children is high. This paper reviews the imaging sequelae with emphasis on CT and sonography findings. Areas of focus include abdominopelvic abscess, peritonitis, pyelephlebitis, pyelethrombosis, and hepatic abscess. Secondary involvement of the urinary and gastrointestinal tracts is also discussed. (orig.)

  20. Crohn's disease and recurrent appendicitis: A case report

    Institute of Scientific and Technical Information of China (English)

    Ron Shaoul; Yosi Rimar; Aurora Toubi; Jorge Mogilner; Reuven Polak; Michael Jaffe

    2005-01-01

    The clinical diagnosis of classic Crohn's disease (CD)of the small bowel is based on a typical history, tender right lower quadrant fullness or mass, and characteristic radiographic findings of the terminal ileum. Appendicitis may as well present with chronic or recurrent symptoms and this presentation may be confused with CD. We herein describe the case of a young teenage girl with a presumptive diagnosis of CD, who was ultimately diagnosed as having chronic nongranulomatous appendicitis. The literature on the subject is reviewed.

  1. Case report of recurrent acute appendicitis in a residual tip.

    LENUS (Irish Health Repository)

    O'Leary, Donal P

    2010-01-01

    INTRODUCTION: Residual appendicitis involving the stump of the appendix has been well described in the literature in the past. CASE REPORT: We report the case of a 43 year old male with acute onset of abdominal pain who had undergone an appendicectomy ten years previously. Ultrasound revealed the presence of an inflamed tubular structure. Subsequent laparotomy and histology confirmed that this structure was an inflamed residual appendiceal tip. CONCLUSION: Residual tip appendicitis has not been reported in the literature previously and should be considered in the differential diagnosis of localised peritonitis in a patient with a history of a previous open appendicectomy.

  2. Xanthogranulomatous Appendicitis Mimicking Residual Burkitt's Lymphoma After Chemotherapy.

    Science.gov (United States)

    Nam, Soomin; Kang, Jeonghyun; Choi, Sung-Eun; Kim, Yu Ri; Baik, Seung Hyuk; Sohn, Seung-Kook

    2016-04-01

    The case of a 23-year-old female treated with aggressive high-dose therapy for Burkitt's lymphoma is reported. A positron emission tomography and computed tomography scan after completion of chemotherapy revealed a residual hypermetabolic lesion in the right pelvic cavity. A pelvic magnetic resonance imaging scan showed circumferential wall thickening at the tip of the appendix. A laparoscopic exploration and appendectomy were performed, and a pathologic examination of the resected appendix revealed xanthogranulomatous appendicitis. This is a rare case of a xanthogranulomatous appendicitis mimicking remnant Burkitt's lymphoma after completion of chemotherapy. PMID:27218100

  3. [Causes of late diagnosis of appendicitis in children].

    Science.gov (United States)

    Zlámal, Z

    1996-07-01

    The author evaluates the case-history of 51 children with perforated appendicitis treated during 1984-1995 at the First Surgical Clinic of the Faculty Hospital Olomouc. The purpose was to find an answer to the problem why in these children the diagnosis was delayed and whose was the fault of the substantial deterioration of the health status. In the evaluation four groups of causal responsibility are differentiated: a very rapid development of appendicitis-parents, arriving late in the surgery-paediatricians-surgeons. The authors discuss circumstances associated with the diagnostic error and delay.

  4. Acute appendicitis mistaken as acute rejection in renal transplant recipients.

    Directory of Open Access Journals (Sweden)

    Talwalkar N

    1994-01-01

    Full Text Available Case histories of 2 renal transplant recipients are reported who had presenting features of fever, leukocytosis and pain/tenderness over right iliac fossa and were diagnosed to be due to acute appendicitis rather than more commonly suspected acute rejection episode which has very similar features. Diagnosis of acute appendicitis was suspected on the basis of rectal examination and later confirmed by laparotomy. The purpose of this communication is to emphasize the need for proper diagnosis in patient with such presentation; otherwise wrong treatment may be received.

  5. Harms of CT scanning prior to surgery for suspected appendicitis.

    Science.gov (United States)

    Rogers, William; Hoffman, Jerome; Noori, Naudereh

    2015-02-01

    In this brief analysis we compare the risks and benefits of performing a CT scan to confirm appendicitis prior to surgery instead of operating based on the surgeon's clinical diagnosis. We conclude that the benefit of universal imaging is to avoid 12 unnecessary appendectomies but the cost of those 12 avoided surgeries is one cancer death due to the imaging. PMID:25429870

  6. Ileocecocolic Intussusception Induced by Acute Appendicitis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Jo, Bang Sil; Kim, Min Jeong; Jang, Kyung Mi; Lee, Hyun; Jeon, Eui Yong; Lee, Kwan Seop; Lee, Yul [Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of)

    2009-09-15

    Intussusception is a rare disease in adults. Moreover, appendiceal disease is very rarely the leading cause of adult intussusception. We report a case in which ileocecocolic intussusception is secondary to an acute appendicitis in an adult, and describe the radiologic, clinical, and pathologic findings.

  7. Oral antibiotics for perforated appendicitis is not recommended

    DEFF Research Database (Denmark)

    Gögenur, Ismail; Rosenberg, Jacob; Alamili, Mahdi

    2010-01-01

    In the majority of surgical departments in Denmark, the postoperative treatment for acute perforated appendicitis comprises three days of intravenous antibiotics. Recently, it has been proposed that such antibiotic regimen should be replaced by orally administered antibiotics. The aim of this paper...

  8. Torsion of an Epiploic Appendix Pretending as Acute Appendicitis

    Directory of Open Access Journals (Sweden)

    Kamran Ahmad Malik

    2010-07-01

    Full Text Available Torsion of an epiploic appendix is a rare surgical entity. Its unusual symptomatology, wide variation in physical findings and the absence of helpful laboratory and radiological studies makes it very difficult to diagnose pre-operatively. This is a report of this rare entity found in a patient upon diagnostic laparoscopy performed for suspected acute appendicitis

  9. Unenhanced MR Imaging in adults with clinically suspected acute appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Chabanova, Elizaveta, E-mail: elcha@heh.regionh.dk [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark); Balslev, Ingegerd, E-mail: inbal@heh.regionh.dk [Department of Pathology, Copenhagen University Hospital at Herlev (Denmark); Achiam, Michael, E-mail: micach01@heh.regionh.dk [Department of Gastrointestinal Surgery, Copenhagen University Hospital at Herlev (Denmark); Nielsen, Yousef W., E-mail: yujwni01@heh.regionh.dk [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark); Adamsen, Sven, E-mail: svad@heh.regionh.dk [Department of Gastrointestinal Surgery, Copenhagen University Hospital at Herlev (Denmark); Gocht-Jensen, Peter, E-mail: petgoc01@heh.reginh.dk [Department of Gastrointestinal Surgery, Copenhagen University Hospital at Herlev (Denmark); Brisling, Steffen K., E-mail: stkibr01@heh.regionh.dk [Department of Gastrointestinal Surgery, Copenhagen University Hospital at Herlev (Denmark); Logager, Vibeke B., E-mail: viloe@heh.regionh.dk [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark); Thomsen, Henrik S., E-mail: heth@heh.regionh.dk [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark)

    2011-08-15

    Purpose: The purpose of the study was to evaluate unenhanced Magnetic Resonance Imaging (MRI) for the diagnosis of appendicitis or another surgery-requiring condition in an adult population scheduled for emergency appendectomy based on a clinical diagnosis of suspected acute appendicitis. Materials and methods: The prospective study included 48 consecutive patients (29 female, 19 male, 18-70 years old, mean age = 37.1 years). MRI examination was designed to be comfortable and fast; no contrast was administered. The sequences were performed during quiet respiration. The MRI findings were reviewed by two radiologists and one surgeon independent of each other and compared with surgical and pathological records. Results: According to the surgical and histopathological findings 30 of 48 patients (63%) had acute appendicitis. Of the remaining 18 patients, 4 patients had no reasons for the clinical symptoms and 14 patients had other pathology. For the three reviewers the performance of MRI in the diagnosis of acute appendicitis showed the following sensitivity, specificity and accuracy ranges: 83-93%, 50-83% and 77-83%. Moderate ({kappa} = 0.51) and fair ({kappa} = 0.31) interobserver agreements in the MR diagnosis of acute appendicitis were found between the reviewers. Sensitivity, specificity and accuracy values for overall performance of MRI in detecting pelvic abnormalities were 100%, 75% (3 of 4 healthy patients were identified by MRI) and 98%, respectively. Conclusion: Unenhanced fast MRI is feasible as an additional fast screening before the appendectomy. It may prevent unnecessary surgeries. The fast MRI examination can be adequately performed on an MRI unit of broad range of field strengths.

  10. Laparoscopic appendectomy in surgical treatment of acute appendicitis

    Directory of Open Access Journals (Sweden)

    G. I. Ohrimenko

    2016-06-01

    Full Text Available Relevance of the topic. At the present time laparoscopic appendectomy has taken its own place at the urgent surgery. In spite of this less is studied in the field of the use of the minimally invasive technologies in the cases of complicated acute appendicitis. The aim of research: to investigate the close results of the patients with acute appendicitis treatment with laparoscopic appendectomy, and to compare them with the open appendectomy results; to estimate the possibilities of laparoscopic appendectomy in the cases of complicated acute appendicitis. Materials and methods. The results of surgical treatment of 146 patients with acute appendicitis were analyzed – 59 patients in the main group, who undergone laparoscopic appendectomy, and 80 patients in the control group, who undergone open surgery. 7 patients who passed through conversion were included in the additional group. Results. The frequency of acute appendicitis complications, which were diagnosed during the operation, in the both groups had no significant distinction (50.8 % in the main group and 47.5% in the control group. But 5 patients with diffuse peritonitis and appendicular abscesses needed a conversion of laparoscopic operation into open one, because of the full sanitation necessity and technique difficulties. In the postoperative period among the patients of main group the suppuration of the wound was observed in 2 (3.4% cases, in the control group – in 10 (12.5%. The average duration of laparoscopic operation was 33.12±2.51 min, open surgery – 66.45±3.33 min. The average hospitalization period in the control group was 6.95±0.2 days and was statistically proved higher than in the main group – 4.72±0.21 days (p≤0.01. Conclusion. Laparoscopic appendectomy can be wide used in the cases of acute appendicitis, including complications, but it can be restricted in the cases of diffuse peritonitis and appendicular abscesses. This minimally invasive surgical operation

  11. Fecal loading in the cecum as a new radiological sign of acute appendicitis

    Institute of Scientific and Technical Information of China (English)

    Andy Petroianu; Luiz Ronaldo Alberti; Renata Indelicato Zac

    2005-01-01

    AIM: Although the radiological features of acute appendicitis have been well documented, the value of plain radiography has not been fully appreciated. The aim of this study was to determine the frequency of the association of acute appendicitis with images of fecal loading in the cecum.METHODS: Plain abdominal radiographs of 400 patients operated upon for acute appendicitis (n = 100), acute cholecystitis (n = 100), right acute pelvic inflammatory disease (n = 100) and right nephrolithiasis (n = 100)were assessed. The presence of fecal loading was recorded and the sensitivity and specificity of this sign for acute appendicitis were calculated.RESULTS: The presence of fecal loading in the cecum occurred in 97 patients with acute appendicitis, 13 patients with acute cholecystitis, 12 patients with acute inflammatory pelvic disease and 19 patients with nephrolithiasis. The sensitivity of this sign for appendicitis was 97% and its specificity to this disease was 85.3%. Its positive predictive value for appendicitis was 68.7%; however, its negative predictive value for appendicitis was 98.8%.CONCLUSION: The present study suggests that the presence of radiological images of fecal loading in the cecum may be a useful sign of acute appendicitis, and the absence of this sign probably excludes this disease.This is the first description of fecal loading as a radiological sign for acute appendicitis.

  12. The Diagnostic Value of D-dimer, Procalcitonin and CRP in Acute Appendicitis

    Directory of Open Access Journals (Sweden)

    Bulent Kaya, Baris Sana, Cengiz Eris, Koray Karabulut, Orhan Bat, Riza Kutanis

    2012-01-01

    Full Text Available BACKGROUND: The early diagnosis of acute abdomen is of great importance. To date, several inflammatory markers have been used for the diagnosis of acute abdominal conditions, including acute appendicitis. The aim of this study was to evaluate the diagnostic utility of D-dimer, Procalcitonin (PCT and C-reactive protein (CRP measurements in the acute appendicitis.METHODS: This prospective study was conducted between March 1st, 2010 and July 1st, 2011. In this period, seventy-eight patients were operated with the diagnosis of acute appendicitis, and D-dimer, PCT and CRP levels of the patients were measured. The patients were grouped as phlegmonous appendicitis (Group 1, gangrenous appendicitis (Group 2, perforated appendicitis (Group 3 and negative appendectomy (Group 4 according to the surgical findings and histopathological results.RESULTS: Of 78 patients, 54 (69.2 % were male and 24 (30.8 % were female, and the mean age was 25.4 ± 11.1 years (range, 18 to 69 years. 66 (84.6 % patients had increased leukocyte count (white blood cell count. The PCT values were higher than the upper normal limit in 20 (25.6% patients, followed by D-dimer in 22 (28.2 % patients and CRP in 54 (69.2 % patients. The diagnostic value of leukocyte count and CRP in acute appendicitis was higher than that of the other markers, whereas leukocyte count showed very low specificity. CRP values were higher in perforated appendicitis when compared with the phlegmonous appendicitis (p<0.05. However, PCT and D-dimer showed lower diagnostic values (26% and 31%, respectively.CONCLUSION: An increase in CRP levels alone is not sufficient to make the diagnosis of acute appendicitis. However, CRP levels may differentiate between phlegmonous appendicitis and perforated appendicitis. Due to their low sensitivity and diagnostic value, PCT and D-dimer are not better markers than CRP for the diagnosis of acute appendicitis.

  13. The activity of granulocyte alpha-amylase in acute appendicitis.

    Science.gov (United States)

    Zakrzewska, I; Gajda, R

    1994-01-01

    The activity of alpha-amylase was measured in isolated granulocytes, serum and urine of 35 patients with acute appendicitis. The measurements were performed before operation and on the 7th day after operation. Slightly increased activity of alpha-amylase was found in the serum and urine of 15 patients. On the 7th day after operation the activity of this enzyme reached normal value. The activity of granulocyte alpha-amylase was elevated in 22 patients. In 2 of them the increased activity still maintained on the 7th day after operation. Positive correlation between the serum and granulocyte alpha-amylase activities was found. These observations allow to conclude that granulocytes are the source of increased alpha-amylase activity in the serum of patients with acute appendicitis.

  14. The activity of granulocyte alpha-amylase in acute appendicitis.

    Science.gov (United States)

    Zakrzewska, I; Gajda, R

    1994-01-01

    The activity of alpha-amylase was measured in isolated granulocytes, serum and urine of 35 patients with acute appendicitis. The measurements were performed before operation and on the 7th day after operation. Slightly increased activity of alpha-amylase was found in the serum and urine of 15 patients. On the 7th day after operation the activity of this enzyme reached normal value. The activity of granulocyte alpha-amylase was elevated in 22 patients. In 2 of them the increased activity still maintained on the 7th day after operation. Positive correlation between the serum and granulocyte alpha-amylase activities was found. These observations allow to conclude that granulocytes are the source of increased alpha-amylase activity in the serum of patients with acute appendicitis. PMID:7497089

  15. Acute appendicitis: computed tomography findings - an iconographic essay

    International Nuclear Information System (INIS)

    Acute appendicitis is the most important cause of abdominal pain requiring surgical intervention in the Western world. The early diagnosis of this disease is of paramount relevance for minimizing its morbidity. Imaging methods have represented a huge progress in the diagnosis of this entity, which used to be based essentially on clinical history, physical examination and laboratory tests results, considering that 20% to 33% of patients present with atypical symptoms. Diagnostic difficulty is higher in children, the elderly, and women in childbearing age. The main imaging methods for evaluation of acute appendicitis are ultrasound and computed tomography. The present study is aimed at describing the disease physiopathology, commenting main computed tomography technical aspects, demonstrating and illustrating tomographic findings, and describing main differential diagnoses. (author)

  16. Synchronized Legg-Calve Perthes disease and comorbid perforated appendicitis

    Directory of Open Access Journals (Sweden)

    Alev Süzen

    2015-08-01

    Full Text Available Abdominal pain is a very common complaint caused by a variety of conditions. Acute appendicitis is the most common cause of acute abdominal pain in children requiring surgical intervention. Legg-Calve-Perthes disease (LCPD is a childhood condition that affects the hip, where the thighbone (femur and pelvis meet in a ball-and-socket joint. The disease is initially asymptomatic or there is painless limp. The pain associated with LCPD is often localized in the inguinal region. The present study is aimed to present a patient with LCPD and comorbid perforated appendicitis and to highlight the importance of the differential diagnosis of abdominal pain as a delay in diagnosis can increase the risk of mortality. Analyzing the imaging technique, from the study it has been found out that clinicians should examine all the field about the diagnosis, not only the field around disease as a patient might have two separate acute problems at same time.

  17. Macroamylasemia in a patient with acute appendicitis: a case report.

    OpenAIRE

    Um, J. W.; Kim, K.H.; Kang, M. S.; Choe, J. H.; Bae, J. W.; Hong, Y S; Suh, S O; Kim, Y C; Whang, C. W.; Kim, S. M.

    1999-01-01

    Macroamylasemia is a condition of persistent, elevated serum amylase activity with no apparent clinical symptoms of a pancreatic disorder. In Korea, however, no such case has been reported to date. We report a case of a 17-year-old female diagnosed with macroamylasemia and acute appendicitis. One day earlier, she developed epigastric and right lower quadrant abdominal pain. She was characterized by high level of serum amylase, but normal lipase. Amylase isoenzyme analysis demonstrated increas...

  18. The platelet indices in pediatric patients with acute appendicitis

    OpenAIRE

    Yunus Yilmaz; Fatih Kara; Musa Gumusdere; Hasan Arslan; Sefer Ustebay

    2015-01-01

    Background: The diagnosis of Acute Appendicitis (AA) remains a problem in pediatric population. It has been suggested that Mean Platelet Volume (MPV) is lower in the patients with AA. The purpose of this study was to investigate the diagnostic value of platelet indices in pediatric AA cases. Methods: A retrospective case-controlled study was designed: 224 subjects were included in this study. All patients had been operated on in division of pediatric surgery at the Kars Government Hospita...

  19. An unusual presentation of perforated appendicitis in epigastric region ☆

    OpenAIRE

    Odabasi, Mehmet; Arslan, Cem; Abuoglu, Hasan; Gunay, Emre; Yildiz, Mehmet Kamil; Eris, Cengiz; Ozkan, Erkan; Aktekin, Ali; Muftuoglu, M. A. Tolga

    2013-01-01

    INTRODUCTION Atypical presentations of appendix have been reported including backache, left lower quadrant pain and groin pain from a strangulated femoral hernia containing the appendix. We report a case presenting an epigastric pain that was diagnosed after computed tomography as a perforated appendicitis on intestinal malrotation. PRESENTATION OF CASE A 27-year-old man was admitted with a three-day history of epigastric pain. Physical examination revealed tenderness and defense on palpation...

  20. Appendicitis within Morgagni Hernia and simultaneous Paraesophageal Hernia

    OpenAIRE

    Bettini, Anna; Ulloa, Jesus G.; Harris, Hobart

    2015-01-01

    Background Morgagni hernia is a congenital diaphragmatic defect that rarely presents with symptomatic findings in adults. The presence of one diaphragmatic defect may decrease the occurrence of a separate diaphragmatic defect. Appendicitis may be a unique presentation of incarcerated bowel in a Morgagni defect. Case presentation Review of recent literature and presentation of a patient with Morgagni defect. Only five cases of simultaneous Morgagni hernia and paraesophageal hernia have been de...

  1. Perforated appendicitis: an underappreciated mimic of intussusception on ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Newman, Beverley; Schmitz, Matthew; Gawande, Rakhee; Vasanawala, Shreyas; Barth, Richard [Lucile Packard Children' s Hospital, Department of Radiology, Stanford University, Stanford, CA (United States)

    2014-05-15

    We encountered multiple cases in which the US appearance of ruptured appendicitis mimicked intussusception, resulting in diagnostic and therapeutic delay and multiple additional imaging studies. To explore the clinical and imaging discriminatory features between the conditions. Initial US images in six children (age 16 months to 8 years; 4 boys, 2 girls) were reviewed independently and by consensus by three pediatric radiologists. These findings were compared and correlated with the original reports and subsequent US, fluoroscopic, and CT images and reports. All initial US studies demonstrated a multiple-ring-like appearance (target sign, most apparent on transverse views) with diagnostic consensus supportive of intussusception. In three cases, US findings were somewhat discrepant with clinical concerns. Subsequently, four of the six children had contrast enemas; two were thought to have partial or complete intussusception reduction. Three had a repeat US examination, with recognition of the correct diagnosis. None of the US examinations demonstrated definite intralesional lymph nodes or mesenteric fat, but central echogenicity caused by debris/appendicolith was misinterpreted as fat. All showed perilesional hyperechogenicity that, in retrospect, represented inflamed fat ''walling off'' of the perforated appendix. There were four CTs, all of which demonstrated a double-ring appearance that correlated with the US target appearance, with inner and outer rings representing the dilated appendix and walled-off appendiceal rupture, respectively. All six children had surgical confirmation of perforated appendicitis. Contained perforated appendicitis can produce US findings closely mimicking intussusception. Clinical correlation and careful multiplanar evaluation should allow for sonographic suspicion of perforated appendicitis, which can be confirmed on CT if necessary. (orig.)

  2. Gastrointestinal variant of Lemierre's syndrome complicating ruptured appendicitis

    OpenAIRE

    Fadi Al Akhrass; Lina Abdallah; Steven Berger; Rami Sartawi

    2015-01-01

    Fusobacterium necrophorum is a non-spore-forming, obligate anaerobic, filamentous, gramnegative bacillus that frequently colonizes the human oral cavity, respiratory tract, and gastrointestinal tract. Fusobacterium species have rarely been implicated in cases of gastrointestinal variant of Lemierre's syndrome. We describe a case of F. necrophorum bacteremia associated with suppurative porto-mesenteric vein thrombosis (PVT) following acute ruptured appendicitis. In addition, we list the docume...

  3. [New ways in the surgery of acute appendicitis?].

    Science.gov (United States)

    Magdeburg, R; Kähler, G

    2013-06-01

    Acute appendicitis is still one of the most common abdominal emergencies necessitating operative treatment. For the past century, the conventional management of appendicitis has been open appendectomy. Since the introduction of laparoscopic appendectomy, it has been performed with increased frequency. Clinical trials evaluating outcomes comparing open appendectomy with laparoscopic appendectomy indicate that laparoscopic appendectomy is associated with lower complication rate and lower mortality and is to be considered the procedure of choice for patients with suspected acute appendicitis. Ever since Kalloo's first report on transgastric peritoneoscopy in a porcine model in 2004, this dramatic surgical revolution has prompted many surgeons and endoscopists to study this new technique. This complex technique involves breaching the wall of a hollow organ to gain access into the peritoneum: Natural Orifice Translumenal Endoscopic Surgery (NOTES). In recent years, several NOTES experiments have been carried out in animal models and even on humans, including appendectomy. NOTES may help to reduce surgical pain and shorten recovery time. The concept of NOTES has generated intensive interest in the medical community as well as in the group of patients. Although the novel procedure is still far from being mature and many technical problems have to be overcome and more clinical studies have to be done before its widespread application in human appendectomy, NOTES is a promising procedure for the future. PMID:23325519

  4. An unusual presentation of perforated appendicitis in epigastric region☆

    Science.gov (United States)

    Odabasi, Mehmet; Arslan, Cem; Abuoglu, Hasan; Gunay, Emre; Yildiz, Mehmet Kamil; Eris, Cengiz; Ozkan, Erkan; Aktekin, Ali; Muftuoglu, M.A. Tolga

    2013-01-01

    INTRODUCTION Atypical presentations of appendix have been reported including backache, left lower quadrant pain and groin pain from a strangulated femoral hernia containing the appendix. We report a case presenting an epigastric pain that was diagnosed after computed tomography as a perforated appendicitis on intestinal malrotation. PRESENTATION OF CASE A 27-year-old man was admitted with a three-day history of epigastric pain. Physical examination revealed tenderness and defense on palpation of epigastric region. There was a left subcostal incision with the history of diaphragmatic hernia repair when the patient was 3 days old. He had an intestinal malrotation with the cecum fixed at the epigastric region and the inflamed appendix extending beside the left lobe of liver. DISCUSSION While appendicitis is the most common abdominal disease requiring surgical intervention seen in the emergency room setting, intestinal malrotation is relatively uncommon. When patients with asymptomatic undiagnosed gastrointestinal malrotation clinically present with abdominal pain, accurate diagnosis and definitive therapy may be delayed, possibly increasing the risk of morbidity and mortality. CONCLUSION Atypical presentations of acute appendicitis should be kept in mind in patients with abdominal pain in emergency room especially in patients with previous childhood operation for diaphragmatic hernia. PMID:24441442

  5. Xanthogranulomatous appendicitis in interval appendectomy specimens of children

    Directory of Open Access Journals (Sweden)

    Yusuf Hakan Çavuşoğlu

    2016-05-01

    Full Text Available Xanthogranulomatous inflammation is common in interval appendectomy specimens in adults, but it is unusual in children. Histopathologic specimens of interval appendectomy, within an 8-year period, were reevaluated to assess the true incidence. A computer search of the hospital database of all appendectomies was performed between January 2008 and June 2015 to identify all interval appendectomy cases. A total of 2694 patients underwent appendectomies. Of these, 13 were interval appendectomies. After pathologic evaluation, 2 (15.4% of the specimens were reported as xanthogranulomatous appendicitis (XA. Histopathologic examination of these interval appendectomy specimens, granulomas (59%, xanthogranulomatous inflammation (36% and Crohn-like changes (50% were common in adults. However, XA is a particularly rare clinical entity among children. Two cases of XA were reported in children in the English literature. One was a 12-year old boy that underwent interval appendectomy 6 weeks after an episode of acute appendicitis. The other was an 11-year old boy with acute (non-interval appendicitis, but the complete blood count was suggestive of an acute suppurative inflammation. These two cases are the 3rd and 4th cases of XA reported in children in the English literature, and both were managed by interval appendectomy. Thus, XA may be encountered in interval appendectomy specimens and association with IBD has to be ruled out.

  6. Retrospective evaluation of acute appendicitis incorrectly diagnosed on CT

    International Nuclear Information System (INIS)

    The purpose of our study was to retrospectively evaluate the CT images of patients suffering with surgically proven appendicitis to determine the causes of missed diagnoses. We reviewed the pathology reports of the patients with surgically proven appendicitis from two hospitals during a 3-year period. Thirty-seven such cases with a misdiagnosis were identified and they served as our misdiagnosed group (17 females and 20 males, mean age: 58 years, age range 15-68 years). These were cases that were misdiagnosed on preoperative abdominal CT. All 57 patients in the control group (30 females and 27 males, mean age: 44 years, age range: 21-78 years) had undergone laparotomy for acute appendicitis and they had been correctly diagnosed preoperatively on CT. Two abdominal radiologists evaluated the following items from all 94 CT examinations: 1) an abnormal appendix, 2) periappendiceal fat inflammation, 3) pericecal extraluminal fluid, 4) pericecal extraluminal air, 5) appendicolith, 6) cecal wall thickening, 7) small bowel dilatation, and 8) the pericecal fat content. Statistical analysis was performed using a Chi-squared test and Fisher's exact test. Any abnormal appendix was not visualized, even retrospectively, in 27 (73%) of the 37 patients from the misdiagnosed group, whereas it was not visualized in 13 (23%) of the 57 patients in the control group (ρ = 0.001). Of the patients who had been misdiagnosed, inflammation of the pericecal fat was observed in 21 patients (57%) as compared to 50 (88%) patients in the control group (ρ =0.001). Pericecal fluid and air were noted in 15 (41%) and 9 (24%) patients, respectively, in the misdiagnosed group and in 19 (33%) and 14 (25%) patients, respectively, in the control group, (ρ = 0.477 and ρ =0.901, respectively). Appendicolith was found in 3 (8%) misdiagnosed subjects and in 10 (18%) of the controls (ρ = 0.001). Focal cecal wall thickening was noted in 14 (38%) misdiagnosed patients and in 28 (49%) control patients (

  7. The diagnostic value of a panel of serological markers in acute appendicitis

    DEFF Research Database (Denmark)

    Farooqui, W; Pommergaard, H-C; Burcharth, J;

    2015-01-01

    markers could increase the prognostic accuracy of diagnosing non-perforated and perforated appendicitis. MATERIAL AND METHODS: Demographic data, histological findings, blood tests, and clinical symptoms were collected on all patients who underwent a diagnostic laparoscopy, a laparoscopic appendectomy...... in predicting acute and perforated appendicitis, and receiving operating characteristics curves were used to find the specificity, sensitivity, and the negative and positive predictive values. RESULTS: A total of 1008 patients were operated under suspicion of appendicitis. From these, 700 patients had...

  8. The US findings of acute nonperforated and perforated appendicitis in children

    International Nuclear Information System (INIS)

    To analyse and interpret different sonographic findings in acute nonperforated and appendicitis. In 46 cases of acute appendicitis in children(26 girls, 20 boys) proven by surgery, sonographic findings were reviewed retrospectively. The findings of nonperforated and perforated appendicitis were analysed, focusing on the size, shape and echogenicity of the appendix, echo patterns of periappendiceal abscesses, mesenteric lymphadenopathy, and the prevalence of appendicolith. A noncompressible distended appendix was present in 18 of 21 patients with nonperforated appendicitis and in 13 of 25 patients with perforation. In 18 patients with nonperforated appendicitis, the average diameter of distended appendix was 8.6 mm ; target appearance was noted in 16 patients and loss of echogenic submucosa in two. In 13 patients with perforated appendicitis, the average diameter of appendix was 9.1 mm ; target appearance was noted in four patients and loss of echogenic submucosa in nine. Periappendiceal abscesses were present in 21 of 25 cases of perforated appendicitis, and the echogenicity of abscesses was mixed in 12 patients, hypoechogenic in eight, and hyperechogenic in one. Mesenteric lymphadenopathy was present in two of 21 patients with nonperforated appendicitis and in four of 25 with perforation. Appendicolith was detected on sonography in three of 25 patients with perforated appendicitis, but was found in seven patients during surgery. One patients with perforated appendicitis also had right side hydronephrosis. Sonographically false-negative results were obtained in six cases. A sonographic examination was useful to differenciate perforated and nonperforated appendicitis in children. Loss of echogenic submucosa in the distended appendix and periappendiceal abscess formation were important findings in diagnosis of perforated appendicitis

  9. Stump appendicitis is a rare delayed complication of appendectomy: A case report

    Institute of Scientific and Technical Information of China (English)

    Mehmet Uludag; Adnan Isgor; Muzaffer Basak

    2006-01-01

    Stump appendicitis is an acute inflammation of the residual appendix and one of the rare complications after appendectomy. Paying attention to the possibility of stump appendicitis in patients with right lower abdominal pain after appendectomy can prevent the delay of diagnosis and treatment. In patients with stump appendicitis,CT scan not only assists in making an accurate preoperative diagnosis but also excludes other etiologies. We report a 47-year old man with preoperatively diagnosed stump appendicitis by CT, who underwent an open appendectomy 20 years ago.

  10. A Rare Case: Appendectomy After Connected Stump Appendicitis Perforation of the Cecum

    Directory of Open Access Journals (Sweden)

    Berke Manoglu

    2016-01-01

    Full Text Available Stump appendicitis is a rare complication after appendectomy . Stump appendicitis made of incomplete appendectomy after a rest appendix tissue develops as a result of the inflammation. Admitted to the emergency department with acute abdomen and a history of appendectomy in patients with a history of current pain in the right lower quadrant , especially that of the patient must be evaluated in terms of stump appendicitis. The fact that the earlier story appendectomy patients , causing a delay in diagnosis and increasing the morbidity Cecal perforation was offered an advanced case of delayed depending on the stump appendicitis in this article.

  11. Diagnostic value of procalcitonin for acute complicated appendicitis

    Science.gov (United States)

    Yamashita, Hiromasa; Yuasa, Norihiro; Takeuchi, Eiji; Goto, Yasutomo; Miyake, Hideo; Miyata, Kanji; Kato, Hideki; Ito, Masafumi

    2016-01-01

    ABSTRACT A rapid and reliable test for detection of complicated appendicitis would be useful when deciding whether emergency surgery is required. We investigated the clinical usefulness of procalcitonin for identifying acute complicated appendicitis. We retrospectively analyzed 63 patients aged ≥15 years who underwent appendectomy without receiving antibiotics before admission and had preoperative data on the plasma procalcitonin level (PCT), body temperature (BT), white blood cell count (WBC), neutrophil / lymphocyte ratio (N/L ratio), and C-reactive protein level (CRP). Patients were classified into 3 groups: group A (inflammatory cell infiltration of the appendix with intact mural architecture), group B (inflammatory cell infiltration with destruction of mural architecture, but without abscess or perforation), and group C (macroscopic abscess and/or perforation). For identifying destruction of mural architecture, the diagnostic accuracy of PCT was similar to that of BT or CRP. However, the diagnostic accuracy of PCT was highest among the five inflammatory indices for identifying abscess and/or perforation, with the positive predictive value of PCT for abscess and/or perforation being higher than that of CRP (73% vs. 48%). Univariate analysis of the predictors of abscess and/or perforation revealed that a plasma PCT level ≥0.46 ng/mL had the highest odds ratio (30.3 [95% confidence interval: 6.5–140.5] versus PCT <0.46 ng/mL). These findings indicate that procalcitonin is a useful marker of acute appendicitis with abscess and/or perforation. PMID:27019529

  12. Granulomatous appendicitis in children: A single institutional experience

    Directory of Open Access Journals (Sweden)

    Kamalesh Pal

    2014-01-01

    Full Text Available Background: Granulomatous appendicitis (GA is a rare entity, mostly mentioned in adults. There have been anecdotal case reports describing GA in the paediatric population. This study was aimed at reviewing the cases of appendectomies to assess the incidence and characteristics of GA in children in a tertiary care University hospital. Materials and Methods: Records of children (<13 years age with biopsy proven granulomatous lesions in the appendectomy specimen, treated during 1991-2011, were analysed. Data regarding demography, clinical presentation, radiological findings, intra-operative finding, histology, diagnosis and follow-up were recorded and descriptively analysed. Results: Twelve out of 1150 (1.04% appendectomies were biopsy proven GA. Male to female ratio was 8:4. Four had Yersinia enterocolitis, two had Crohn′s disease (CD; one isolated Crohn′s Appendicitis, one Ileo-cecal Crohn′ with appendicitis and five were idiopathic. Remaining one case, initially diagnosed as idiopathic GA, developed full blown ileo-cecal CD at 2 nd month post-operative. Age ranged between 4 and 11 years with inflammatory bowel disease (IBD affecting older children and Yersinia, seen in younger children. Majority (10/12 remained asymptomatic at a maximum of 5 years of follow-up. Two patients had recurrent symptoms; one with sub-acute obstruction (2 years follow-up and another with flaring of Crohn′s ileitis (2 months follow-up. Conclusions: GA in children is a rare entity, with incidence of 1.04% and male preponderance in our series. Idiopathic causes were the most common followed by Yersinia enterocolitis and CD. Although majority remained asymptomatic, IBD should be ruled out in case of recurrence of pain or alteration of bowel habit. Therefore, a long-term follow-up (at least for 5 years of idiopathic GA is suggested in children.

  13. A rare case of appendicitis incarcerated in an inguinal hernia

    OpenAIRE

    Smith-Singares, Eduardo; Boachie, Joseph Adjei; Iglesias, Izaskun Melania

    2016-01-01

    Amyand's hernia was coined after Claudius Amyand (1660–1740), who was the first to describe the presence of a perforated appendix in a hernial sac and also was the first to perform a successful appendectomy in 1735. It is an exceptionally rare condition in which the hernia itself contains the appendix, which may not necessarily be inflamed. The presence of an inflamed appendix further contributes to the rarity of this case. We report a case of acute appendicitis brought on by its incarceratio...

  14. The stranded stone: Relationship between acute appendicitis and appendicolith

    Directory of Open Access Journals (Sweden)

    Aljefri Ahmad

    2009-01-01

    Full Text Available Background/Aim: To examine the relationship between acute appendicitis and the presence of an appendicolith in abdominal CT scans of patients attending emergency services. Materials and Methods: Abdominal CT scan reports were retrospectively reviewed for 267 patients through the PACS database. A 16-slices MDCT GE Light Speed scanner (Milwaukee WI was used with a scanning protocol of 5 mm axial collimation and a pitch of 1.0, along with oral contrast material (Gastrografin 3.7% diatrizoate meglumine and 140 mL of intravenous (IV nonionic contrast material (Omnipaque. Particular attention was given to the study protocol, patients′ age, and gender. Statistical Analysis: We used MS-EXCEL and SPSS version 12.0 to perform chi-square and Fisher′s exact tests. Bookends and Papers, components in Mac OS X software, were used for literature reviews and the organization of results. Results: Two hundred and sixty-seven abdominal CT scan reports were examined along side their respective images on a GE Centricity workstation. Thirty-four (12.7% were labeled as acute appendicitis cases based on the CT findings and the rest were assigned other diagnoses. Twenty-six of the 267 CT scan reports were plain studies and 241 were contrast-enhanced scans. Less than half of the patients (123, 46.1% were males and 144 (53.9% were females. Thirteen males (48.1% and 14 (51.9% females were found to have an appendicolith. Only 3% in the ≤ 11 years′ age group, in contrast to 40% in the 11-20 years′ age group, was diagnosed with appendicitis. The incidence in other age groups was as follows: 19% in the 21-30, 14% in the 31-40, 2.5% in the 41-50, 8% each in the 51-60 and 61-70, and none in the ≥71 years′ age groups. Conclusions: We conclude that the presence of an appendicolith i has no particular predilection for gender or age, and ii is not associated with a diagnosis of appendicitis.

  15. Computer tomography imaging of an unusual cause of appendicitis: a case report

    OpenAIRE

    Ngatchou, William; Mols, Pierre; Ramadan, Ahmed S.E.; Ngassa, Michèle; Towo, Pierre Youatou

    2015-01-01

    Foreign body occlusion of appendices lumen is a quite rare cause of appendicitis due to foreign body. We present a case of a 63-year-old male who presented with right lower quadrant pain since 24 hours. Computed tomography (CT) demonstrated an acute appendicitis due to a metallic foreign body which was found to be a bullet.

  16. Computer tomography imaging of an unusual cause of appendicitis: a case report

    Science.gov (United States)

    Mols, Pierre; Ramadan, Ahmed S. E.; Ngassa, Michèle; Towo, Pierre Youatou

    2015-01-01

    Foreign body occlusion of appendices lumen is a quite rare cause of appendicitis due to foreign body. We present a case of a 63-year-old male who presented with right lower quadrant pain since 24 hours. Computed tomography (CT) demonstrated an acute appendicitis due to a metallic foreign body which was found to be a bullet. PMID:26029649

  17. Acute appendicitis in children: ultrasound and CT findings in negative appendectomy cases

    International Nuclear Information System (INIS)

    To decrease the negative appendectomy rate in children, knowledge of the misleading imaging findings on US and CT in negative appendicitis cases is important. To evaluate the negative appendectomy rate and describe the imaging findings of US and CT that lead radiologists to misdiagnose acute appendicitis in children. From 2007 to 2013, 374 children operated for suspected appendicitis were proved to either have acute appendicitis (n = 348) or to be negative for appendicitis (n = 26) on pathological reports. Negative appendectomy rates were compared among imaging modalities, age groups and genders. We retrospectively reviewed US and CT findings from negative appendectomy cases. The overall negative appendectomy rate was 7.0% (26/374). There were no statistically significant differences among the subgroups. The most common misleading presentations on US were sonographic tenderness (9/16, 56%) and non-compressibility (9/16, 56%). The most common misleading finding on CT were the presence of an appendicolith or hyperdense feces (5/12, 42%). Periappendiceal fat inflammation was observed in only one case of negative appendicitis on US and on CT. Radiologists can misdiagnose children with equivocal diameters of appendices as having acute appendicitis when sonographic tenderness or non-compressibility is present on US and when an appendicolith or hyperdense feces is noted on CT. The possibility of negative appendicitis should be borne in mind when periappendiceal fat inflammation is absent or minimal in indeterminate cases. (orig.)

  18. The ectopic appendicolith from perforated appendicitis as a cause of tubo-ovarian abscess

    Energy Technology Data Exchange (ETDEWEB)

    Vyas, Rajashree C.; Sides, Corey; Klein, Deborah J. [University of Rochester Medical Center, Rochester, NY (United States); Reddy, Sireesha Y. [University of Rochester, Obstetrics and Gynecology, Rochester, NY (United States); Santos, Mary C. [University of Rochester, Pediatric Surgery, Rochester, NY (United States)

    2008-09-15

    Acute appendicitis is a common surgical cause of abdominal pain in the pediatric population. History and physical examination are atypical in up to a third of patients. Known potential complications of untreated or delayed management of acute appendicitis include appendiceal perforation, periappendiceal abscess formation, peritonitis, bowel obstruction and rarely septic thrombosis of mesenteric vessels. We report an unusual complication of perforated appendicitis. A tubo-ovarian abscess developed secondary to appendicolith migration into the right fallopian tube in a patient who had undergone interval laparoscopic appendectomy for perforated appendicitis. The retained appendicolith was visualized within the obstructed and dilated fallopian tube on contrast-enhanced CT. We discuss the CT imaging features of this unusual complication of perforated appendicitis. (orig.)

  19. Macroamylasemia in a patient with acute appendicitis: a case report.

    Science.gov (United States)

    Um, J W; Kim, K H; Kang, M S; Choe, J H; Bae, J W; Hong, Y S; Suh, S O; Kim, Y C; Whang, C W; Kim, S M

    1999-12-01

    Macroamylasemia is a condition of persistent, elevated serum amylase activity with no apparent clinical symptoms of a pancreatic disorder. In Korea, however, no such case has been reported to date. We report a case of a 17-year-old female diagnosed with macroamylasemia and acute appendicitis. One day earlier, she developed epigastric and right lower quadrant abdominal pain. She was characterized by high level of serum amylase, but normal lipase. Amylase isoenzyme analysis demonstrated increased fraction of salivary type and follow-up amylase level was persistently increased. Immunofixation disclosed the macroamylase binding with an immunoglobulin, consisting of IgA and kappa chain. The patient was treated by appendectomy, and the abdominal pain subsided.

  20. Macroamylasemia in a patient with acute appendicitis: a case report.

    Science.gov (United States)

    Um, J W; Kim, K H; Kang, M S; Choe, J H; Bae, J W; Hong, Y S; Suh, S O; Kim, Y C; Whang, C W; Kim, S M

    1999-12-01

    Macroamylasemia is a condition of persistent, elevated serum amylase activity with no apparent clinical symptoms of a pancreatic disorder. In Korea, however, no such case has been reported to date. We report a case of a 17-year-old female diagnosed with macroamylasemia and acute appendicitis. One day earlier, she developed epigastric and right lower quadrant abdominal pain. She was characterized by high level of serum amylase, but normal lipase. Amylase isoenzyme analysis demonstrated increased fraction of salivary type and follow-up amylase level was persistently increased. Immunofixation disclosed the macroamylase binding with an immunoglobulin, consisting of IgA and kappa chain. The patient was treated by appendectomy, and the abdominal pain subsided. PMID:10642949

  1. Gastrointestinal variant of Lemierre's syndrome complicating ruptured appendicitis

    Directory of Open Access Journals (Sweden)

    Fadi Al Akhrass

    2015-01-01

    Full Text Available Fusobacterium necrophorum is a non-spore-forming, obligate anaerobic, filamentous, gramnegative bacillus that frequently colonizes the human oral cavity, respiratory tract, and gastrointestinal tract. Fusobacterium species have rarely been implicated in cases of gastrointestinal variant of Lemierre's syndrome. We describe a case of F. necrophorum bacteremia associated with suppurative porto-mesenteric vein thrombosis (PVT following acute ruptured appendicitis. In addition, we list the documented twelve cases of Fusobacterium pylephlebitis. Recanalization of the porto-mesenteric veins and relief of the extrahepatic portal hypertension were achieved with early empiric antibiotic and local thrombolytic therapy. Our patient's case underscores the importance of recognizing Fusobacterium bacteremia as a possible cause of suppurative PVT after disruption of the gastrointestinal mucosa following an acute intraabdominal infectious process. Early treatment of this condition using anticoagulation and endovascular thrombolysis as adjunctive therapies may prevent PVT complications.

  2. Gastrointestinal variant of Lemierre's syndrome complicating ruptured appendicitis.

    Science.gov (United States)

    Akhrass, Fadi Al; Abdallah, Lina; Berger, Steven; Sartawi, Rami

    2015-01-01

    Fusobacterium necrophorum is a non-spore-forming, obligate anaerobic, filamentous, gramnegative bacillus that frequently colonizes the human oral cavity, respiratory tract, and gastrointestinal tract. Fusobacterium species have rarely been implicated in cases of gastrointestinal variant of Lemierre's syndrome. We describe a case of F. necrophorum bacteremia associated with suppurative porto-mesenteric vein thrombosis (PVT) following acute ruptured appendicitis. In addition, we list the documented twelve cases of Fusobacterium pylephlebitis. Recanalization of the porto-mesenteric veins and relief of the extrahepatic portal hypertension were achieved with early empiric antibiotic and local thrombolytic therapy. Our patient's case underscores the importance of recognizing Fusobacterium bacteremia as a possible cause of suppurative PVT after disruption of the gastrointestinal mucosa following an acute intraabdominal infectious process. Early treatment of this condition using anticoagulation and endovascular thrombolysis as adjunctive therapies may prevent PVT complications. PMID:26793462

  3. Acute perforated appendicitis: An analysis of risk factors to guide surgical decision making

    Directory of Open Access Journals (Sweden)

    Savio G Barreto

    2010-01-01

    Full Text Available Introduction: Acute perforated appendicitis is associated with increased post-operative morbidity and mortality. Avoiding delays in surgery in these patients may play a role in reducing observed morbidity. Objective: To analyze the clinico-pathological profile and outcomes in a cohort of patients undergoing emergency appendicectomies for suspected acute appendicitis and to determine factors influencing the risk of perforated appendicitis in order to aid better identification of such patients and develop protocols for improved management of this subset of patients. Materials and Methods: A retrospective analysis of patients undergoing emergency appendicectomies following presentation with acute appendicitis to the Modbury hospital, South Australia from March 2007 to April 2011 was conducted. Statistical analyses were performed in SAS 9.2. Results and Discussion: 506 patients underwent emergency appendectomy for acute appendicitis which included equal number of male and female patients with a median age of 25 years. Perforated appendicitis was found in 102 (20% patients. Post-operative morbidity was significantly higher in patients with perforated appendicitis (28.4% vs 4.7%; P<0.0001. Male sex, patients older than 60 years, along with raised neutrophil counts and C-reactive protein levels were found to be significantly associated with the risk of perforation (P<0.05. Conclusions: Acute perforated appendicitis is associated with high morbidity. The increased risk of perforation in males and elderly patients appears unrelated to delays in presentation, diagnosis, or surgery. Patients with clinically diagnosed acute appendicitis and an elevation in neutrophil count and CRP level must be considered candidates for early surgery as they are likely to have an appendicular perforation.

  4. Magnetic resonance imaging in pediatric appendicitis: a systematic review.

    Science.gov (United States)

    Moore, Michael M; Kulaylat, Afif N; Hollenbeak, Christopher S; Engbrecht, Brett W; Dillman, Jonathan R; Methratta, Sosamma T

    2016-05-01

    Magnetic resonance imaging for the evaluation of appendicitis in children has rapidly increased recently. This change has been primarily driven by the desire to avoid CT radiation dose. This meta-analysis reviews the diagnostic performance of MRI for pediatric appendicitis and discusses current knowledge of cost-effectiveness. We used a conservative Haldane correction statistical method and found pooled diagnostic parameters including a sensitivity of 96.5% (95% confidence interval [CI]: 94.3-97.8%), specificity of 96.1% (95% CI: 93.5-97.7%), positive predictive value of 92.0% (95% CI: 89.3-94.0%) and negative predictive value of 98.3% (95% CI: 97.3-99.0%), based on 11 studies. Assessment of patient outcomes associated with MRI use at two institutions indicates that time to antibiotics was 4.7 h and 8.2 h, time to appendectomy was 9.1 h and 13.9 h, and negative appendectomy rate was 3.1% and 1.4%, respectively. Alternative diagnoses were present in ~20% of cases, most commonly adnexal cysts and enteritis/colitis. Regarding technique, half-acquisition single-shot fast spin-echo (SSFSE) pulse sequences are crucial. While gadolinium-enhanced T1-weighted pulse sequences might be helpful, any benefit beyond non-contrast MRI has not been confirmed. Balanced steady-state free precession (SSFP) sequences are generally noncontributory. Protocols do not need to exceed five sequences; four-sequence protocols are commonly utilized. Sedation generally is not indicated; patients younger than 5 years might be attempted based on the child's ability to cooperate. A comprehensive pediatric cost-effectiveness analysis that includes both direct and indirect costs is needed.

  5. Appendicitis in Diabetics: Predictors of Complications and Their Incidence.

    Science.gov (United States)

    Bach, Lindsay; Donovan, Andrew; Loggins, Whitney; Thompson, Stephanie; Richmond, Bryan

    2016-08-01

    Appendicitis is the most common surgical emergency encountered by the general surgeon. Literature has demonstrated that diabetics may manifest atypical signs of infection, often clouding the diagnostic picture. We conducted a 3-year retrospective analysis of adults with appendicitis to determine differences in presentation, diagnosis, treatment, and outcomes for diabetic versus nondiabetic patients. Demographics, symptoms, imaging, procedure(s), complications, and length of stay (LOS) were obtained via chart review. Factors were compared between patients with and without diabetes using chi-squared test, t test, or Mann-Whitney U test (significance at P ≤ 0.05). Multivariate regression analysis identified variables predicting longer LOS or perforation at diagnosis. Overall, 339 patients met inclusion criteria [303 were nondiabetic (ND), 36 were diabetic (D)]. On univariate analysis, diabetics were more likely to have other comorbid illnesses: obesity (P Diabetics presented with lower white blood cell counts (mean 14.2 ND, 11.9 D, P = 0.02), and were more likely to present with perforation (18.5% ND, 38.9% D, P = 0.008). LOS was longer in diabetics (1.0 day for ND, 3.0 day for D, P diabetics (19.4% D vs 8.6% ND), which trended toward but failed to reach significance (P = 0.066). On multivariate analysis, however, old age was the only characteristic associated with perforation [odds ratio: 1.05 (1.02-1.06), P diabetes, chronic obstructive pulmonary disease, and older age predicted longer LOS (P ≤ 0.001). Diabetics present a more complicated clinical picture having significantly more comorbidities and a trend toward postoperative complications necessitating a higher index of suspicion to detection complications. Further study is needed to evaluate the optimal diagnostic and management approach in this challenging population. PMID:27657594

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

    Science.gov (United States)

    Khaavel', A A; Birkenfeldt, R R

    1978-04-01

    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.

  7. Appendicular mass complicating acute appendicitis in a patient with dengue fever.

    Science.gov (United States)

    Low, Y N; Cheong, B M K

    2016-04-01

    Abdominal pain with dengue fever can be a diagnostic challenge. Typically, pain is localised to the epigastric region or associated with hepatomegaly. Patients can also present with acute abdomen. We report a case of a girl with dengue fever and right iliac fossa pain. The diagnosis of acute appendicitis was made only after four days of admission. An appendicular mass and a perforated appendix was noted during appendectomy. The patient recovered subsequently. Features suggestive of acute appendicitis are persistent right iliac fossa pain, localised peritonism, persistent fever and leucocytosis. Repeated clinical assessment is important to avoid missing a concurrent diagnosis like acute appendicitis. PMID:27326951

  8. Left-Sided Appendicitis in an Elderly Patient with Midgut Malrotation.

    Science.gov (United States)

    Chuang, Pei Wen; Huang, Bo-Ming; Liu, Chung Hsien; Chen, Chien-Chin; Tsai, Ming-Jen

    2015-12-01

    Appendicitis is a common surgical abdominal disease with various presentations. Its diagnosis may be obscured by asymptomatic congenital anatomical anomalies like midgut malrotation. Midgut malrotation is a rare fetal anomaly resulting from incomplete or failure of midgut rotation and fixation. It is mostly presented with bowel obstruction or volvulus in early life. Presentation in adult is rare. Here, we report an elderly patient presented with left lower abdominal pain and urinary tract infection. Abdominal computed tomography revealed left-sided appendicitis with non-rotational-type midgut malrotation. Clinicians should bear in mind the possibility of underlying midgut malrotation, as appendicitis could be the first presentation of this rare congenital condition. PMID:27011586

  9. Bedside Ultrasonography as an Adjunct to Routine Evaluation of Acute Appendicitis in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Samuel H.F. Lam

    2014-11-01

    Full Text Available Introduction: Appendicitis is a common condition presenting to the emergency department (ED. Increasingly emergency physicians (EP are using bedside ultrasound (BUS as an adjunct diagnostic tool. Our objective is to investigate the test characteristics of BUS for the diagnosis of appendicitis and identify components of routine ED workup and BUS associated with the presence of appendicitis. Methods: Patients four years of age and older presenting to the ED with suspected appendicitis were eligible for enrollment. After informed consent was obtained, BUS was performed on the subjects by trained EPs who had undergone a minimum of one-hour didactic training on the use of BUS to diagnose appendicitis.They then recorded elements of clinical history, physical examination, white blood cell count (WBC with polymophonuclear percentage (PMN, and BUS findings on a data form. We ascertained subject outcomes by a combination of medical record review and telephone follow-up. Results: A total of 125 subjects consented for the study, and 116 had adequate image data for final analysis. Prevalence of appendicitis was 40%. Mean age of the subjects was 20.2 years, and 51% were male. BUS was 100% sensitive (95% CI 87-100% and 32% specific (95% CI 14-57% for detection of appendicitis, with a positive predictive value of 72% (95% CI 56-84%, and a negative predictive value of 100% (95% CI 52-100%. Assuming all non-diagnostic studies were negative would yield a sensitivity of 72% and specificity of 81%. Subjects with appendicitis had a significantly higher occurrence of anorexia, nausea, vomiting, and a higher WBC and PMN count when compared to those without appendicitis. Their BUS studies were significantly more likely to result in visualization of the appendix, appendix diameter >6mm, appendix wall thickness >2mm, periappendiceal fluid, visualization of the appendix tip, and sonographic Mcburney’s sign (p6mm, appendix wall thickness >2mm, periappendiceal fluid were

  10. Changes in the epidemiology of acute appendicitis and appendectomy in Danish children 1996-2004

    DEFF Research Database (Denmark)

    Andersen, S B; Paerregaard, A; Larsen, K

    2009-01-01

    PURPOSE: Aim of the study was to describe changes in the epidemiology of acute appendicitis in Danish children between 0-19 years of age for the period 1996-2004. METHODS: The study was based on discharge diagnoses taken from the Danish National Patient Registry of all 28 274 patients with a diag......PURPOSE: Aim of the study was to describe changes in the epidemiology of acute appendicitis in Danish children between 0-19 years of age for the period 1996-2004. METHODS: The study was based on discharge diagnoses taken from the Danish National Patient Registry of all 28 274 patients...... with a diagnosis of acute uncomplicated or complicated appendicitis, and/or a registered procedure code of appendectomy. These data were computed together with data on the background population, and incidences were calculated. RESULTS: A significant decrease in the incidence of acute uncomplicated appendicitis...

  11. Synthesis and characterization of dendronized poly(methylsiloxane) with appendent Fréchet-type dendrons

    Institute of Scientific and Technical Information of China (English)

    JIANG; Jing(姜静); LIU; Hongwei(刘宏伟); ZHAO; Youliang(赵优良); CHEN; Chuanfu(陈传福); XI; Fu(习复)

    2002-01-01

    A new kind of dendronized poly(methylsiloxane) (3a and 3b) with appendent Fréchet-type poly(aryl ether) dendrons has been synthesized and characterized by GPC, DSC, TGA, fluorescence and UV-Vis spectra.

  12. A case of acute appendicitis in a patient with crossed renal ectopia

    Institute of Scientific and Technical Information of China (English)

    Ulvi Meral; Murat Zor; Orhan Ureyen; Nisa Cem Oren; Hilmi Gungor

    2016-01-01

    Crossed renal ectopia is a rare anomaly in urological clinical practice. Patients with this anomaly are usually asymptomatic. Herein, we reported a case of acute appendicitis in a patient with crossed renal ectopia. A 22-year-old man with abdominal pain admitted to the emergency department. His physical examination revealed muscular defense and painful mass at the lower quadrant. Abdominal ultrasonography revealed crossed renal ectopia with no sign of stones and acute appendicitis. Tomography confirmed crossed renal ectopia but not acute appendicitis. On-going clinical symptoms lead to surgical intervention and acute appendicitis diagnosis. The patient was treated with appendectomy with no perioperative complications. Appendectomy is a common surgical procedure in surgical clinical practice. Acute abdominal pain must be managed carefully in patients with unusual anatomy. Also surgeons should be aware of ectopic organs in surgical procedures, to avoid iatrogenic intraoperative injuries.

  13. Extracting actionable findings of appendicitis from radiology reports using natural language processing.

    Science.gov (United States)

    Rink, Bryan; Roberts, Kirk; Harabagiu, Sanda; Scheuermann, Richard H; Toomay, Seth; Browning, Travis; Bosler, Teresa; Peshock, Ronald

    2013-01-01

    Radiology reports often contain findings about the condition of a patient which should be acted upon quickly. These actionable findings in a radiology report can be automatically detected to ensure that the referring physician is notified about such findings and to provide feedback to the radiologist that further action has been taken. In this paper we investigate a method for detecting actionable findings of appendicitis in radiology reports. The method identifies both individual assertions regarding the presence of appendicitis and other findings related to appendicitis using syntactic dependency patterns. All relevant individual statements from a report are collectively considered to determine whether the report is consistent with appendicitis. Evaluation on a corpus of 400 radiology reports annotated by two expert radiologists showed that our approach achieves a precision of 91%, a recall of 83%, and an F1-measure of 87%. PMID:24303268

  14. Imaging the child with right lower quadrant pain and suspected appendicitis: current concepts

    Energy Technology Data Exchange (ETDEWEB)

    Sivit, Carlos J. [Departments of Radiology and Pediatrics, Rainbow Babies and Childrens Hospital of the University Hospitals of Cleveland and Case Western Reserve School of Medicine, Euclid Avenue, 11100, 44106-5056, Cleveland, OH (United States)

    2004-06-01

    Acute appendicitis is the most common condition presenting with right lower quadrant pain requiring acute surgical intervention in childhood. The clinical diagnosis of acute appendicitis is often not straightforward and can be challenging. Approximately one-third of children with the condition have atypical clinical findings and are initially managed non-operatively. Complications usually result from perforation and include abscess formation, peritonitis, sepsis, bowel obstruction and death. Cross-sectional imaging with sonography and computed tomography (CT) have proven useful for the evaluation of suspected acute appendicitis in children. The principal advantages of sonography are its lower cost, lack of ionizing radiation, and ability to precisely delineate gynecologic disease. The principal advantages of CT are its operator independency with resultant higher diagnostic accuracy, enhanced delineation of disease extent in perforated appendicitis, and improved patient outcomes including decreased negative laparotomy and perforation rates. (orig.)

  15. Amebiasis presenting as acute appendicitis: Report of a case and review of Japanese literature

    Directory of Open Access Journals (Sweden)

    Daisuke Ito

    2014-01-01

    CONCLUSION: We report a case of acute amebic appendicitis in a 31-year-old woman and review the ages at presentation, causative factors, treatments, and outcomes of 11 cases reported in Japan between 1995 and 2013.

  16. May Ingestion of Leachate from Decomposed Corpses Cause Appendicitis? A Case Report

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    Maurício Domingues-Ferreira

    2011-01-01

    Full Text Available The general consensus is that appendicitis is basically provoked by fecaliths or lymphoid hyperplasic obstruction. Several studies based on histological diagnosis have not confirmed this hypothesis. On the contrary, obstruction has been proved in only a minority of cases. Diverse infections by parasites, bacteria, fungus, and noninfective agents have been associated with appendicitis in the medical literature. We describe a firefighter, who ingested a small quantity of leachate from decomposing corpses while working and developed enteritis a few hours later, which lasted several days and evolved to appendicitis. This case raises the possibility that the high quantity of bacteria concentration present in the leachate could have provoked enteritis and the subsequent appendicitis due to a direct effect of the bacteria on the appendix.

  17. May Ingestion of Leachate from Decomposed Corpses Cause Appendicitis? A Case Report

    Science.gov (United States)

    Domingues-Ferreira, Maurício; Saddi-Rosa, Pedro; dos Santos, André Luis

    2011-01-01

    The general consensus is that appendicitis is basically provoked by fecaliths or lymphoid hyperplasic obstruction. Several studies based on histological diagnosis have not confirmed this hypothesis. On the contrary, obstruction has been proved in only a minority of cases. Diverse infections by parasites, bacteria, fungus, and noninfective agents have been associated with appendicitis in the medical literature. We describe a firefighter, who ingested a small quantity of leachate from decomposing corpses while working and developed enteritis a few hours later, which lasted several days and evolved to appendicitis. This case raises the possibility that the high quantity of bacteria concentration present in the leachate could have provoked enteritis and the subsequent appendicitis due to a direct effect of the bacteria on the appendix. PMID:21541232

  18. Abdominal CT Does Not Improve Outcome for Children with Suspected Acute Appendicitis

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    Danielle I. Miano

    2015-12-01

    Full Text Available Introduction: Acute appendicitis in children is a clinical diagnosis, which often requires preoperative confirmation with either ultrasound (US or computed tomography (CT studies. CTs expose children to radiation, which may increase the lifetime risk of developing malignancy. US in the pediatric population with appropriate clinical follow up and serial exam may be an effective diagnostic modality for many children without incurring the risk of radiation. The objective of the study was to compare the rate of appendiceal rupture and negative appendectomies between children with and without abdominal CTs; and to evaluate the same outcomes for children with and without USs to determine if there were any associations between imaging modalities and outcomes. Methods: We conducted a retrospective chart review including emergency department (ED and inpatient records from 1/1/2009–2/31/2010 and included patients with suspected acute appendicitis. Results: 1,493 children, aged less than one year to 20 years, were identified in the ED with suspected appendicitis. These patients presented with abdominal pain who had either a surgical consult or an abdominal imaging study to evaluate for appendicitis, or were transferred from an outside hospital or primary care physician office with the stated suspicion of acute appendicitis. Of these patients, 739 were sent home following evaluation in the ED and did not return within the subsequent two weeks and were therefore presumed not to have appendicitis. A total of 754 were admitted and form the study population, of which 20% received a CT, 53% US, and 8% received both. Of these 57%, 95% CI [53.5,60.5] had pathology-proven appendicitis. Appendicitis rates were similar for children with a CT (57%, 95% CI [49.6,64.4] compared to those without (57%, 95% CI [52.9,61.0]. Children with perforation were similar between those with a CT (18%, 95% CI [12.3,23.7] and those without (13%, 95% CI [10.3,15.7]. The proportion of

  19. Diagnostic Value of White Blood Cell and C-Reactive Protein in Pediatric Appendicitis

    OpenAIRE

    Sevgi Buyukbese Sarsu; Fatma Sarac

    2016-01-01

    Background. Acute appendicitis (AA) associated with acute phase reaction is the most prevalent disease which requires emergency surgery. Its delayed diagnosis and unnecessarily performed appendectomies lead to numerous complications. In our study, we aimed to detect the role of WBC and CRP in the exclusion of acute and complicated appendicitis and diagnostic accuracy in pediatric age group. Methods. Appendectomized patient groups were constructed based on the results of histological evaluatio...

  20. Limits and advantages of abdominal ultrasonography in children with acute appendicitis syndrome

    Directory of Open Access Journals (Sweden)

    Valentina Pastore

    2014-01-01

    Full Text Available Background: Graded compression ultrasonography (US has become the most popular technique used in suspected appendicitis and in our prospective study, we have evaluated its contribution to the diagnosis of acute appendicitis during the period 2010-2013. Materials and Methods: Four hundred and eighty children underwent urgent abdominal suspected of having acute appendicitis. Patients were divided into operated groups; (220 patients and non-operated (260 patients the final diagnosis was established on histopathological findings in the first group and on the phone interview in the second one. US was the sole imaging modality in all the non-operated patients and in 203 out of 220 operated ones. Seven children in the operated group underwent CT, while a second US was performed in 10 patients. Results: Acute appendicitis was confirmed in 188 operated patients while no one in the non-operated group returned to the hospital or was operated for appendicitis. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 79%, 78%, 95%, 39% and 79%, respectively. Negative appendectomy and perforation rates were 14% and 8%. Seventeen children in the operated group required a second diagnostic imaging: 7 CTs and 10 USs. All the seven CTs were consistent with appendicitis and 6 out of 10 USs showed ecographic signs of appendicitis. Conclusion: Our results support routine US in all the children with suspected appendicitis because it helps in reducing negative appendectomy and perforation rate. Moreover, a negative US does not justify a subsequent and immediate CT because clinical re-evaluation and a second US can clarify the diagnosis.

  1. Xanthogranulomatous Appendicitis in a Child: Report of a Case and Review of the Literature

    OpenAIRE

    Al-Rawabdeh, Sura M.; Vinay Prasad; Denis R. King; Kahwash, Samir B.

    2013-01-01

    Xanthogranulomatous inflammation is a well-described inflammatory process, which may involve any organ but is most frequently encountered in the gall bladder and the kidney. There are rare reports of xanthogranulomatous appendicitis (XA) in the adult population, but only one brief mention of such a diagnosis in a child. In this report, we describe the case of an 11-year-old boy who presented with clinical signs and symptoms of acute appendicitis necessitating appendectomy. Upon microscopic ex...

  2. Abdominal computed tomography during pregnancy for suspected appendicitis: a 5-year experience at a maternity hospital.

    Science.gov (United States)

    Shetty, Mahesh K; Garrett, Nan M; Carpenter, Wendy S; Shah, Yogesh P; Roberts, Candace

    2010-02-01

    The objective of this article is to evaluate the role of computed tomography (CT) in a pregnant patient with right lower quadrant pain in whom there was a clinical suspicion of acute appendicitis. During a 5-year period the clinical records of all pregnant women who underwent imaging examination for clinically suspected appendicitis were reviewed. The imaging findings were correlated with patient management and final outcome. Thirty-nine pregnant patients were referred for imaging, of which 35 underwent initial evaluation with sonography, 23 of these women underwent a computed tomographic examination, and an additional 4 patients were directly imaged with CT without earlier sonographic assessment. Surgery confirmed appendicitis in all 5 patients who were operated on on the basis of findings of appendicitis on a CT scan. Two patients underwent surgery based on an alternate diagnosis suggested preoperatively (tubal torsion = 1, ovarian torsion = 1). All patients with negative findings at CT had an uneventful clinical course. In those patients who were evaluated only with ultrasound, a diagnosis of appendicitis was missed in 5 patients. The sensitivity of CT in the diagnosis of appendicitis in our study group was 100%, compared with a sensitivity of 46.1% for ultrasound. CT provides an accurate diagnosis in patients suspected to have acute appendicitis and is of value in avoiding false negative exploratory laparatomy with its consequent risk of maternal and fetal mortality and morbidity. Although sonography is the preferred initial imaging modality as its lack of ionizing radiation, CT is more accurate in providing a timely diagnosis and its use is justified to reduce maternal mortality and mortality in patients with appendicitis. PMID:20102691

  3. A Rare Case of Neonatal Complicated Appendicitis in a Child with Patau’s Syndrome

    OpenAIRE

    Valentina Pastore; Fabio Bartoli

    2014-01-01

    Neonatal appendicitis is a rare condition with high mortality rate. Signs and symptoms are often nonspecific, imaging modalities are not always diagnostic, and preoperative diagnosis is difficult with subsequent delay and complications. Its pathophysiology may be different from appendicitis in older children and comorbidities can be found. We report a case of a female neonate with Patau’s syndrome, intestinal malrotation, and Fallot tetralogy in whom perforated appendix, probably occurring du...

  4. Acute appendicitis in a 14-year-old boy with familial Mediterranean fever

    OpenAIRE

    Yoshihiko Sakurai; Takaaki Murata; Hirohisa Hirata; Takeshi Morita

    2015-01-01

    Familial Mediterranean fever (FMF) is one manifestation of a heritable periodic fever syndrome that is characterized by recurrent attacks of febrile polyserositis, most frequently peritonitis. An FMF abdominal attack is often misdiagnosed as acute appendicitis, a more common cause of an acute abdomen. We report a 14-year-old boy with FMF who developed acute appendicitis during his follow-up. The patient had a several-year history of abdominal pain episodes, and was initially admitted for an a...

  5. Inflammatory stricture of the right ureter following perforated appendicitis: The first Indian report.

    Science.gov (United States)

    Rajkumar, Janavikula Sankaran; Ganesh, Deepa; Rajkumar, Anirudh

    2016-01-01

    Perforated appendicitis leading to inflammatory stricture of the right ureter is a rarity. We present this fairly uncommon case of a patient who developed a stricture of the right ureter secondary to an ongoing inflammatory process in the peritoneum and retroperitoneum. A perforated appendicitis was operated upon, and on follow-up the mild hydronephrosis had worsened. Stenting of the right ureter completely solved the problem.

  6. Round ligament lipoma mimicking acute appendicitis in a 24-week pregnant female: a case report.

    Science.gov (United States)

    Miller, T J; Paulk, D G

    2013-04-01

    An exhaustive search of the literature using the Pub Med database revealed no reports of round ligament lipomas mimicking acute appendicitis in pregnant patients. There are relatively few articles on round ligament lipomas and even less on round ligament lipomas during pregnancy. This case report is on a 27-year-old 24-week pregnant female who presented with signs and symptoms similar to acute appendicitis who in fact had a large right pelvic round ligament lipoma that was causing her pain.

  7. Evaluation of a low-dose CT protocol with oral contrast for assessment of acute appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Platon, Alexandra; Jlassi, Helmi; Becker, Christoph D.; Poletti, Pierre-Alexandre [University Hospital of Geneva, Department of Radiology, Geneva 14 (Switzerland); Rutschmann, Olivier T. [University Hospital of Geneva, Emergency Center, Geneva (Switzerland); Verdun, Francis R. [University Institute for Radiation Physics, Lausanne (Switzerland); Gervaz, Pascal [University Hospital of Geneva, Clinic of Digestive Surgery, Geneva (Switzerland)

    2009-02-15

    The aim of this study was to evaluate a low-dose CT with oral contrast medium (LDCT) for the diagnosis of acute appendicitis and compare its performance with standard-dose i.v. contrast-enhanced CT (standard CT) according to patients' BMIs. Eighty-six consecutive patients admitted with suspicion of acute appendicitis underwent LDCT (30 mAs), followed by standard CT (180 mAs). Both examinations were reviewed by two experienced radiologists for direct and indirect signs of appendicitis. Clinical and surgical follow-up was considered as the reference standard. Appendicitis was confirmed by surgery in 37 (43%) of the 86 patients. Twenty-nine (34%) patients eventually had an alternative discharge diagnosis to explain their abdominal pain. Clinical and biological follow-up was uneventful in 20 (23%) patients. LDCT and standard CT had the same sensitivity (100%, 33/33) and specificity (98%, 45/46) to diagnose appendicitis in patients with a body mass index (BMI) {>=} 18.5. In slim patients (BMI < 18.5), sensitivity to diagnose appendicitis was 50% (2/4) for LDCT and 100% (4/4) for standard CT, while specificity was identical for both techniques (67%, 2/3). LDCT may play a role in the diagnostic workup of patients with a BMI {>=} 18.5. (orig.)

  8. Evaluation of a low-dose CT protocol with oral contrast for assessment of acute appendicitis

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate a low-dose CT with oral contrast medium (LDCT) for the diagnosis of acute appendicitis and compare its performance with standard-dose i.v. contrast-enhanced CT (standard CT) according to patients' BMIs. Eighty-six consecutive patients admitted with suspicion of acute appendicitis underwent LDCT (30 mAs), followed by standard CT (180 mAs). Both examinations were reviewed by two experienced radiologists for direct and indirect signs of appendicitis. Clinical and surgical follow-up was considered as the reference standard. Appendicitis was confirmed by surgery in 37 (43%) of the 86 patients. Twenty-nine (34%) patients eventually had an alternative discharge diagnosis to explain their abdominal pain. Clinical and biological follow-up was uneventful in 20 (23%) patients. LDCT and standard CT had the same sensitivity (100%, 33/33) and specificity (98%, 45/46) to diagnose appendicitis in patients with a body mass index (BMI) ≥ 18.5. In slim patients (BMI < 18.5), sensitivity to diagnose appendicitis was 50% (2/4) for LDCT and 100% (4/4) for standard CT, while specificity was identical for both techniques (67%, 2/3). LDCT may play a role in the diagnostic workup of patients with a BMI ≥ 18.5. (orig.)

  9. Correlation of serum C-reactive protein, white blood count and neutrophil percentage with histopathology findings in acute appendicitis

    OpenAIRE

    Xharra Shefki; Gashi-Luci Lumturije; Xharra Kumrije; Veselaj Fahredin; Bicaj Besnik; Sada Fatos; Krasniqi Avdyl

    2012-01-01

    Abstract Background Acute appendicitis is one of the most common surgical emergencies. Accurate diagnosis of acute appendicitis is based on careful history, physical examination, laboratory and imaging investigation. The aim of the study is to analyze the role of C-reactive protein (CRP), white blood count (WBC) and Neutrophil percentage (NP) in improving the accuracy of diagnosis of acute appendicitis and to compare it with the intraoperative assessment and histopathology findings. Materials...

  10. The Use of Delta Neutrophil Index and Myeloperoxidase Index for Predicting Acute Complicated Appendicitis in Children

    Science.gov (United States)

    Kim, Oh Hyun; Cha, Yong Sung; Hwang, Sung Oh; Jang, Ji Young; Choi, Eun Hee; Kim, Hyung Il; Cha, KyoungChul; Kim, Hyun; Lee, Kang Hyun

    2016-01-01

    Background In children with acute appendicitis, 30% to 75% present with a complication, such as perforation, and the early diagnosis of complications is known to improve outcomes. Serum delta neutrophil index (DNI) and myeloperoxidase index (MPXI) are new inflammatory markers, and thus, in the present study, the authors evaluated the predictive values of these two markers for the presence of a complication in children with acute appendicitis. Methods This retrospective observational study was conducted on 105 consecutive children (<12 years old) with acute appendicitis treated over a 31-month period. DNI, MPXI, C-reactive protein (CRP), and white blood cells (WBCs) were measured in an emergency department and investigated with respect to their abilities to predict the presence of acute complicated appendicitis. Results Twenty-nine of the 105 patients (median age, 9 years) were allocated to the complicated group (27.6%) and 76 to the non-complicated group (72.4%). Median serum DNI and CRP were significantly higher in the complicated group [0% vs. 2.2%, p<0.001 and 0.65 mg/dL vs. 8.0 mg/dL, p<0.001], but median MPXI was not (p = 0.316). Area under curve (AUC) for the ability of serum DNI and CRP to predict the presence of acute complicated appendicitis were 0.738 and 0.840, respectively. Multiple logistic regression analyses showed initial CRP [odds ratio 1.301, 95% confidence interval (1.092–1.549), p = 0.003] significantly predicted the presence of a complication. The optimal cutoff for serum CRP was 4.0 mg/dL (sensitivity 69%, specificity 83%, AUC 0.840). Conclusions Although serum DNI values were significantly higher in children with acute complicated appendicitis, no evidence was obtained to support the notion that serum DNI or serum MPXI aid the differentiation of acute complicated and non-complicated appendicitis in the ED setting. PMID:26859663

  11. EVALUATION OF HYPERBILIRUBINAEMIA AS A NEW DIAGNOSTIC MARKER FOR ACUTE APPENDICITIS AND ITS ROLE IN THE PREDICTION OF APPENDICULAR PERFORATION

    Directory of Open Access Journals (Sweden)

    Lalit Kumar Regar

    2016-07-01

    Full Text Available BACKGROUND There are various investigations recommended to diagnose acute appendicitis; however, till date there is no confirmatory laboratory marker to diagnose preoperatively acute appendicitis & appendicular perforation. The purpose of study is to evaluate hyperbilirubinaemia as a new diagnostic marker for acute appendicitis and its role in the prediction of appendicular perforation. Preoperative assessment of serum bilirubin appears to be a promising new laboratory marker for diagnosing acute appendicitis & have a predictive potential for the diagnosis of appendicular perforation. METHODS A prospective analytical study of 100 cases comprising of a non-randomised cohort. RESULTS Hyperbilirubinaemia was found in most of the patients diagnosed with acute appendicitis (68.23% or appendicular perforation (73.33%. The mean total bilirubin level in patients diagnosed with acute appendicitis was 1.34 mg% while in patients diagnosed with appendicular perforation was 2.12 mg%. CONCLUSIONS Preoperative assessment of serum bilirubin should be routinely performed in cases of acute appendicitis as it can help in diagnosis of acute appendicitis as well as also serve as an important maker of acute gangrenous appendicitis.

  12. The platelet indices in pediatric patients with acute appendicitis

    Directory of Open Access Journals (Sweden)

    Yunus Yilmaz

    2015-06-01

    Full Text Available Background: The diagnosis of Acute Appendicitis (AA remains a problem in pediatric population. It has been suggested that Mean Platelet Volume (MPV is lower in the patients with AA. The purpose of this study was to investigate the diagnostic value of platelet indices in pediatric AA cases. Methods: A retrospective case-controlled study was designed: 224 subjects were included in this study. All patients had been operated on in division of pediatric surgery at the Kars Government Hospital with the preliminary diagnosis of AA. 204 and 20 of these patients were pathologically diagnosed as AA (group 1 and normal appendix vermiformis (group 2, respectively. Platelet indices had been studied in the biochemistry laboratory of the hospital, before the surgery. Results: In group 1, platelet count, mean platelet volume, plateletcrit and platelet distribution width were 305 +/- 94x103/ and micro;L; 7.37 +/- 0.90 fL; 0,220 +/- 0.057 % and 16.3 +/- 0.5%, respectively. In group 2, platelet count, mean platelet volume, plateletcrit and platelet distribution width were 283 +/- 85 103/ and micro;L; 7.60 +/- 1.24 fL; 0.208 +/- 0.045 % and 16.4 +/- 0.7%, respectively. There was no statistically significant difference between the groups studied with regard to platelet indices (P>0.05. Conclusions: Our study showed that platelet indices have no diagnostic value in the diagnosis of AA at pediatric age group. [Int J Res Med Sci 2015; 3(6.000: 1388-1391

  13. Stump Appendicitis: An Uncompleted Surgery, a Rare but Important Entity with Potential Problems

    Directory of Open Access Journals (Sweden)

    J. A. A. Awe

    2013-01-01

    Full Text Available Appendicectomy for appendicitis is one of the commonest surgical procedures performed worldwide. The residual appendiceal stump left after an initial appendectomy risks the development of stump appendicitis. Stump appendicitis is a real recognized entity but not often considered when evaluating patients with right lower quadrant abdominal pain, especially those with past history of appendectomy. It remains a clinical challenge with the result that its diagnosis and effective treatment are often delayed with possible attendant morbidity or mortality. Stump appendicitis results from obstruction of the lumen of the remaining appendix stump, usually by a faecolith. This increases intraluminal pressure, impairing venous drainage and allowing subsequent bacterial infection. We present the case of a twenty-five (25-year-old female who underwent laparoscopic appendicectomy and presented four and half (4(1/2 months later with fever, right lower quadrant abdominal pain, and tenderness associated with repeated vomiting. Exploratory laparotomy was carried out after clinical and imaging studies which revealed big inflammatory mass with abscess at the right iliac fossa and recurrent appendicitis of the appendiceal stump. Surgical treatment is easy but recognition of this important entity but potentially dangerous condition should always be borne in mind in order to avoid delay in its diagnosis and treatment.

  14. Identical appended series of points as invariants in the collocal general-colinear fields

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    Krasić Sonja

    2003-01-01

    Full Text Available In order to bring the collocal collinear fields from the general into the perspective position, it is required to determine the identical appended series of points. Because of the properties depending on the projectivity that is given by the four appended points (straight lines the appended identical series of the points and types are ranked among the invariants of general-collinear and perspectively-collinear fields. The procedure of determination of appended identical series of points is comprised of the following: in the set of ∞1 of perspectively similar series in one field (whose center of perspective is a point on the vanishing line, find those that are identical to all the series in the set ∞1 of perspective identical series of points in the other field (whose center of perspective is the point on the infinitely distant straight line. In the procedure, one begins from the appended similar methods obtained by the general method. The procedure is simplified by the introduction of the specially given similar series of points.

  15. Acute appendicitis in preschoolers: a study of two different populations of children

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    Sivridis Efthimios

    2011-07-01

    Full Text Available Abstract Objective To assess the incidence and the risk factors implicated in acute appendicitis in preschoolers in our region. Methods Over a 7-year period, 352 children underwent appendectomy for suspected acute appendicitis. Of these, data for 23 children were excluded because no inflammation of the appendix was found on subsequent histology. Of the remaining 329, 82 were ≤ 5 years old (i.e., preschool children and 247 were 5-14 years old. These two groups of children were further divided according to their religion into Muslims and Christian Orthodox: 43 of the children aged ≤ 5 years were Muslims and 39 were Christian Orthodox. A household questionnaire was designed to collect data concerning age, gender, type of residence area, living conditions, vegetable consumption, and family history of surgery for acute appendicitis as preschool children. The removed appendices were also assessed histologically for the amount of lymphoid tissue. Results Acute appendicitis of preschoolers developed more frequently in Muslims (39.4% than in Christians (17.7%; p p p > 0.05. Conclusions In our region, the percentage of preschool-aged Muslim children with acute appendicitis was remarkably high. One possible explanation for this finding could be the higher amount of lymphoid tissue in the wall of the appendix in Muslim preschool children together with their low standard of hygiene.

  16. Does adding an appended oncology module to the Global Trigger Tool increase its value?

    DEFF Research Database (Denmark)

    Mattsson, Thea Otto; Knudsen, Janne Lehmann; Brixen, Kim;

    2014-01-01

    OBJECTIVE: To determine any additional value in the evaluation of safety levels by adding an appended oncology module to the Institute for Healthcare Improvement's Global Trigger Tool (GTT). DESIGN: Comparison of two independent retrospective chart reviews: one review team using the general GTT...... method and one using the general GTT method plus the appended oncology module on the same inpatient charts. SETTING: The Department of Clinical Oncology at a Danish University Hospital (1000 beds). PARTICIPANTS: All inpatients admitted to the hospital in 2010, n = 3692, biweekly sample of 10 admission...... per 1000 admission days. RESULTS: No significant (95% confidence interval) difference was found between review teams using the general GTT versus the general GTT plus the appended oncology module on the total number of identified AEs, AEs per 100 admissions, AEs per 1000 admission days...

  17. Clinical significance of elevated serum and urine amylase levels in patients with appendicitis.

    Science.gov (United States)

    Swensson, E E; Maull, K I

    1981-12-01

    During the 45 month period beginning January 1977, 251 patients with a pathologically confirmed diagnosis of acute appendicitis underwent celiotomy at the Medical College of Virginia Hospital. A preoperative serum or urine amylase determination was recorded in 155 of the patients (62 percent). Of this group, 15 patients (10 percent) had elevation of serum amylase or 2 hour urine amylase. Hyperamylasemia or hyperamylasuria directly led to misdiagnosis or treatment delay in 5 of the 15 patients. Appendiceal rupture occurred in three patients, two of whom had prolonged (greater than 1 month) hospitalizations directly attributable to the misdiagnosis. As a result of this study, we conclude that (1) acute appendicitis and elevated amylase levels may occur concurrently, (2) hyperamylasemia or hyperamylasuria should not dissuade the surgeon from early operation if other clinical features suggest appendicitis, and (3) abdominal pain and elevation of amylase level define significant intraabdominal disease, not specifically pancreatic disease.

  18. Mucosal invasion by fusobacteria is a common feature of acute appendicitis in Germany, Russia, and China

    Directory of Open Access Journals (Sweden)

    Alexander Swidsinski

    2012-01-01

    Full Text Available Background/Aim: To investigate the geographic occurrence of mucosa-invading Fusobacteria in acute appendicitis. Patients and Methods: Carnoy- and formalin-fixated appendices from Germany, Russia, and China were comparatively investigated. Bacteria were detected using fluorescent in situ hybridization. Cecal biopsies from patients with inflammatory bowel disease and other conditions were used as disease controls. Results: Fusobacteria represented mainly by Fusobacterium nucleatum were the major invasive component in bacterial infiltrates in acute appendicitis but were completely absent in controls. The occurrence of invasive Fusobacteria in Germany, Russia, and China was the same. The detection rate in Carnoy-fixated material was 70-71% and in formalin-fixated material was 30-36%. Conclusions: Acute appendicitis is a polymicrobial infectious disease in which F. nucleatum and other Fusobacteria play a key role.

  19. Clinical significance of elevated serum and urine amylase levels in patients with appendicitis.

    Science.gov (United States)

    Swensson, E E; Maull, K I

    1981-12-01

    During the 45 month period beginning January 1977, 251 patients with a pathologically confirmed diagnosis of acute appendicitis underwent celiotomy at the Medical College of Virginia Hospital. A preoperative serum or urine amylase determination was recorded in 155 of the patients (62 percent). Of this group, 15 patients (10 percent) had elevation of serum amylase or 2 hour urine amylase. Hyperamylasemia or hyperamylasuria directly led to misdiagnosis or treatment delay in 5 of the 15 patients. Appendiceal rupture occurred in three patients, two of whom had prolonged (greater than 1 month) hospitalizations directly attributable to the misdiagnosis. As a result of this study, we conclude that (1) acute appendicitis and elevated amylase levels may occur concurrently, (2) hyperamylasemia or hyperamylasuria should not dissuade the surgeon from early operation if other clinical features suggest appendicitis, and (3) abdominal pain and elevation of amylase level define significant intraabdominal disease, not specifically pancreatic disease. PMID:6172043

  20. Transumbilical Laparoscopic-Assisted Appendectomy in the Treatment of Acute Uncomplicated Appendicitis in Children

    Directory of Open Access Journals (Sweden)

    Carmine Noviello

    2015-01-01

    Full Text Available Transumbilical laparoscopic-assisted appendectomy (TULAA is increasingly being performed worldwide. The authors report their experience in the treatment of acute uncomplicated appendicitis in children with TULAA. From January 2008 to December 2012 all types of acute appendicitis were divided, according to the clinical and ultrasonographic findings, into complicated (appendiceal mass/abscess, diffuse peritonitis and uncomplicated. Complicated appendicitis was treated by open appendectomy (OA. All patients with the suspicion of uncomplicated appendicitis were offered TULAA by all surgeons of the team. Conversion to open or laparoscopic appendectomy (LA was performed in case of impossibility to complete TULAA, depending on the choice of surgeon. The histopathologic examination of appendix was always performed. 444 children (252 males with acute appendicitis were treated. The mean age was 9.2 years (range, 2 to 14 years. Primary OA was performed in 144 cases. In 300 patients a transumbilical laparoscopic-assisted approach was performed. TULAA was completed in 252 patients. Conversion to OA was performed in 45 patients and to LA in 3. Conversion was related to the impossibility to adequately expose the appendix in 47 patients and bleeding in 1. The mean operative time for TULAA was 42 minutes. Histopathologic examination of the appendix removed by TULAA showed a phlegmonous/gangrenous type in 92.8% of cases. Among the 252 TULAA there were 11 cases of umbilical wound infection. TULAA is a feasible and effective procedure for uncomplicated appendicitis in children. It combines the advantages of open and laparoscopic technique (low operative time, low complications rate, and excellent cosmetic results.

  1. Extra-appendiceal findings in pediatric abdominal CT for suspected appendicitis

    International Nuclear Information System (INIS)

    Much has been written regarding the incidence, types, importance and management of abdominal CT incidental findings in adults, but there is a paucity of literature on incidental findings in children. We sought to determine the prevalence and characteristics of extra-appendiceal and incidental findings in pediatric abdominal CT performed for suspected appendicitis. A retrospective review was performed of abdominal CT for suspected appendicitis in a pediatric emergency department from July 2010 to June 2012. Extra-appendiceal findings were recorded. Any subsequent imaging was noted. Extra-appendiceal findings were divided into incidental findings of doubtful clinical significance, alternative diagnostic findings potentially providing a diagnosis other than appendicitis explaining the symptoms, and incidental findings that were abnormalities requiring clinical correlation and sometimes requiring further evaluation but not likely related to the patient symptoms. One hundred sixty-five children had abdominal CT for suspected appendicitis. Seventy-seven extra-appendiceal findings were found in 57 (34.5%) patients. Most findings (64 of 77) were discovered in children who did not have appendicitis. Forty-one of these findings (53%) could potentially help explain the patient's symptoms, while 30 of the findings (39%) were abnormalities that were unlikely to be related to the symptoms but required clinical correlation and sometimes further work-up. Six of the findings (8%) had doubtful or no clinical significance. Extra-appendiceal findings are common in children who undergo abdominal CT in the setting of suspected appendicitis. A significant percentage of these patients have findings that help explain their symptoms. Knowledge of the types and prevalence of these findings may help radiologists in the planning and interpretation of CT examinations in this patient population. (orig.)

  2. Case report of idiopathic cecal perforation presenting as acute appendicitis on ultrasound

    Directory of Open Access Journals (Sweden)

    Calista Harbaugh

    2016-08-01

    Full Text Available Cecal perforation is an uncommon phenomenon in a pediatric population. It has been linked to a number of underlying medical conditions, which may result in focal inflammation or relative ischemia including hematologic malignancy, infection, and inflammatory bowel disease. We present an otherwise healthy 16-year-old male diagnosed with acute uncomplicated appendicitis on ultrasound, who was found to have cecal perforation with normal appendix intraoperatively, ultimately requiring ileocectomy. With this report, we aim to present the numerous pathophysiologic etiologies of cecal perforation, and to promote a comprehensive differential diagnosis despite the clinical and radiologic findings consistent with uncomplicated appendicitis.

  3. Synchronous presentation of acute acalculous cholecystitis and appendicitis: a case report

    LENUS (Irish Health Repository)

    Sahebally, Shaheel M

    2011-11-14

    Abstract Introduction Acute acalculous cholecystitis is traditionally associated with elderly or critically ill patients. Case presentation We present the case of an otherwise healthy 23-year-old Caucasian man who presented with acute right-sided abdominal pain. An ultrasound examination revealed evidence of acute acalculous cholecystitis. A laparoscopy was undertaken and the dual pathologies of acute acalculous cholecystitis and acute appendicitis were discovered and a laparoscopic cholecystectomy and appendectomy were performed. Conclusion Acute acalculous cholecystitis is a rare clinical entity in young, healthy patients and this report describes the unusual association of acute acalculous cholecystitis and appendicitis. A single stage combined laparoscopic appendectomy and cholecystectomy is an effective treatment modality.

  4. Diagnostic Performance on Low Dose Computed Tomography For Acute Appendicitis Among Attending and Resident Radiologists

    Directory of Open Access Journals (Sweden)

    Chang

    2016-01-01

    Full Text Available Background Low-dose computed tomography (LDCT techniques can reduce exposure to radiation. Several previous studies have shown that radiation dose reduction in LDCT does not decrease the diagnostic performance for appendicitis among attending radiologists. But, the LDCT diagnostic performance for acute appendicitis in radiology residents with variable training levels has not been well discussed. Objectives To compare inter-observer and intra-observer differences of diagnostic performance on non-enhanced LDCT (NE-LDCT and contrast-enhanced standard dose CT (CE-SDCT for acute appendicitis among attending and resident radiologists. Patients and Methods This retrospective study included 101 patients with suspected acute appendicitis who underwent NE-LDCT and CE-SDCT. The CT examinations were interpreted and recorded on a five-point scale independently by three attending radiologists and three residents with 4, 1 and 1 years of training. Diagnostic performance for acute appendicitis of all readers on both examinations was represented by area under receiver operating characteristic (ROC curves. Inter-observer and intra-observer AUC values were compared using Jackknife FROC software on both modalities. The diagnostic accuracy of each reader on NE-LDCT was compared with body mass index (BMI subgroups and noise using independent T test. Results Diagnostic performances for acute appendicitis were not statistically different for attending radiologists at both examinations. Better performance was noted on the CE-SDCT with a borderline significant difference (P = 0.05 for senior radiology resident. No statistical difference of AUC values was observed between attending radiologists and fourth year resident on both examinations. Statistically significant differences of AUC values were observed between attending radiologists and first year residents (P = 0.001 ~ 0.018 on NE-LDCT. Diagnostic accuracies of acute appendicitis on NE-LDCT for each reader were not

  5. Acute appendicitis in acute leukemia and the potential role of decitabine in the critically ill patient

    Directory of Open Access Journals (Sweden)

    Deepti Warad

    2015-01-01

    Full Text Available Acute appendicitis in children with acute leukemia is uncommon and often recognized late. Immunocompromised host state coupled with the importance of avoiding treatment delays makes management additionally challenging. Leukemic infiltration of the appendix though rare must also be considered. Although successful conservative management has been reported, surgical intervention is required in most cases. We present our experience with acute appendicitis in children with acute leukemia and a case of complete remission of acute myeloid leukemia with a short course of decitabine. Decitabine may serve as bridging therapy in critically ill patients who are unable to undergo intensive chemotherapy.

  6. Synthesis, characterization and self-assembly of Co3+ complexes appended with phenol and catechol groups

    Indian Academy of Sciences (India)

    Afsar Ali; Deepak Bansal; Rajeev Gupt

    2014-09-01

    This work presents the syntheses, characterization and hydrogen bonding based self-assembly of Co3+ complexes of pyridine-amide based bidentate ligands containing appended phenol and catechol groups. Placement of multiple hydrogen bond donors (phenolic OH and amidic NH groups) and acceptors (Oamide groups) in these molecules results in interesting self-assembled architectures.

  7. Assessing Murphy Sequence as a Clinical Element in Acute Appendicitis Diagnosis

    Directory of Open Access Journals (Sweden)

    Andy Rocha Quintana

    2011-04-01

    Full Text Available Background: at present, the presence or lack of agreement between clinical diagnosis and evidence when exploring the abdominal cavity and performing excision of the pathological piece in cases of acute appendicitis, has become an increasingly contested issue. Objective: to characterize the presentation of Murphy Sequence in patients who underwent acute appendicitis surgery. Methods: descriptive study on a case series of patients who underwent acute appendicitis surgery in the General University Hospital of Cienfuegos between March and September 2006. Variables analyzed: age, sex, skin color, evolution duration and order of appearance of symptoms, presentation of Murphy Sequence, complementary tests and pathological diagnosis. Results: the average age for cases where Murphy Sequence was not presented was 34 years old, predominantly brown skinned males. The sequence was not completed in 96, 8% of cases, mainly those found in catarrhal stage. Laparoscopy was not performed in 69.7% of patients and, within this group, 97.7% of patients did not complete the sequence. In 51.9% of the cases, the first symptom was epigastric pain that then moved to the right iliac fossa. A broad spectrum of values of white blood cells was found in cases of catarrhal appendicitis. Conclusions: in 96.8% of cases Murphy Sequence was absent. Even in cases of long evolutions, these symptoms were not related to the disease stages.

  8. Geographic disparities in the risk of perforated appendicitis among children in Ohio: 2001–2003

    Directory of Open Access Journals (Sweden)

    Nwomeh Benedict C

    2008-11-01

    Full Text Available Abstract Background Rural-urban disparities in health and healthcare are often attributed to differences in geographic access to care and health seeking behavior. Less is known about the differences between rural locations in health care seeking and outcomes. This study examines how commuting patterns in different rural areas are associated with perforated appendicitis. Results Controlling for age, sex, insurance type, comorbid conditions, socioeconomic status, appendectomy rates, hospital type, and hospital location, we found that patient residence in a rural ZIP code with significant levels of commuting to metropolitan areas was associated with higher risk of perforation compared to residence in rural areas with commuting to smaller urban clusters. The former group was more likely to seek care in an urbanized area, and was more likely to receive care in a Children's Hospital. Conclusion To our knowledge, this is the first study to differentiate rural dwellers with respect to outcomes associated with appendicitis as opposed to simply comparing "rural" to "urban". Risk of perforated appendicitis associated with commuting patterns is larger than that posed by several individual indicators including some age-sex cohort effects. Future studies linking the activity spaces of rural dwellers to individual patterns of seeking care will further our understanding of perforated appendicitis and ambulatory care sensitive conditions in general.

  9. Drainage Systems Effect on Surgical Site Infection in Children with Perforated Appendicitis

    Directory of Open Access Journals (Sweden)

    Seref Kilic

    2014-12-01

    Full Text Available Aim: Effect of replacing open drainage system to closed drainage system on surgical site infection (SSI in children operated for perforated appendicitis was evaluated. Material and Method: Hospital files and computer records of perforated appendicitis cases operated in 2004-2010 were evaluated retrospectively. Open drainage systems were used for 70 in cases (group I and closed systems were used in the others (group II. Results: Eleven of SSI cases had superficial infection and 3 had the organ/space infection. SSI rate was 15.7% for group I and 7.5% for the group II. The antibiotic treatment length was 7.5 ± 3.4 days for group I and 6.4 ± 2.2 days for group II and the difference between groups was not statistically significant. Hospitalization length for group I was 8.2 ± 3.1 days and 6.8 ± 1.9 days for group II and the difference was statistically significant. Discussion: SSI is an important problem increasing morbidity and treatment costs through increasing hospitalization and antibiotic treatment length. Open drainage system used in operation in patients with perforated appendicitis leads an increased frequency of SSI when compared to the closed drainage system. Thus, closed drainage systems should be preferred in when drainage is necessary in operations for perforated appendicitis in children.

  10. The impact of diagnostic delay on the course of acute appendicitis

    NARCIS (Netherlands)

    V.C. Cappendijk; F.W.J. Hazebroek (Frans)

    2000-01-01

    textabstractBACKGROUND: The diagnosis of acute appendicitis is often delayed, which may complicate the further course of the disease. AIMS: To review appendectomy cases in order to determine the incidence of diagnostic delay, the underlying factors, and impact on the co

  11. How to improve the clinical diagnosis of acute appendicitis in resource limited settings.

    Science.gov (United States)

    Alvarado, Alfredo

    2016-01-01

    This article is a general review of the diagnostic tools that the clinician can use for the early diagnosis of acute appendicitis with emphasis on the Alvarado Score, and it is aimed principally to the medical practitioners in different parts of the world where the diagnostic facilities and technological resources are limited.

  12. Influence of delays on perforation risk in adults with acute appendicitis.

    LENUS (Irish Health Repository)

    Kearney, D

    2012-02-03

    PURPOSE: This study analyzed whether prehospital or in-hospital delay was the more significant influence on perforation rates for acute appendicitis and whether any clinical feature designated patients requiring higher surgical priority. METHODS: A retrospective analysis was conducted over one year at a tertiary referral hospital without a dedicated emergency surgical theater. Admission notes, theater logbook, and the Hospital Inpatient Enquiry system were reviewed to identify the characteristics and clinical course of patients aged greater than 16 years who were operated upon for histologically confirmed acute appendicitis. RESULTS: One hundred and fifteen patients were studied. The overall perforation rate was 17 percent. The mean duration of symptoms prior to hospital presentation was 38.1 hours with the mean in-hospital waiting time prior to operation being 23.4 hours. Although body temperature on presentation was significantly greater in patients found to have perforated appendicitis (P < 0.05), only patient heart rate at presentation and overall duration of symptoms, but not in-hospital waiting time, independently predicted perforation by stepwise linear regression modeling. CONCLUSION: In-hospital delay was not an independent predictor of perforation in adults with acute appendicitis although delays may contribute if patients are left to wait unduly. Tachycardia at presentation may be a quantifiable feature of those more likely to have perforation and who should be given higher surgical priority.

  13. Mesenteric teratoma associated with acute perforated appendicitis in a 2-year-old girl

    Directory of Open Access Journals (Sweden)

    Jihoon Jang

    2016-07-01

    Full Text Available Mesenteric teratoma is a rare tumor, with few cases reported in the literature. Because mesenteric teratomas have no specific signs or symptoms, their clinical manifestations depend on their size and location. This report describes a mesenteric teratoma associated with acute perforated appendicitis in a 2-year-old girl who presented with abdominal pain and high grade fever.

  14. Interleukin 6 and lipopolysaccharide binding protein - markers of inflammation in acute appendicitis.

    Science.gov (United States)

    Brănescu, C; Serban, D; Dascălu, A M; Oprescu, S M; Savlovschi, C

    2013-01-01

    The rate of incidence of acute appendicitis is 12% in the case of male patients and 25% in case of women, which represents about 7% of the world population. The appendectomy rate has remained constant (i.e. 10 out of 10,000 patients per year). Appendicitis most often occurs in patients aged between 11-40 years, on the threshold between the third and fourth decades, the average age being 31.3 years. Since the first appendectomy performed by Claudius Amyand (1681/6 -1740), on December, 6th, 1735 to our days, i.e., 270 years later, time has confirmed the efficiency of both the therapy method and the surgical solution. The surgical cure in case of acute appendicitis has proved to be acceptable within the most widely practised techniques in general surgery. The variety of clinical forms has reached all age ranges, which in its turn has resulted in a large number of semiotic signs. In the case of acute appendicitis, interdisciplinarity has allowed the transfer of concept and methodology transfer among many areas of expertise, aimed at a better, minute understanding of the inflammatory event itself. Acute appendicitis illustrates inflammation development at digestive level and provides for a diagnostic and paraclinical exploration which continually upgrades. The recent inclusion in the studies of the Lipopolysaccharide binding protein (LBP)- type inflammation markers has laid the foundation of the latter's documented presence in the case of acute appendicitis-related inflammation. Proof of the correlation between the histopathological, clinical and evolutive forms can be found by identifying and quantifying these inflammation markers. The importance of studying inflammation markers allows us to conduct studies going beyond the prognosis of the various stages in which these markers were identified. The present article shows the results of a 1-year monitoring of the inflammation markers' values for Interleukin-6 and Lipopolysaccharide binding protein (LBP)-types, both pre

  15. Hyperbilirubinaemia a predictive factor for complicated acute appendicitis: a study in a tertiary care hospital

    International Nuclear Information System (INIS)

    Objective: To study the role of hyperbilirubinaemia as a predictive factor for appendiceal perforation in acute appendicitis. Methods: The prospective, descriptive study was conducted at the Abbasi Shaheed Hospital and the Karachi Medical and Dental College, Karachi, from January 2010 to June 2012. It comprised all patients coming to the surgical outpatient department and emergency department with pain in the right iliac fossa with duration less than seven days. They were clinically assessed for signs and symptoms of acute appendicitis and relevant tests were conducted. Patients were diagnosed as a case of acute appendicitis on the basis of clinical and ultrasound findings, and were prepared for appendicectomy. Per-operative findings were recorded and specimens were sent for histopathology to confirm the diagnosis. SPSS version 10 was used to analyse the data. Results: Of the 71 patients, 37 (52.10%) were male and 34 (47.90%) were female. The age range was 3-57 years, and most of the patients (n=33; 46.5%) were between 11 and 20 years. Besides, 63 (89%) patients had pain in the right iliac fossa of less than four-days duration, while 8 (11%) had pain of longer duration. Total leukocyte count was found to be elevated in 33 (46.5%) patients, while total serum bilirubin was elevated in 41 (57.70%). Ultrasound of abdomen showed 9 (12.70%) patients having normal appearance of appendix and 59 (83.30%) had inflamed appendix. Four (5.60%) patients had no signs of inflammation on naked eye appearance per operatively. Histopathology of appendix showed 10 (14.10%) patients had non-inflammatory appendix. Conclusion: Patients with signs and symptoms of acute appendicitis and a raised total serum bilirubin level indicated a complication of acute appendicitis requiring an early intervention to prevent peritonitis and septicaemia. A raised serum bilirubin level is a good indicator of complicated acute appendicitis, and should be included in the assessment of patients with

  16. Total leucocyte count, C-reactive protein and neutrophil count: Diagnostic Aid in acute appendicitis

    Directory of Open Access Journals (Sweden)

    Shafi Sheikh

    2009-01-01

    Full Text Available Background/Aim: Acute appendicitis is one of the most common acute intraabdominal affections seen in surgical departments, which can be treated easily if an accurate diagnosis is made in time. Otherwise, delay in diagnosis and treatment can lead to diffuse peritonitis. Materials and Methods: A study was conducted on 110 patients who were operated for acute appendicitis to determine the role and predictive value of the total leucocyte count (TLC, C-reactive protein (CRP and percentage of neutrophil count in the diagnosis of acute appendicitis. Preoperative TLC, CRP and percentage of neutrophil count were determined and were compared with the results of the histopathology of the removed appendix. Results: Of all the patients studied, 92 had histopathologically positive appendicitis. The TLC was found to be significantly high in 90 patients who proved to have acute appendicitis, whereas CRP was high in only 88 patients and neutrophil percentage was raised in 91; four had a normal CRP level. Thus, TLC had a sensitivity, specificity and positive predictive value of 97.82%, 55.55% and 91.8%, respectively. CRP had a sensitivity, specificity and positive predictive value of 95.6%, 77.77% and 95.6% respectively. Percentage of neutrophil count had a sensitivity, specificity and positive predictive value of 98.9%, 38.88% and 89.21%, respectively. When used in combination, there was a marked improvement in the specificity and the positive predictive value to 88.04% and 98.7%, respectively. Conclusion: The inflammatory markers, i.e., TLC, CRP and neutrophil count can be helpful in the diagnosis when measured together as this increases their specificity and positive predictive value.

  17. Role of drains in laparoscopic appendectomy for complicated appendicitis at a busy county hospital.

    Science.gov (United States)

    Pakula, Andrea M; Skinner, Ruby; Jones, Amber; Chung, Ray; Martin, Maureen

    2014-10-01

    Laparoscopic appendectomy (LA) has become the treatment of choice for acute appendicitis with equal or better outcomes than traditional open appendectomy (OA). LA in patients with a gangrenous or perforated appendicitis carries increased rate of pelvic abscess formation when compared with OA. We hypothesized routine placement of pelvic drains in gangrenous or perforated appendicitis decreases pelvic abscess formation after LA. Three hundred thirty-one patients undergoing LA between January 2007 and June 2011 were reviewed. Patients with perforated or gangrenous appendicitis were included. Group I had a Jackson-Pratt (JP) drain(s) placed and Group II had no JP drain. Data included patient demographics, emergency department laboratory values and vital signs, and computed axial tomography scan findings, intra-abdominal or pelvic abscess postoperatively, interventional radiology drainage, and length of stay. Clinic follow-up notes were reviewed. One hundred forty-eight patients were identified. Forty-three patients had placement of JP drains (Group I) and 105 patients had no JP drain (Group II). Three patients (three of 43 [6%]) in Group I developed pelvic abscess and 21 of 105 (20%) patients in Group II developed pelvic abscesses requiring subsequent drainage. This was statistically significant. Patient demographics, temperature, and mean white blood count before surgery were similar. Presurgery computed tomography (CT) with appendicolith and CT with abscess were more prevalent in Group I. The use of JP drainage in patients with perforated or gangrenous appendicitis during LA has decreased rates of pelvic abscess. This was demonstrated despite the drain group having appendicolith or abscess on preoperative CT. PMID:25264664

  18. A study of the usefulness of CT in diagnosis of diverticulitis of the right colon and acute appendicitis

    International Nuclear Information System (INIS)

    It is difficult to differentiate between diverticulitis of the right colon and acute appendicitis based on pathological and hematological findings. This study was designed to investigate the usefulness of CT in differentiation between the both diseases and indications of operation. Eight cases of right colon diverticulitis and 39 cases of acute appendicitis undergone abdominal plain CT scan before surgery were enrolled in the study. As for diverticulitis cases, diverticulum was visualized on abdominal CT scan in seven (87.5%) out of the eight cases. Of 39 cases of acute appendicitis, the appendix vermiformis was able to be visualized on abdominal CT scan in 26 (66.7%) cases. Some correlations between CT findings and postoperative pathological diagnosis of appendicitis were observed. A comparison was made on acute appendicitis cases by dividing them into two groups; namely, the non-surgery group comprising of cases pathologically diagnosed as non-inflammatory and catarrhal' and the surgery group comprising of cases diagnosed as 'phlegmonous and gangrenous' after surgery. Statistically significant difference was noted between both groups in two factors, whole-circumferential thickening of the appendiceal wall and fading panniculus adiposus around the appendix. It is concluded that abdominal CT scan is useful for differential diagnosis between right colon diverticulitis and acute appendicitis, and further that CT diagnosis of acute appendicitis well reflects the severity of the disease and contribute to decide indication of operation. (author)

  19. Improving the Hadoop Map/Reduce Framework to Support Concurrent Appends through the BlobSeer BLOB management system

    OpenAIRE

    Moise, Diana; Antoniu, Gabriel; Bougé, Luc

    2010-01-01

    Hadoop is a reference software framework supporting the Map/Reduce programming model. It relies on the Hadoop Distributed File System (HDFS) as its primary storage system. Although HDFS does not offer support for concurrently appending data to existing files, we argue that Map/Reduce applications as well as other classes of applications can benefit from such a functionality. We provide support for concurrent appends by building a concurrency-optimized data storage layer based on the BlobSeer ...

  20. Imaging of acute appendicitis in children: EU versus U.S.... or US versus CT? A North American perspective

    International Nuclear Information System (INIS)

    The timing, type, and technique of imaging evaluation of suspected appendicitis in children are all debated. This debate is both local and international. The fact is that choices in imaging evaluation will depend on both local and national influences, which are reasonable and to be expected. There still is a responsibility, though, for those involved with evaluation of patients with possible appendicitis to come to agreement about an appropriate diagnostic pathway that considers standards of care and available resources. (orig.)

  1. Acute Appendicitis in a Man Undergoing Therapy for Mantle Cell Lymphoma

    Directory of Open Access Journals (Sweden)

    Michael Linden

    2012-01-01

    Full Text Available A 71-year-old man was diagnosed with an aggressive mantle cell lymphoma and was started on six cycles of R-CHOP chemotherapy. Approximately two weeks after starting his first cycle of chemotherapy, he complained of severe right lower quadrant abdominal pain, and an abdominal CT scan demonstrated an enlarged appendix with evidence of contained perforation. The man underwent open appendectomy for acute appendicitis and recovered. The appendectomy specimen was submitted for routine pathological analysis. There was histologic evidence of perforation in association with an inflammatory infiltrate with fibrin adhered to the serosal surface; scattered small lymphoid aggregates were present on the mucosal surface. Although the lymphoid aggregates in the submucosa and lamina propria were rather unremarkable by routine histologic examination, immunohistochemistry revealed the lymphocytes to be predominantly Cyclin D1-overexpressing B cells. To our knowledge, this is the first reported case of acute appendicitis in association with appendiceal involvement by mantle cell lymphoma.

  2. An atypical clinical presentation of acute appendicitis in a young man with midgut malrotation

    Energy Technology Data Exchange (ETDEWEB)

    Pinto, Antonio [Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Piazza delle Cliniche no 2, 90127 Palermo (Italy)]. E-mail: pinto@neomedia.it; Di Raimondo, Domenico [Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Piazza delle Cliniche no 2, 90127 Palermo (Italy); Tuttolomondo, Antonino [Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Piazza delle Cliniche no 2, 90127 Palermo (Italy); Fernandez, Paola [Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Piazza delle Cliniche no 2, 90127 Palermo (Italy); Caronia, Aurelio [Dipartimento di Biotecnologie Mediche - Sezione di Radiologia, University of Palermo, Via del Vespro no 129, 90127 Palermo (Italy); Lagalla, Roberto [Dipartimento di Biotecnologie Mediche - Sezione di Radiologia, University of Palermo, Via del Vespro no 129, 90127 Palermo (Italy); Arnao, Valentina [Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Piazza delle Cliniche no 2, 90127 Palermo (Italy); Law, Robert L. [Department of Radiology, Frenchay Hospital, Bristol (United Kingdom); Licata, Giuseppe [Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Piazza delle Cliniche no 2, 90127 Palermo (Italy)

    2007-05-15

    Midgut malrotation occurs as a result of failure in normal intestinal rotation and fixation during early pregnancy. Pathological conditions reported in the literature involving midgut malrotation predominantly relate to infants and children. In adults malrotation is often revealed as an incidental finding on computed tomography (CT), or the associated altered anatomy can be the cause of atypical clinical symptoms of relatively common intestinal disorders. An unusual presentation of acute appendicitis, with fever and recurrent pain in left iliac fossa is reported. Underlying intestinal malrotation delayed the correct clinical diagnosis of acute appendicitis. It was not until a CT scan was performed that a malrotation was identified. The predominant appearances of malrotation are the siting of the ascending colon, caecum (and appendix) in the left side of the abdomen and the right-sided placement of the duodenojejunal junction.

  3. Clinico-pathological study of appendicitis in a tertiary centre in Vindhya region, Madhya Pradesh, India

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    Priyank Sharma

    2016-07-01

    Conclusions: In this study we found that clinical score is a simple, rapid and non-invasive method to early diagnosis of appendicitis. TLC are inflammatory marker are also useful in early diagnosis of acute appendicitis. Ultrasound abdomen is also useful to confirm the diagnosis. The majority of our patients presented early disease. Conservative approach of treatment gave positive response and then we planned for elective appendectomy after regular interval. Because of these negative appendectomy rate are decreasing and morbidity period are also decreasing pre or post appendectomy. There was much less post-operative complication, which were higher in emergency appendectomy. In our study we concluded that timely intervention reduce the negative appendectomy and reduce the length of morbidity. [Int J Res Med Sci 2016; 4(7.000: 2914-2920

  4. Teníase: uma causa rara de apendicite aguda Taeniasis: a rare cause of acute appendicitis

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    Fábio Vieira Teixeira

    2008-02-01

    Full Text Available Acute appendicitis is the most common surgical condition of acute abdomen. Approximately 7 percent of the population will have appendicitis during their lifetime, with the peak incidence occurring between 10 through 30 years-old. Obstruction of the appendix lumen with subsequent bacterial infection initiates the pathophysiological sequence of acute appendicitis. Obstruction may have multiple causes, including fecalith, lymphoid hyperplasia (related to viral illnesses, including upper respiratory infection, mononucleosis, and gastroenteritis, foreign bodies, carcinoid tumor, and parasites. In Asia, Africa and Latin America, Enterobius vermicularis has been reported as the main parasite that causes appendix obstruction. Rarely, Taenia sp., has been pointed as a cause of parasitic appendicitis. We reported a 30 years-old patient clinically diagnosed with acute appendicitis. The appendectomy was performed through a McBurney incision. The patient's convalescence was uneventful, and he was discharged from hospital 48 hours after operation. Histological examination of the appendix showed acute appendicitis, and it was found a parasite (Taenia sp. lying inside of the appendix lumen at a transverse section. He has received 10 mg/Kg weight of praziquantel for taeniasis treatment.

  5. The value of pancreatic stone protein in predicting acute appendicitis in patients presenting at the emergency department with abdominal pain

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    Tschuor Christoph

    2012-10-01

    Full Text Available Abstract Background Pancreatic Stone Protein (PSP is a protein naturally produced mainly in the pancreas and the gut. There is evidence from experimental and clinical trials that blood PSP levels rise in the presence of inflammation or infection. However, it is not known whether PSP is superior to other established blood tests (e.g. White Blood Count, Neutrophils or C - reactive protein in predicting appendicitis in patients presenting with abdominal pain and a clinical suspicion of appendicitis at the emergency room. Methods/design The PSP Appendix Trial is a prospective, multi-center, cohort study to assess the value of PSP in the diagnostic workup of acute appendicitis. 245 patients will be prospectively recruited. Interim analysis will be performed once 123 patients are recruited. The primary endpoint of the study concerns the diagnostic accuracy of PSP in predicting acute appendicitis and therefore the evidence of appendicitis on the histopathological specimen after appendectomy. Discussion The PSP Appendix Trial is a prospective, multi-center, cohort study to assess the value of PSP in the diagnostic workup of acute appendicitis. Trial registration ClinicalTrials.gov: NCT01610193; Institution Ethical Board Approval ID: KEKZH- Nr. 2011–0501

  6. Suspected appendicitis during pregnancy: prevalence and management at prince Hashem Ben AL-Hussein Hospital (Zarqa/Jordan

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    Hasan Al-Dahamsheh

    2012-09-01

    Full Text Available To evaluate the clinical picture and outcome of suspected appendicitis in pregnant women. Retrospective analytic study of 28 appendectomies performed during pregnancy for suspected appendicitis in our hospital at period April 2004 to September 2006. All files and medical records of these patients were analyzed and studied. Those including variables (demographic, clinical, laboratory and surgical outcomes data were collected retrospectively. Prevalence of appendicitis was calculated from the total number of deliveries and abortions that occurred during this period. Numbers of correct and wrong diagnosis were reported and comparison of perinatal outcome, maternal morbidity and different variables in negative and positive laparotomies performed. The prevalence of suspected appendicitis in pregnancy is 0.29%. Incidences of negative laparotomies were 36%. The most diagnostic findings for acute appendicitis were history of periumbilical pain, anorexia and Rt iliac fossa findings. Half of wrong diagnosis were related to premature labor pain or abortion. The prevalence of suspected appendicitis during pregnancy in our environment during this period was higher than the reported incidence and rate of wrong diagnosis still high. Good clinical assessment with adjunct ultrasonic examination could reduce the incidence of negative laparotomies or prevent late complication. Delay in operation leading to higher rate of maternal morbidity and adversely affect the obstetric outcome. Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-1, 36-43 DOI: http://dx.doi.org/10.3126/jcmsn.v8i1.6824

  7. [Contribution of abdominal sonography in acute appendicitis diagnostics--our experience].

    Science.gov (United States)

    Smíd, D; Skalický, T; Treska, V

    2009-08-01

    Acute apendicitis is the most frequent case of acute abdomen. During a two year period (2006-2007) it was performed in Department of Surgery of Faculty Hospital in Pilsen 678 appendectomies, 30 days post-operative mortality rate was 0%. Abdomen ultrasonography like helping method to clinic examination was performed in 313 patients, suspect of acute appendicitis was in 191 patients (61%), in remaining patients was normal ultrasound picture.

  8. Apendicitis del muñón apendicular Appendicitis of the appendicular stump

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    María Carolina Berrogain

    2012-03-01

    Full Text Available La apendicitis del muñón es una entidad rara, caracterizada por un proceso inflamatorio del remanente apendicular luego de una apendicectomía incompleta. Los signos y síntomas no difieren de una apendicitis aguda. Al no ser una patología usualmente pensada como posible diagnóstico diferencial del abdomen agudo inflamatorio, tiene mayor riesgo de complicaciones y morbi-mortalidad. Los métodos seccionales de diagnósticos por imágenes resultan muy beneficiosos para definir el diagnóstico. La ultrasonografía (US y tomografía computada (TC demuestran signos similares a los observados en cuadros habituales de inflamación aguda del apéndice cecal. Se presentan dos casos de apendicitis del muñón, uno de ellos recibió tratamiento quirúrgico y el otro tratamiento médico.Stump appendicitis is a rare entity characterized by inflammation of the appendiceal remanent after incomplete appendectomy. Signs and symptoms do not differ from acute appendicitis. As it is not a condition usually considered as a potential differential diagnosis of acute inflammatory abdomen, it has higher risks of complications and morbidity and mortality. Imaging methods are highly useful to define the diagnosis. Ultrasound (US and Computed Tomography (CT show signs similar to those found in standard cases of acute appendicitis. Two cases of stump appendicitis are reponed: one managed with surgical treatment and the other with medical treatment.

  9. A rare presentation of appendicitis as groin swelling: a case report

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    Pitchaimuthu, Maheswaran; Dace, Stephen

    2009-01-01

    Background Appendicitis in femoral hernia is a rare condition, which raises diagnostic challenge. Case Report A 40-year-old man presented with painful right-sided groin swelling of 1-week duration. The area was explored, with presumpted diagnosis of inguinal abscess. At exploration a femoral hernia was found which contained a mildly inflammed appendix. Appendicectomy and hernia repair was done. Post surgical course was uneventful. We present this case with brief summary of literature pertaini...

  10. Spontaneous chylous peritonitis mimicking acute appendicitis: A case report and review of literature

    Institute of Scientific and Technical Information of China (English)

    Fu-Chi Fang; Sheng-Der Hsu; Chuang-Wei Chen; Teng-Wei Chen

    2006-01-01

    Acute abdominal pain with signs and symptoms of peritonitis due to sudden extravasation of chyle into the peritoneal cavity is a rare condition that is often mistaken for other disease processes. The diagnosis is rarely suspected preoperatively. We report a case of spontaneous chylous peritonitis that presented with typical symptoms of acute appendicitis such as intermittent fever and epigastric pain radiating to the lower right abdominal quadrant before admission.

  11. Laparoscopic appendectomy for perforated appendicitis in children: Is intraperitoneal drainage necessary?

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    Mithat Günaydın

    2015-09-01

    Full Text Available Objective: In this study, our aim is to evaluate the necessity of intraperitoneal drainage in perforated appendicitis. Methods: 510 pediatric patients [246 laparoscopic (LA and 264 open (OA] underwent appendectomy between 2007 and 2014. 275 of them were perforated appendicitis (106 LA, 169 OA. The patients were retrospectively evaluated in terms of age, sex, symptoms, length of hospital stay (LOHS, antibiotherapy, postoperative nasogastric tube placement and intraperitoneal drainage, follow-up period, intraoperative and postoperative complications. Results: Statistically significant differences were observed between laparoscopic perforated appendicitis (71 male, 35 female; median 9.5 years and open perforated appendicitis (108 male, 61 female; median 9 years groups in terms of placement of nasogastric tube (102/106 vs.169/169 (p=0.021, length of hospital stay (1.67± 0.11 days vs. 2.34± 0.09 days (p<0.001, intraperitoneal drainage (32/106 vs. 138/169, (p<0.001, duration of intraperitoneal drainage (1.66± 0.28 vs. 4.21± 0.2 days and LOHS (5.82± 0.3 vs. 4.23± 0.6 days respectively (p <0.001. There was no significant difference between the two groups in terms of development of intra-abdominal abscess (10/106 vs. 9/169, (p=0.144, surgical site infection (2/106 vs. 8/169, (p=0.187 and development of adhesive intestinal obstruction (1/106 vs. 9/169 (p=0.053. Conclusion: Laparoscopic access reduces the necessity for drainage and shortens duration of nasogastric tube and length of hospital stay. J Clin Exp Invest 2015; 6 (3: 224-227

  12. A hybrid decision support model to discover informative knowledge in diagnosing acute appendicitis

    OpenAIRE

    Son Chang Sik; Jang Byoung Kuk; Seo Suk Tae; Kim Min Soo; Kim Yoon Nyun

    2012-01-01

    Abstract Background The aim of this study is to develop a simple and reliable hybrid decision support model by combining statistical analysis and decision tree algorithms to ensure high accuracy of early diagnosis in patients with suspected acute appendicitis and to identify useful decision rules. Methods We enrolled 326 patients who attended an emergency medical center complaining mainly of acute abdominal pain. Statistical analysis approaches were used as a feature selection process in the ...

  13. The Houdini effect--an unusual case of blunt abdominal trauma resulting in perforative appendicitis.

    LENUS (Irish Health Repository)

    O'Kelly, F

    2012-03-01

    We present a unique case of perforative appendicitis that occurred in an adult following blunt abdominal trauma. This case represents the first such reported case from Ireland. It also represents a modern practical example of Laplace\\'s theory of the effect of increased pressure on colonic wall tension leading to localized perforation, and serves to highlight not only the importance in preoperative imaging for blunt abdominal trauma, but also the importance of considering appendiceal perforation.

  14. Torsion of a lipoma of parietal peritoneum: a rare case mimicking acute appendicitis

    OpenAIRE

    Shrestha, Binod Bade; Karmacharya, Mikesh

    2014-01-01

    Lipomas are found most often on the torso, neck, upper thighs, upper arms and armpits; they can also occur almost anywhere in the body. Parietal peritoneum lipoma is a rare intraoperative finding during abdominal surgery. We present a case of a torted, pedunculated parietal wall lipoma in the right iliac fossa that gave rise to a clinical diagnosis of appendicitis. So far only one case has been reported.

  15. Patient and surgeon factors are associated with the use of laparoscopy in appendicitis.

    LENUS (Irish Health Repository)

    McCartan, D P

    2012-02-01

    Aim The use of a minimally invasive approach to treat appendicitis has yet to be universally accepted. The objective of this study was to examine recent trends in Ireland in the surgical management of acute appendicitis. Method Data were obtained from the Irish Hospital In-Patient Enquiry system for patients discharged with a diagnosis of appendicitis between 1999 and 2007. An anonymous postal survey was sent to all general surgeons of consultant and registrar level in Ireland to assess current attitudes to the use of laparoscopic appendectomy. Results The use of laparoscopic appendectomy increased throughout the study and was the most common approach for appendectomy in 2007. Multivariate analysis revealed age under 50 years (OR = 1.51), female sex (OR = 2.84) and residence in high-density population areas (OR = 4.15) as predictive factors for undergoing laparoscopic appendectomy in the most recent year of the study. While 97% of surgeons reported current use of laparoscopy in patients with acute right iliac fossa pain, in most cases it was selective. Surgeons in university teaching hospitals (42 of 77; 55%) were more likely to report using laparoscopic appendectomy for all cases of appendicitis than those in regional (six of 23; 26%) or general (13 of 53; 25%) hospitals (P = 0.048). Conclusion This study has demonstrated a significant increase in laparoscopic appendectomy, yet a variety of patient and surgeon factors contribute to the choice of procedure. Differences in the perception of benefit of the laparoscopic approach amongst surgeons appears to be an important factor in determining the operative approach for appendectomy.

  16. Acute appendicitis presenting with abdominal wall and right groin abscess: A case report

    Institute of Scientific and Technical Information of China (English)

    Mustafa Yildiz; Ahmet Sevki Karakayali; Saadet Ozer; Hilal Ozer; Aydin Demir; Bugra Kaptanoglu

    2007-01-01

    We report a case of right lower abdominal wall and groin abscess resulting from acute appendicitis. The patient was an 27-year-old man who had no apparent abdominal signs and was brought to the hospital due to progressive painful swelling of right lower abdomen and the groin for 10 d. Significant inflammatory changes of soft tissue involving the right lower trunk were noted without any apparent signs of peritonitis. Laboratory results revealed leukocytosis. Abdominal ultrasonography described the presence of abscess at right inguinal site also communicating with the intraabdominal region. Right inguinal exploration and laparotomy were performed and about 250 mL of pus was drained from the subcutaneous tissue and preperitoneal space. No collection of pus was found intraabdominally and subserous acute appendicitis was the cause of the abscess. The patient fully recovered at the end of the second post-operation week. This case reminds us that acute appendicitis may have an atypical clinical presentation and should be treated carefully on an emergency basis to avoid serious complications.

  17. Acute appendicitis: diagnostic value of nonenhanced CT with selective use of contrast in routine clinical settings

    Energy Technology Data Exchange (ETDEWEB)

    Tamburrini, Stefania [Universita' di Napoli ' ' Federico II' ' , Dip. Sc. Biomorfologiche e Funzionali, Naples (Italy); UCSD Medical Center, Department of Radiology, San Diego, CA (United States); Brunetti, Arturo [Universita' di Napoli ' ' Federico II' ' , Dip. Sc. Biomorfologiche e Funzionali, Naples (Italy); Brown, Michele; Sirlin, Claude; Casola, Giovanna [UCSD Medical Center, Department of Radiology, San Diego, CA (United States)

    2007-08-15

    The purposes of this study were to determine the (1) frequency with which nonenhanced computed tomography (CT) (NECT) permits conclusive diagnosis of acute appendicitis, (2) accuracy of NECT when findings are conclusive, and (3) overall accuracy of a CT protocol consisting of NECT with selective use of contrast. Five hundred and thirty-six patients underwent a NECT protocol with selective use of contrast. Diagnostic accuracy was then determined separately for (1) patients with conclusive initial NECT, (2) patients with inconclusive initial NECT, and (3) all patients. NECT was conclusive on initial interpretation in 404/536 patients and inconclusive in 132/536. Of 132 inconclusive studies, 126 were repeated with contrast (intravenous, oral or rectal). Sensitivity, specificity, and positive and negative predictive value for diagnosis of acute appendicitis were (1) 90%, 96.0%, 84.8%, and 97.4% in patients with conclusive NECT (n = 404); (2) 95.6%, 92.3%, 73%, and 99% in patients with inconclusive NECT followed by repeat CT with contrast; and (3) 91.3%, 95%, 82%, and 98% in all patients. The initial diagnosis of appendicitis may be made by NECT in 75% of patients, with contrast administration reserved for inconclusive NECT studies. (orig.)

  18. Acute appendicitis: diagnostic value of nonenhanced CT with selective use of contrast in routine clinical settings

    International Nuclear Information System (INIS)

    The purposes of this study were to determine the (1) frequency with which nonenhanced computed tomography (CT) (NECT) permits conclusive diagnosis of acute appendicitis, (2) accuracy of NECT when findings are conclusive, and (3) overall accuracy of a CT protocol consisting of NECT with selective use of contrast. Five hundred and thirty-six patients underwent a NECT protocol with selective use of contrast. Diagnostic accuracy was then determined separately for (1) patients with conclusive initial NECT, (2) patients with inconclusive initial NECT, and (3) all patients. NECT was conclusive on initial interpretation in 404/536 patients and inconclusive in 132/536. Of 132 inconclusive studies, 126 were repeated with contrast (intravenous, oral or rectal). Sensitivity, specificity, and positive and negative predictive value for diagnosis of acute appendicitis were (1) 90%, 96.0%, 84.8%, and 97.4% in patients with conclusive NECT (n = 404); (2) 95.6%, 92.3%, 73%, and 99% in patients with inconclusive NECT followed by repeat CT with contrast; and (3) 91.3%, 95%, 82%, and 98% in all patients. The initial diagnosis of appendicitis may be made by NECT in 75% of patients, with contrast administration reserved for inconclusive NECT studies. (orig.)

  19. Acute isolated appendicitis due to Aspergillus carneus in a neutropenic child with acute myeloid leukemia.

    Science.gov (United States)

    Decembrino, Nunzia; Zecca, Marco; Tortorano, Anna Maria; Mangione, Francesca; Lallitto, Fabiola; Introzzi, Francesca; Bergami, Elena; Marone, Piero; Tamarozzi, Francesca; Cavanna, Caterina

    2016-01-01

    We describe a case of isolated acute appendicitis due to Aspergillus carneus in a neutropenic child with acute myeloid leukemia (AML) treated according to the AIEOP AML 2002/01 protocol. Despite prophylaxis with acyclovir, ciprofloxacin and fluconazole administered during the neutropenic phase, 16 days after the end of chemotherapy the child developed fever without identified infective foci, which prompted a therapy shift to meropenem and liposomial amphotericin B. After five days of persisting fever he developed ingravescent abdominal lower right quadrant pain. Abdominal ultrasound was consistent with acute appendicitis and he underwent appendectomy with prompt defervescence. PAS+ fungal elements were found at histopathology examination of the resected vermiform appendix, and galactomannan was low positive. A. carneus, a rare species of Aspergillus formerly placed in section Flavipedes and recently considered a member of section Terrei, was identified in the specimen. Treatment with voriconazole was promptly started with success. No other site of Aspergillus localization was detected. Appendicitis is rarely caused by fungal organisms and isolated intestinal aspergillosis without pulmonary infection is unusual. To our knowledge, this is the first report of infection due to A. carneus in a child and in a primary gastrointestinal infection.

  20. Quantitative measurement of elasticity of the appendix using shear wave elastography in patients with suspected acute appendicitis.

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    Seung-Whan Cha

    Full Text Available Shear wave elastography (SWE has not been studied for diagnosing appendicitis. We postulated that an inflamed appendix would become stiffer than a normal appendix. We evaluated the elastic modulus values (EMV by SWE in healthy volunteers, patients without appendicitis, and patients with appendicitis. We also evaluated diagnostic ability of SWE for differentiating an inflamed from a normal appendix in patients with suspected appendicitis.Forty-one patients with clinically suspected acute appendicitis and 11 healthy volunteers were prospectively enrolled. Gray-scale ultrasonography (US, SWE and multi-slice computed tomography (CT were performed. The EMV was measured in the anterior, medial, and posterior appendiceal wall using SWE, and the highest value (kPa was recorded.Patients were classified into appendicitis (n = 30 and no appendicitis groups (n = 11. One case of a negative appendectomy was detected. The median EMV was significantly higher in the appendicitis group (25.0 kPa compared to that in the no appendicitis group (10.4 kPa or in the healthy controls (8.3 kPa (p<0.001. Among SWE and other US and CT features, CT was superior to any conventional gray-scale US feature or SWE. Either the CT diameter criterion or combined three CT features predicted true positive in 30 and true negative in 11 cases and yielded 100% sensitivity and 100% specificity. An EMV of 12.5 kPa for the stiffest region of the appendix predicted true positive in 28, true negative in 11, and false negative in two cases. The EMV (≥12.5 kPa yielded 93% sensitivity and 100% specificity.Our results suggest that EMV by SWE helps distinguish an inflamed from a normal appendix. Given that SWE has high specificity, quantitative measurement of the elasticity of the appendix may provide complementary information, in addition to morphologic features on gray-scale US, in the diagnosis of appendicitis.

  1. [Validation of a diagnostic scoring system (Ohmann score) in acute appendicitis].

    Science.gov (United States)

    Zielke, A; Sitter, H; Rampp, T A; Schäfer, E; Hasse, C; Lorenz, W; Rothmund, M

    1999-07-01

    A diagnostic scoring system, recently published by Ohmann et al. in this journal, was validated by analyzing the clinicopathological data of a consecutive series of 2,359 patients, admitted for suspicion of acute appendicitis. The results of the scoring system were compared to the results of clinical evaluation by junior (provisional) and senior surgeons (final clinical diagnosis). To assess the diagnostic ability of the score, the accuracy and positive predictive value were defined as the major diagnostic performance parameters; the rate of theoretical negative laparotomies and that of diagnostic errors served as the major procedural performance parameters. Of 2,359 patients admitted for suspected acute appendicitis, 662 were proven to have acute appendicitis by histology, for a prevalence of 28%. The overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the provisional clinical diagnosis were 0.50, 0.94, 0.77, 0.83, and 0.82; 0.93, for the score 0.63, 0.93, 0.77, 0.86 and 0.84, and for the final clinical diagnosis 0.90, 0.94, 0.85, 0.96, and 0.93, respectively. Of the main diagnostic performance parameter, the accuracy of the score was significantly better than that of provisional clinical diagnosis (P apendicitis, the score demonstrated a superior performance, with only 6 cases missed (0.9%). However, the number of patients with acute appendicitis, including those with perforated disease, who were not identified by the score, was almost four times that of the final clinical diagnosis (245 vs 63). With regard to the main procedural performance parameter, the score resulted in a significantly smaller number of diagnostic errors than the provisional clinical investigator (P < 0.05, chi 2 test). The results of this study indicate that the diagnostic scoring system might be helpful when experienced investigators or additional diagnostic modalities such as ultrasonography are not available. It may therefore be of value

  2. Accuracy and interobserver agreement between MR-non-expert radiologists and MR-experts in reading MRI for suspected appendicitis

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    Leeuwenburgh, Marjolein M.N., E-mail: m.m.leeuwenburgh@amc.uva.nl [Department of Surgery, Academic Medical Center, University of Amsterdam (Netherlands); Department of Radiology, Academic Medical Center, University of Amsterdam (Netherlands); Wiarda, Bart M. [Department of Radiology, Alkmaar Medical Center, Alkmaar (Netherlands); Jensch, Sebastiaan [Department of Radiology, Sint Lucas Andreas Hospital, Amsterdam (Netherlands); Wouter van Es, H. [Department of Radiology, Sint Antonius Hospital, Nieuwegein (Netherlands); Stockmann, Hein B.A.C. [Department of Surgery, Kennemer Gasthuis, Haarlem (Netherlands); Gratama, Jan Willem C. [Department of Radiology, Gelre Hospitals, Apeldoorn (Netherlands); Cobben, Lodewijk P.J. [Department of Radiology, Haaglanden Medical Center, Leidschendam (Netherlands); Bossuyt, Patrick M.M. [Department of Clinical Epidemiology, Academic Medical Center, University of Amsterdam (Netherlands); Boermeester, Marja A. [Department of Surgery, Academic Medical Center, University of Amsterdam (Netherlands); Stoker, Jaap [Department of Radiology, Academic Medical Center, University of Amsterdam (Netherlands)

    2014-01-15

    Objective: To compare accuracy and interobserver agreement between radiologists with limited experience in the evaluation of abdominal MRI (non-experts), and radiologists with longer MR reading experience (experts), in reading MRI in patients with suspected appendicitis. Methods: MR imaging was performed in 223 adult patients with suspected appendicitis and read independently by two members of a team of eight MR-inexperienced radiologists, who were trained with 100 MR examinations previous to this study (non-expert reading). Expert reading was performed by two radiologists with a larger abdominal MR experience (>500 examinations) in consensus. A final diagnosis was assigned after three months based on all available information, except MRI findings. We estimated MRI sensitivity and specificity for appendicitis and for all urgent diagnoses separately. Interobserver agreement was evaluated using kappa statistics. Results: Urgent diagnoses were assigned to 147 of 223 patients; 117 had appendicitis. Sensitivity for appendicitis was 0.89 by MR-non-expert radiologists and 0.97 in MR-expert reading (p = 0.01). Specificity was 0.83 for MR-non-experts versus 0.93 for MR-expert reading (p = 0.002). MR-experts and MR-non-experts agreed on appendicitis in 89% of cases (kappa 0.78). Accuracy in detecting urgent diagnoses was significantly lower in MR-non-experts compared to MR-expert reading: sensitivity 0.84 versus 0.95 (p < 0.001) and specificity 0.71 versus 0.82 (p = 0.03), respectively. Agreement on urgent diagnoses was 83% (kappa 0.63). Conclusion: MR-non-experts have sufficient sensitivity in reading MRI in patients with suspected appendicitis, with good agreement with MR-expert reading, but accuracy of MR-expert reading was higher.

  3. Accuracy and interobserver agreement between MR-non-expert radiologists and MR-experts in reading MRI for suspected appendicitis

    International Nuclear Information System (INIS)

    Objective: To compare accuracy and interobserver agreement between radiologists with limited experience in the evaluation of abdominal MRI (non-experts), and radiologists with longer MR reading experience (experts), in reading MRI in patients with suspected appendicitis. Methods: MR imaging was performed in 223 adult patients with suspected appendicitis and read independently by two members of a team of eight MR-inexperienced radiologists, who were trained with 100 MR examinations previous to this study (non-expert reading). Expert reading was performed by two radiologists with a larger abdominal MR experience (>500 examinations) in consensus. A final diagnosis was assigned after three months based on all available information, except MRI findings. We estimated MRI sensitivity and specificity for appendicitis and for all urgent diagnoses separately. Interobserver agreement was evaluated using kappa statistics. Results: Urgent diagnoses were assigned to 147 of 223 patients; 117 had appendicitis. Sensitivity for appendicitis was 0.89 by MR-non-expert radiologists and 0.97 in MR-expert reading (p = 0.01). Specificity was 0.83 for MR-non-experts versus 0.93 for MR-expert reading (p = 0.002). MR-experts and MR-non-experts agreed on appendicitis in 89% of cases (kappa 0.78). Accuracy in detecting urgent diagnoses was significantly lower in MR-non-experts compared to MR-expert reading: sensitivity 0.84 versus 0.95 (p < 0.001) and specificity 0.71 versus 0.82 (p = 0.03), respectively. Agreement on urgent diagnoses was 83% (kappa 0.63). Conclusion: MR-non-experts have sufficient sensitivity in reading MRI in patients with suspected appendicitis, with good agreement with MR-expert reading, but accuracy of MR-expert reading was higher

  4. The Role of Digital Rectal Examination for Diagnosis of Acute Appendicitis: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Toshihiko Takada

    Full Text Available Digital rectal examination (DRE has been traditionally recommended to evaluate acute appendicitis, although several reports indicate its lack of utility for this diagnosis. No meta-analysis has examined DRE for diagnosis of acute appendicitis.To assess the role of DRE for diagnosis of acute appendicitis.Cochrane Library, PubMed, and SCOPUS from the earliest available date of indexing through November 23, 2014, with no language restrictions.Clinical studies assessing DRE as an index test for diagnosis of acute appendicitis.Two independent reviewers extracted study data and assessed the quality, using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Bivariate random-effects models were used for the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio (DOR as point estimates with 95% confidence intervals (CI.The main outcome measure was the diagnostic performance of DRE for diagnosis of acute appendicitis.We identified 19 studies with a total of 7511 patients. The pooled sensitivity and specificity were 0.49 (95% CI 0.42-0.56 and 0.61 (95% CI 0.53-0.67, respectively. The positive and negative likelihood ratios were 1.24 (95% CI 0.97-1.58 and 0.85 (95% CI 0.70-1.02, respectively. The DOR was 1.46 (0.95-2.26.Acute appendicitis cannot be ruled in or out through the result of DRE. Reconsideration is needed for the traditional teaching that rectal examination should be performed routinely in all patients with suspected appendicitis.

  5. Enhanced CT in the diagnosis of acute appendicitis to evaluate the severity of disease. Comparison of CT findings and histological diagnosis

    International Nuclear Information System (INIS)

    To assess the potential of CT in evaluating the histological severity of acute appendicitis in comparison with surgical and pathological findings. The CT images of 75 patients with surgically proven appendicitis, including 10 cases of catarrhal, 34 of phlegmonous, and 31 of gangrenous appendicitis, were retrospectively analyzed for the following five CT findings: hazy periappendiceal densities, enlarged appendix, increased enhancement of the appendiceal wall, increased enhancement of the periappendiceal intestinal wall, and deficiency of the appendiceal wall. By comparing all the CT findings and the pathological severity of appendicitis (catarrhal, phlegmonous, and gangrenous), the prevalence of the five CT findings was calculated for each pathological category. Abnormal CT findings were noted in only one case of catarrhal appendicitis. Increased enhancement of the appendiceal wall was observed in all 29 cases of phlegmonous appendicitis (100%), but in only 66.7% (18 cases) of gangrenous appendicitis. Deficiency of the appendiceal wall was more frequently observed in gangrenous (19/27, 70.4%) than phlegmonous appendicitis (4/29, 13.8%). Findings of enhanced CT provide useful information in evaluating the pathological severity of acute appendicitis. (author)

  6. 急性阑尾炎的CT诊断%CT FINDINGS IN ACUTE APPENDICITIS

    Institute of Scientific and Technical Information of China (English)

    吴俊凤; 潘旭民; 陈慧妙; 李秀芳

    2014-01-01

    目的:研究急性阑尾炎的典型CT表现。方法收集45例经手术病理证实的急性阑尾炎病例,回顾性分析其表现特征。结果45例中CT诊断为急性阑尾炎可能1例(2.22%);急性阑尾炎8例(17.78%);急性阑尾炎并阑尾周围炎14例(31.11%);急性阑尾炎并穿孔5例(11.11%);阑尾脓肿13例(28.89%);阑尾炎性肿块4例(8.89%)。急性阑尾炎的CT直接征象为阑尾肿大增粗(直径>6mm)、阑尾壁增厚和阑尾石,间接征象有阑尾-盲肠周围脂肪内条索影等。临床诊断为急性阑尾炎可能4例;急性阑尾炎21例;阑尾炎包块16例;另有4例因右上腹痛而拟诊胆囊炎。主要CT表现:①阑尾肿胀,管壁增厚,可呈不同密度分层的“同心圆”样结构;阑尾边缘模糊,密度近似甚至高于邻近肌肉;②阑尾管腔内可见积液、粪石和气体;③阑尾系膜肿胀,周围脂肪组织密度升高;④阑尾穿孔,周围形成脓肿;⑤相邻盲肠壁可有增厚,末端呈尖角样改变;右侧肾筋膜和侧锥筋膜增厚;⑥小肠低位梗阻、肝脓肿等并发症。CT所显示的阑尾形态及其周围组织的改变,与手术和病理所见一致。结论急性阑尾炎有典型CT表现。CT检查可准确显示阑尾本身和周围组织改变及其合并症,为临床的诊治提供有价值的信息。CT对急性阑尾炎的诊断特别是对临床表现不甚典型的阑尾炎及其并发症的诊断,具有很高准确率。%Objective To investigate CT characteristics of acute appendicitis and to find the significance of CT findings in acute appendicitis .Methods A total of of 45 patients with acute appendicitis confirmed by CT were included in this study ,in which 21 male patients and 24 female patients were included and the av-erage age was 48 years old with the range from 38y to 65y .The clinical and CT data were analyzed retro

  7. INCIDENCE, RISK FACTORS AND COMPLICATIONS OF ACUTE PERFORATED AND NON - PERFORATED APPENDICITIS IN A RURAL SETUP OF ANDHRA PRADESH

    Directory of Open Access Journals (Sweden)

    Anil Kumar

    2015-05-01

    Full Text Available Appendicitis is one of the most common surgical emergencies. The incidence of appendicitis and chances of complication in the form of perforation are dependent on both the patients and non - patient factors . There are various studies conducted to address this problem, but there are no studies conducted to look in to the incidence of appendicitis in east Godavari district of Andhra Pradesh. Our study was aimed to bridge thi s gap. METHOD S AND MATERIALS: this was a retrospective study, patient data from 2009 - 2014 was analyzed and the age, distance from hospital, educational and socioeconomic background of the patients was collected. The duration between first appearance of sy mptoms and hospitalization was recorded. The incidence of post - op complication was also recorded. RESULTS: T he incidence of perforation was 15% in our study population, most of the patients were from low socioeconomic group and having income less than 5000 /month. The middle age group between 30 - 40 years was commonly affected by the appendicitis. The time laps between appearance of symptoms and hospitalization was found to be a predominant factor in the perforation. Surgical site infection was most common co mplication in the patients treated. CONCLUSION: T he incidence of perforation is still high and the time laps between first appearance of symptoms and hospitalization is a major determinant of perforation or complication in the appendicitis.

  8. Blunt abdominal trauma with handlebar injury: A rare cause of traumatic amputation of the appendix associated with acute appendicitis

    Directory of Open Access Journals (Sweden)

    Amanda Jensen

    2016-04-01

    Full Text Available We describe traumatic appendicitis in a 7-year-old boy who presented after sustaining blunt abdominal trauma to his right lower abdomen secondary to bicycle handlebar injury. With diffuse abdominal pain following injury, he was admitted for observation. Computed axial tomography (CT obtained at an outside hospital demonstrated moderate stranding of the abdomen in the right lower quadrant. The CT was non-contrasted and therefore significant appendiceal distention could not be confirmed. However, there was a calcified structure in the right pelvis with trace amount of free fluid. Patient was observed with conservative management and over the course of 15 h his abdominal pain continued to intensify. With his worsening symptoms, we elected to take him for diagnostic laparoscopy. In the operating room we found an inflamed traumatically amputated appendix with the mesoappendix intact. We therefore proceeded with laparoscopic appendectomy. Pathology demonstrated acute appendicitis with fecalith. It was unclear as to whether the patient's appendicitis and perforation were secondary to fecalith obstruction, his blunt abdominal trauma or if they concurrently caused his appendicitis. Acute appendicitis is a common acute surgical condition in the pediatric population and continues to be a rare and unique cause of operative intervention in the trauma population.

  9. Propulsion efficiency of bodies appended with multiple flapping fins: When more is less

    Science.gov (United States)

    Bandyopadhyay, Promode R.; Leinhos, Henry A.

    2013-04-01

    Underwater animals propel themselves by flapping their pectoral and caudal fins in a narrow range of frequencies, given by Strouhal number St, to produce transitional vortex jets (St is generally expressed non-dimensionally as the product of flapping frequency and stroke (arc) length divided by forward speed). The organized nature of the selection of St and of the vortex jet is thought to maximize hydrodynamic efficiency, although the exact mechanism is not known. Our recent Stuart-Landau equation models, which have self-regulation properties, indicate that the fin and its jet vortices couple. Temporal maps of forces in single isolated fins show a bimodal behavior in certain ranges of the transitional Reynolds number; this behavior bears resemblance to neural bifurcation properties that owe their origin to the self-regulation mechanism. In view of our theoretical and biorobotic evidence of self-regulation in single flapping fins, we explore if this property is altered in a fin-appended body, the goal being to understand how the narrow selection of St, self-regulation, and maximization of hydrodynamic efficiency are related. Swimming vehicles of 1-m scale have been built where a rigid cylindrical body is appended with six flapping fins, three at each end. The fins are rigid, have a rounded leading edge and a laminar section (NACA 0012), and are hinged at one end. The planform is an abstracted version of the penguin wing; it has low aspect ratio and a chord Reynolds number that varies in the transitional range from 10 000 to 60 000. The fin geometry, Reynolds number range, and the nonflexible nature of the main body are in common with those in penguins, and the length and displacement volume are similar to those of sharks. The maximum hydrodynamic efficiency of the fin-appended body (0.40) is lower than that of the single fin (0.57), but is close to that of a fish using several fins. The propulsion density (kW/m3 of displacement volume) of the fin-appended cylinder

  10. Comparative analysis between single incision and conventional laparoscopic appendectomy for acute appendicitis

    Directory of Open Access Journals (Sweden)

    Sreeram Sateesh

    2014-08-01

    Full Text Available Appendicitis is an acute inflammatory condition of appendix. Since it is a surgical emergency, needs early diagnosis and treatment strategies which include clinical examination, followed by Laboratory investigations and Imaging studies. The scoring systems like Alvarado score have been considered for better diagnosis. In most studies surgery has been reported as the best modality of treatment. Several studies clearly mentioned the impact of various surgical procedures which include Open appendectomy (OA, Conventional laparoscopic appendectomy (CLA and Single incision laparoscopic appendectomy (SILA. Hence, the present study is carried in an aim to assess and compare the merits and demerits between the surgical procedures Like SILA and CLA. The patients were randomly selected from the surgical department (NMCH who presented with acute pain abdomen and diagnosed as acute appendicitis. 50 patients were enrolled in the study after fulfilling the inclusion and exclusion criteria. The various demographic variables have been studied between the surgical procedures to demonstrate their impact, which include wound infection rate, pain scores at 24 and 48hrs, the amount of time period for surgery in minutes, patient satisfaction scores and post-operative stay tenure at the hospital in days. The laparoscopic hand instruments used in both techniques are similar, except covidien port which was reused in SILA, following gas sterilization to reduce the cost. Findings reveal that the pain score was significantly lower in SILA than CLA group. The procedure time is comparatively more in SILA than CLA group. Patients had significant satisfaction score in SILA measured at 6 weeks after appendectomy. However the post operative stay, wound infection rate was almost similar in both the groups. There was no conversion to open Appendectomy performed in either of these groups. Results also clearly suggest that the SILA procedure is the safe, alternative and effective

  11. Appendicitis as an early manifestation of subsequent malignancy: an asian population study.

    Directory of Open Access Journals (Sweden)

    Shih-Chi Wu

    Full Text Available Cancer risk after appendectomy in patients with appendicitis remains unclear. This study examined the role of appendicitis as an early manifestation harbingering the distant malignancy.From the insurance claims data of Taiwan, we identified a cohort of 130,374 patients newly received appendectomy from 2000-2009, without cancer diagnosis. A comparison cohort of 260,746 persons without appendectomy and cancer was selected from the same database, frequency matched by age, sex, comorbidity and index year. We monitored subsequent cancers with a12-month follow-up.Over all, 1406 and 616 cancer cases were identified in the appendectomy cohort and comparisons, respectively, with all cancers incidence rate 4.64-fold higher in the appendectomy cohort (9.06 vs. 1.96 per 1000 person-months. Digestive and female genital organs harbored 80.9% of cancer cases in the appendectomy cohort. The Cox model measured site-specific hazard ratio (HR was the highest for female genital cancers (23.3, followed by cancers of colorectum (14.7, small intestine (10.1, pancreas (7.40, lymphoma (5.89 and urinary system (4.50, all significant at 0.001 level. The HR of all cancers decreased from 13.7 within 3 months after appendectomy to 1.37 in 7-12 months after the surgery. In general, relative to the comparison cohort, younger appendectomy patients tended to have a higher HR than older patients.The high incident cancers identified soon after appendectomy suggest the acute appendicitis is the early sign of distant metastatic malignancy. The risk of colorectal cancer, female genital cancer and haemopoietic malignancy deserve attention.

  12. Epiploic appendagitis of caecum: a diagnostic dilemma [Appendicitis epiploica des Blinddarms: ein diagnostisches Dilemma

    Directory of Open Access Journals (Sweden)

    Rashid, Arshad

    2012-10-01

    Full Text Available [english] Epiploic appendagitis is a rare cause of acute abdomen. Depending on the site of occurrence, it can mimic any cause of acute abdomen or disease of the colon and caecal appendix; making its preoperative diagnosis very difficult. We present here a case of a 7-year-old boy misdiagnosed preoperatively as acute appendicitis and later on, upon surgical exploration, found to have caecal appendagitis. The affected epiploic appendage was removed and the patient had an uneventful recovery. We also review the relevant literature and discuss the measures to overcome this diagnostic dilemma. General surgeons should be aware of this self-limiting disease and consider it as a differential diagnosis of acute abdomen.[german] Appendicitis epiploica oder epiploische Appendagitis ist eine seltene Ursache des akuten Abdomens. Je nach Ort des Auftretens kann sie jede Ursache für akuten Unterleibsschmerz oder Erkrankungen des Dickdarms und Appendix vermiformis imitieren, was ihre präoperative Diagnose sehr schwierig macht. Wir präsentieren hier den Fall eines alten Jungen, bei dem präoperativ akute Blinddarmentzündung diagnostiziert wurde. Beim chirurgischen Eingriff stellte sich dann eine Appendicitis epiploica des Blinddarms als Befund heraus. Der betroffene Appendix epiploica wurde entfernt und der Patient erholte sich ohne besondere Vorkommnisse. Wir geben auch eine Übersicht über die relevante Literatur und diskutieren die Maßnahmen, um dieses diagnostische Dilemma zu überwinden. Allgemeine Chirurgen sollten sich dieser selbstlimitierenden Krankheit bewusst sein und sie als eine Differentialdiagnose bei akutem Abdomen in Betracht ziehen.

  13. Comparison of clinical judgment and diagnostic ultrasonography in the diagnosis of acute appendicitis

    DEFF Research Database (Denmark)

    Jahn, H; Mathiesen, F K; Neckelmann, K;

    1997-01-01

    of having acute appendicitis admitted between 0800 and midnight from June 1990 to June 1992. INTERVENTIONS: 148 Patients (67%) underwent appendicectomy and the remaining 74 patients were observed. 193 Patients (87%) had a diagnostic US examination. 21 Predictive variables were collected prospectively...... to create a scoring system. MAIN OUTCOME MEASURES: Results of surgical pathological findings, clinical outcome (observed group), diagnostic US, and values of diagnostic score. RESULTS: The decision to operate was made by a junior surgeon solely on the clinical examination, which yielded a diagnostic...

  14. Perforated appendicitis masquerading as acute pancreatitis in a morbidly obese patient.

    Science.gov (United States)

    Forster, Michael-J; Akoh, Jacob-A

    2008-03-21

    Diagnosis and treatment of common conditions in morbidly obese patients still pose a challenge to physicians and surgeons. Sometimes too much reliance is put on investigations that can lead to a misdiagnosis. This case demonstrates an obese woman admitted under the medical team with a presumed diagnosis of pneumonia, who was later found to have an acute abdomen and raised amylase, which led to an assumed diagnosis of pancreatitis. She died within 24 h of admission and post mortem confirmed the cause of death as systemic sepsis due to perforated appendicitis, with no evidence of pancreatitis. Significantly elevated serum amylase level may occur in non-pancreatitic acute abdomen.

  15. Perforated appendicitis masquerading as acute pancreatitis in a morbidly obese patient

    Institute of Scientific and Technical Information of China (English)

    Michael J Forster; Jacob A Akoh

    2008-01-01

    Diagnosis and treatment of common conditions in morbidly obese patients still pose a challenge to physicians and surgeons. Sometimes too much reliance is put on investigations that can lead to a misdiagnosis. This case demonstrates an obese woman admitted under the medical team with a presumed diagnosis of pneumonia, who was later found to have an acute abdomen and raised amylase, which led to an assumed diagnosis of pancreatitis. She died within 24 h of admission and post mortem confirmed the cause of death as systemic sepsis due to perforated appendicitis, with no evidence of pancreatitis. Significantly elevated serum amylase level may occur in non-pancreatitic acute abdomen.

  16. Perforated appendicitis masquerading as acute pancreatitis in a morbidly obese patient.

    Science.gov (United States)

    Forster, Michael-J; Akoh, Jacob-A

    2008-03-21

    Diagnosis and treatment of common conditions in morbidly obese patients still pose a challenge to physicians and surgeons. Sometimes too much reliance is put on investigations that can lead to a misdiagnosis. This case demonstrates an obese woman admitted under the medical team with a presumed diagnosis of pneumonia, who was later found to have an acute abdomen and raised amylase, which led to an assumed diagnosis of pancreatitis. She died within 24 h of admission and post mortem confirmed the cause of death as systemic sepsis due to perforated appendicitis, with no evidence of pancreatitis. Significantly elevated serum amylase level may occur in non-pancreatitic acute abdomen. PMID:18350613

  17. A case-control study of acute appendicitis and diet in children.

    OpenAIRE

    Nelson, M.; Morris, J; Barker, D J; Simmonds, S

    1986-01-01

    The diets of 53 Southampton children who had had appendicitis were compared with those of two sets of age-sex matched controls using a seven-day weighed food record. One set of controls comprised classmates of the cases; the other was a random sample of all schoolchildren in the city. The cases weighed less and were shorter in height; they had lower intakes of energy, all the main nutrients and water. The differences in weight and water intake were statistically significant. Low water intake ...

  18. Left-sided appendicitis:Review of 95 published cases and a case report

    Institute of Scientific and Technical Information of China (English)

    Sami; Akbulut; Abdullah; Ulku; Ayhan; Senol; Mahmut; Tas; Yusuf; Yagmur

    2010-01-01

    AIM:To give an overview of the literature on left-sided acute appendicitis (LSAA) associated with situs inversus totalis (SIT) and midgut malrotation (MM).METHODS:We present a new case of LSAA with SIT and a literature review of studies published in the English language on LSAA,accessed via PubMed and Google Scholar databases.RESULTS:Ninety-five published cases of LSAA were evaluated and a 25-year-old female,who presented to our clinic with left lower abdominal pain caused by LSAA,is reported.In the reviewe...

  19. Appendiceal immunoglobulin G4-related disease mimicking appendiceal tumor or appendicitis: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Soo; Kang, Won Kyung; Chung, Dong Jin [Yeouido St. Mary' s Hospital, The Catholic University of Korea, Seoul (Korea, Republic of)

    2016-02-15

    Immunoglobulin G4 (IgG4)-related disease is an autoimmune disease that forms tumorous lesions. Several cases involving various organs are reported, however, IgG4-related disease involving appendix has not been reported yet. In this report, we presented a case of IgG4-related disease of appendix, which raised a suspicion of appendiceal tumor or usual appendicitis and, therefore, led to unnecessary surgical resection. IgG4-related disease should be considered in the differential diagnosis for a mass-like swelling of the appendix, in order to avoid unnecessary surgery.

  20. Alvarado score: A valuable clinical tool for diagnosis of acute appendicitis –a retros-pective study

    Directory of Open Access Journals (Sweden)

    Swagata Brahmachari1 and Ashwini B. Jajee2

    2013-08-01

    Full Text Available Appendicitis is a common surgical emergency and diagnosis is still a great challenge. Accurate diagnosis and timely intervention re-duces morbidity and mortality. The present study was conducted to evaluate Alvarado scoring system for diagnosis of acute appen-dicitis in Indian set up. The study was carried out on 200 patients admitted in Surgery ward between January 2009 and December 2010 with right lower quadrant abdominal pain. Alvarado score was calculated and all patients were divided in three groups. Mean age of presentation was 29.12 years and male to female ratio was 1.27:1. Higher the Alvarado score, more is the sensitivity. So pa-tients having score 7 or above had sensitivity of 66%. We con-clude that Alvarado score is unique since it incorporates signs, symptoms and laboratory findings of suspicious patients. Alvarado score can be utilized safely for diagnosis of acute appendicitis.

  1. Left-sided appendicitis in children with congenital gastrointestinal malrotation: a diagnostic pitfall in the emergency department.

    Science.gov (United States)

    Taslakian, Bedros; Issa, Ghada; Hourani, Roula; Akel, Samir

    2013-06-10

    Acute appendicitis is one of the most common conditions requiring emergency surgery. However, acute appendicitis presenting with left lower quadrant abdominal pain is extremely rare. Imaging, particularly CT , plays an important role in establishing an accurate and prompt diagnosis, as delay in diagnosis may occur due to lack of uniformity in the clinical signs and symptoms. We report a rare case of a 10-year-old boy who presented with persistent left lower quadrant pain of several days duration, in which the CT scan of the abdomen and pelvis was essential in establishing the correct diagnosis. The malpositioned inflamed appendix was clearly identified in the left side of the abdomen, with the characteristic CT findings of uncomplicated intestinal malrotation. Left-sided acute appendicitis should be considered in the differential diagnosis of young patients presenting with left lower quadrant pain, in order to avoid delay in diagnosis and guide the surgical intervention.

  2. Diagnostic performance of contrast-enhanced MR for acute appendicitis and alternative causes of abdominal pain in children

    Energy Technology Data Exchange (ETDEWEB)

    Koning, Jeffrey L. [University of California San Diego, Department of Radiology, San Diego, CA (United States); Naheedy, John H.; Kruk, Peter G. [University of California San Diego, Department of Radiology, San Diego, CA (United States); Rady Children' s Hospital, Department of Radiology, San Diego, CA (United States)

    2014-08-15

    Unenhanced MRI has emerged as a useful tool for diagnosing pediatric acute appendicitis. The use of contrast-enhanced MRI for diagnosing pediatric appendicitis has not been documented. The purpose of this study is to examine the diagnostic performance of contrast-enhanced MRI for acute appendicitis and alternative entities in the pediatric population presenting with acute abdominal pain. A retrospective review was conducted of 364 consecutive pediatric patients undergoing contrast-enhanced MRI for the evaluation of possible appendicitis at a single institution between November 2012 and September 2013. There were 132 cases of pathologically confirmed appendicitis out of 364 pediatric patients (36.3%) included in the study. Overall sensitivity and specificity were 96.2% (95% CI [91.4-98.4%]) and 95.7% (95% CI [92.3-97.6%]), respectively. Positive predictive value and negative predictive value were 92.7% (95% CI [86.6-96.3%]) and 97.8% (95% CI [94.7-99.1%]), respectively. The appendix was visualized in 243 cases (66.8%). Imaging confirmed alternative diagnoses in 75 patients, including most commonly colitis, enteritis or terminal ileitis (n = 25, 6.9%), adnexal cysts (n = 25, 6.9%) and mesenteric adenitis (n = 7, 1.9%). Contrast-enhanced MRI is capable of accurately diagnosing acute appendicitis while detecting many alternative entities of abdominal pain, and it allows good visualization of the appendix. Further evaluation is needed to determine whether contrast-enhanced MRI provides an advantage over non-enhanced MRI for imaging evaluation of acute abdominal pain in the pediatric population. (orig.)

  3. A Feasibility Study of Real-Time Remote CT Reading for Suspected Acute Appendicitis Using an iPhone.

    Science.gov (United States)

    Kim, Changsun; Kang, Bossng; Choi, Hyuk Joong; Park, Joon Bum

    2015-08-01

    We aimed to evaluate the feasibility of an iPhone-based remote control system as a real-time remote computed tomography (CT) reading tool for suspected appendicitis using a third-generation (3G) network under suboptimal illumination. One hundred twenty abdominal CT scans were selected; 60 had no signs of appendicitis, whereas the remaining 60 had signs of appendicitis. The 16 raters reviewed the images using the liquid crystal display (LCD) monitor of a picture archiving and communication system (PACS) workstation, as well as using an iPhone connected to the PACS workstation via a remote control system. We graded the probability of the presence of acute appendicitis for each examination using a five-point Likert scale. The overall sensitivity and specificity for the diagnosis of suspected appendicitis using the iPhone and the LCD monitor were high, and they were not significantly different (sensitivity P = 1.00, specificity P = 0.14). The average areas under the receiver operating characteristic curves for all CT readings with the iPhone and LCD monitor were 0.978 (confidence interval 0.965-0.991) and 0.974 (0.960-0.988), respectively, and the two devices did not have significantly different diagnostic performances (P = 0.55). The inter-rater agreement for both devices was very good; the kappa value for the iPhone was 0.809 (0.793-0.826), and that for the LCD monitor was 0.817 (0.801-0.834). Each rater had moderate-to-very good intra-observer agreement between the two devices. We verified the feasibility of an iPhone-based remote control system as a real-time remote CT reading tool for identifying suspected appendicitis using a 3G network and suboptimal illumination.

  4. A Patient with an Unusual Cause Right Lower Quadrant Pain and Vomiting: Pyelonephritis of an Ectopic Right Kidney Masquerading as Acute Appendicitis

    Directory of Open Access Journals (Sweden)

    Michele N. Lossius

    2009-01-01

    Full Text Available An adolescent female presented with one day of abdominal pain and clinical findings of acute appendicitis. CT scan revealed an ectopic right kidney with changes of acute pyelonephritis. This paper underscores the importance of imaging the right pelvis prior to surgical intervention in suspected cases of acute appendicitis in children.

  5. Utility of abdominal ultrasonography in acute painful tables of right iliac Fossa with appendicitis acute suspicion. Maciel Hospital Experience

    International Nuclear Information System (INIS)

    Acute appendicitis is one of the most frequent causes of consultation and of indication of emergency laparotomy in most western countries. Despite its diagnostic being based mainly on clinical examination, there is a certain percentage of patients whose clinical presentation is atypical. In these cases image methods such as the abdominal ultrasound are particularly useful as diagnostic auxiliaries.The objective of this work is to compare the echographic with the Anatomopathological diagnosis in 80 patients who consulted the Hospital Maciel emergency service with episodes of acute appendicitis

  6. Non-surgical contraindication for acute appendicitis with secondary thrombocytopenia: a case report.

    Science.gov (United States)

    Zhang, Hai-Hong; Gu, Guo-Li; Zhang, Xiang-Yang; Fan, Qin; Wang, Xin-Yan; Wei, Xue-Ming

    2015-03-01

    A 26-year-old man presented with migrated right lower abdominal pain and without any history of hematological systemic diseases. Blood routine test showed a leukocyte count of 22.74 × 10(9)/L, with 91.4% neutrophils, and a platelet count of 4 × 10(9)/L before admission. The case question was whether the team should proceed with surgery. Obviously, a differential diagnosis is essential before making such a decision. Acute appendicitis was easily diagnosed based on clinical findings, including migrating abdominal pain, a leukocyte count of 22.74 × 10(9)/L and the result of abdominal computed tomography scan. However, it was not clear whether the severe thrombocytopenia was primary or secondary. So smear of peripheral blood and aspiration of bone marrow were ordered to exclude hematological diseases. Neither of the tests indicated obvious pathological hematological changes. There was no hepatosplenomegaly found by ultrasound examination of the liver and spleen. Therefore, operative intervention may be a unique clinical scenario in acute severe appendicitis patients with secondary thrombocytopenia. PMID:25759558

  7. Can Clinical Findings Prevent Negative Laparotomy in Parasitosis Mimicking Acute Appendicitis?

    Directory of Open Access Journals (Sweden)

    Musa Zorlu

    2016-01-01

    Full Text Available Objectives. Rates of negative laparotomy (NL for acute appendicitis have been reported as 15% and parasitosis contributed to 2%. This study was planned to reduce the rates of NL by preoperative determination of parasitosis. Methods. In retrospective examination of 2730 appendectomy specimens in Hitit University Department of General Surgery between 2008 and 2012, 55 patients were determined with parasitosis and compared with 102 age-matched randomly selected patients with lymphoid hyperplasia. Results. The parasite group comprised 63.6% females with a mean age of 15.1 years. The number of patients in the parasitosis group increased from city centre to rural areas of towns and villages (p2.2% was determined as a diagnostic value. Conclusion. It is important to determine parasitosis to prevent NL. When acute appendicitis is considered for young patients living in rural areas, the observation of high eosinophil together with negative sonographic findings should bring Enterobius vermicularis parasitosis to mind and thereby should prevent NL.

  8. C-reactive protein and white blood cell count do not improve clinical decision-making in acute appendicitis

    DEFF Research Database (Denmark)

    Tind, Sofie; Lassen, Annmarie Touborg; Zimmermann-Nielsen, Erik;

    2015-01-01

    INTRODUCTION: Acute appendicitis (AA) remains a diagnostic challenge as indicated by the high rate of unnecessary surgery. Blood samples, primarily C-reactive protein (CRP) and leucocyte counts, are used as a diagnostic supplement despite their relatively low sensitivities and specificities...... leucocyte counts did not influence clinical decision-making....

  9. Acute right lower quadrant pain beyond acute appendicitis: MDCT in evaluation of benign and malignant gastrointestinal causes

    Directory of Open Access Journals (Sweden)

    Reem Hassan Bassiouny

    2014-09-01

    Conclusion: Using a systematic pattern approach MDCT has proved to be an extremely useful noninvasive method for evaluation of patients with acute RLQP, allowing diagnosis and management of not only the most common conditions such as appendicitis but also less common conditions.

  10. A hybrid decision support model to discover informative knowledge in diagnosing acute appendicitis

    Directory of Open Access Journals (Sweden)

    Son Chang Sik

    2012-03-01

    Full Text Available Abstract Background The aim of this study is to develop a simple and reliable hybrid decision support model by combining statistical analysis and decision tree algorithms to ensure high accuracy of early diagnosis in patients with suspected acute appendicitis and to identify useful decision rules. Methods We enrolled 326 patients who attended an emergency medical center complaining mainly of acute abdominal pain. Statistical analysis approaches were used as a feature selection process in the design of decision support models, including the Chi-square test, Fisher's exact test, the Mann-Whitney U-test (p Results Of 55 variables, two subsets were found to be indispensable for early diagnostic knowledge discovery in acute appendicitis. The two subsets were as follows: (1 lymphocytes, urine glucose, total bilirubin, total amylase, chloride, red blood cell, neutrophils, eosinophils, white blood cell, complaints, basophils, glucose, monocytes, activated partial thromboplastin time, urine ketone, and direct bilirubin in the univariate analysis-based model; and (2 neutrophils, complaints, total bilirubin, urine glucose, and lipase in the multivariate analysis-based model. The experimental results showed that the model with univariate analysis (80.2%, 82.4%, 78.3%, 76.8%, 83.5%, and 80.3% outperformed models using multivariate analysis (71.6%, 69.3%, 73.7%, 69.7%, 73.3%, and 71.5% with entry and removal criteria of 0.01 and 0.05; 73.5%, 66.0%, 80.0%, 74.3%, 72.9%, and 73.0% with entry and removal criteria of 0.05 and 0.10 in terms of accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and area under ROC curve, during a 10-fold cross validation. A statistically significant difference was detected in the pairwise comparison of ROC curves (p p Conclusions The decision model developed in this study can be applied as an aid in the initial decision making of clinicians to increase vigilance in cases of suspected acute

  11. Correlation of serum C-reactive protein, white blood count and neutrophil percentage with histopathology findings in acute appendicitis

    Directory of Open Access Journals (Sweden)

    Xharra Shefki

    2012-08-01

    Full Text Available Abstract Background Acute appendicitis is one of the most common surgical emergencies. Accurate diagnosis of acute appendicitis is based on careful history, physical examination, laboratory and imaging investigation. The aim of the study is to analyze the role of C-reactive protein (CRP, white blood count (WBC and Neutrophil percentage (NP in improving the accuracy of diagnosis of acute appendicitis and to compare it with the intraoperative assessment and histopathology findings. Materials and methods This investigation was a prospective double blinded clinical study. The study was done on 173 patients surgically treated for acute appendicitis. The WBC, NP, and measurement of CRP were randomly collected pre-operatively from all involved patients. Macroscopic assessment was made from the operation. Appendectomy and a histopathology examination were performed on all patients. Gross description was compared with histopathology results and then correlated with CRP, WBC, and NP. Results The observational accuracy was 87,3%, as compared to histopathological accuracy which was 85.5% with a total of 173 patients that were operated on. The histopathology showed 25 (14.5% patients had normal appendices, and 148 (85.5% patients had acutely inflamed, gangrenous, or perforated appendicitis. 52% were male and 48% were female, with the age ranging from 5 to 59 with a median of 19.7. The gangrenous type was the most frequent (52.6%. The WBC was altered in 77.5% of the cases, NP in 72.3%, and C-reactive protein in 76.9% cases. In those with positive appendicitis, the CRP and WBC values were elevated in 126 patients (72.8%, whereas NP was higher than 75% in 117 patients (67.6%. Out of 106 patients with triple positive tests, 101 (95.2% had appendicitis. The sensitivity, specificity, and positive predictive values of the 3 tests in combination were 95.3%, 72.2%, and 95.3%, respectively. Conclusion The raised value of the CRP was directly related to the severity of

  12. Diagnosing acute appendicitis using a nonoral contrast CT protocol in patients with a BMI of less than 25.

    Science.gov (United States)

    Ramalingam, Vijay; Bates, David D B; Buch, Karen; Uyeda, Jennifer; Zhao, Kathy M; Storer, Lindsey A; Roberts, Marisa B; Lebedis, Christina A; Soto, Jorge A; Anderson, Stephan W

    2016-10-01

    The objective of this study was to compare the accuracy for the diagnosis of appendicitis in patients presenting to the emergency department (ED) with acute, nontraumatic abdominal pain and a body mass index (BMI) of less than 25 before and after the implementation of a nonoral contrast computed tomography (CT) protocol with intravenous contrast. The IRB approved this HIPAA-compliant retrospective study; informed consent was waived. This study included 736 adult patients with a BMI of less than 25 presenting to our ED with acute, nontraumatic abdominal pain over two distinct 6-month time periods. An oral and intravenous contrast-enhanced protocol was utilized in the first cohort (group A), and an intravenous contrast-enhanced protocol without oral contrast was utilized in the second cohort (group B). Three abdominal fellowship-trained readers retrospectively reviewed all CT studies and electronic medical records, including surgical/pathology reports that served as reference standards. Group A consisted of 359 patients; 41 patients had surgically proven appendicitis. The sensitivity and specificity of the readers for diagnosing appendicitis in group A ranged from 95.2-100 and 98.1-99.5 %, respectively. Group B consisted of 372 patients; 39 had surgically proven appendicitis. The sensitivity and specificity of the readers in group B ranged from 92.0-100 and 98.6-100 %, respectively. There were no statistically significant differences in sensitivity or specificity for CT scans performed in groups A and B. In patients with a BMI of less than 25, an intravenous contrast-enhanced CT protocol without oral contrast demonstrates similar accuracy to an intravenous contrast-enhanced protocol with oral contrast for diagnosing acute appendicitis. PMID:27392572

  13. Charge-transfer interaction mediated organogels from 18β-glycyrrhetinic acid appended pyrene

    Directory of Open Access Journals (Sweden)

    Jun Hu

    2013-12-01

    Full Text Available We describe herein the two-component charge-transfer (CT interaction induced organogel formation with 18β-glycyrrhetinic acid appended pyrene (GA-pyrene, 3 as the donor, and 2,4,7-trinitrofluorenone (TNF, 4 as the acceptor. The use of TNF (4 as a versatile electron acceptor in the formation of CT gels is demonstrated through the formation of gels in a variety of solvents. Thermal stability, stoichiometry, scanning electron microscopy (SEM, optical micrographs, and circular dichroism (CD are performed on these CT gels to investigate their thermal and assembly properties. UV–vis, fluorescence, mass spectrometric as well as variable-temperature 1H NMR experiments on these gels suggest that the CT interaction is one of the major driving forces for the formation of these organogels.

  14. Multifunctional 8-hydroxyquinoline-appended cyclodextrins as new inhibitors of metal-induced protein aggregation.

    Science.gov (United States)

    Oliveri, Valentina; Attanasio, Francesco; Puglisi, Antonino; Spencer, John; Sgarlata, Carmelo; Vecchio, Graziella

    2014-07-14

    Mounting evidence suggests a pivotal role of metal imbalances in protein misfolding and amyloid diseases. As such, metal ions represent a promising therapeutic target. In this context, the synthesis of chelators that also contain complementary functionalities to combat the multifactorial nature of neurodegenerative diseases is a highly topical issue. We report two new 8-hydroxyquinoline-appended cyclodextrins and highlight their multifunctional properties, including their Cu(II) and Zn(II) binding abilities, and capacity to act as antioxidants and metal-induced antiaggregants. In particular, the latter property has been applied in the development of an effective assay that exploits the formation of amyloid fibrils when β-lactoglobulin A is heated in the presence of metal ions.

  15. Conducting nanofibers and organogels derived from the self-assembly of tetrathiafulvalene-appended dipeptides.

    Science.gov (United States)

    Nalluri, Siva Krishna Mohan; Shivarova, Nadezhda; Kanibolotsky, Alexander L; Zelzer, Mischa; Gupta, Swati; Frederix, Pim W J M; Skabara, Peter J; Gleskova, Helena; Ulijn, Rein V

    2014-10-21

    We demonstrate the nonaqueous self-assembly of a low-molecular-mass organic gelator based on an electroactive p-type tetrathiafulvalene (TTF)-dipeptide bioconjugate. We show that a TTF moiety appended with diphenylalanine amide derivative (TTF-FF-NH2) self-assembles into one-dimensional nanofibers that further lead to the formation of self-supporting organogels in chloroform and ethyl acetate. Upon doping of the gels with electron acceptors (TCNQ/iodine vapor), stable two-component charge transfer gels are produced in chloroform and ethyl acetate. These gels are characterized by various spectroscopy (UV-vis-NIR, FTIR, and CD), microscopy (AFM and TEM), rheology, and cyclic voltammetry techniques. Furthermore, conductivity measurements performed on TTF-FF-NH2 xerogel nanofiber networks formed between gold electrodes on a glass surface indicate that these nanofibers show a remarkable enhancement in the conductivity after doping with TCNQ. PMID:25259412

  16. Chronic appendicitis and complete appendiceal invagination: UC, CT and MRI findings

    International Nuclear Information System (INIS)

    The appendiceal intussusception is a rare entity. Usually there is a predisposing factor such as a tumor, mucocele, etc. We report the case of a 61 years old female patient, with recurrent abdominal pain, localized in the right lower quadrant. We performed different diagnostic imaging exams including: double-contrast barium enema, enteroclysis, ultrasonography, computed tomography and magnetic resonance. After endoscopy a surgical procedure removed the appendix. The pathological anatomy confirmed the diagnosis of an appendiceal intussusception, complicated with a chronic inflammatory process. Appendiceal intussusception and chronic appendicitis are infrequent; it is even more uncommon the association of both entities. In addition, it was not found a predisposing cause to intussusception. For the reasons described above, we conclude that this case is an unusual presentation of appendiceal intussusception, not previously reported. (author)

  17. INVESTIGATION OF VISCOUS FLOW FIELD AROUND AN APPENDED REVOLUTION BODY WITH GUIDE VANE PROPELLER

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    A RANS solver is presented to numerically simulate the viscous wake of an appended revolution body with guide vane propeller at the Reynolds number 107. The k-ε turbulence model together with wall function is used. The resulting finite difference equations are solved by SIMPLEC and ADI. The technique of rising up the bottom surface is presented to overcome radial contraction problem in Cartesian coordinate system. The three-dimensional body forces are separately adopted to model the affection of the guide vane and propeller. The detailed flow characteristics,especially the counter-swirl component generated by the guide vane in the propeller inflow, are numerically seized successfully. Compared with the experimental data, The computational axial velocity on the propeller disk plane comes up to engineering requirement.

  18. [Chilaiditi's syndrome complicated by subdiaphragmatic perforated appendicitis: unusual manifestation of a rare condition].

    Science.gov (United States)

    Lenz, M; Kindler, M; Schilling, M; Pollack, T; Schwab, W; Becker, M

    2011-09-01

    We report on a case of an 80-year-old female patient who presented to the emergency room of with right upper quadrant abdominal pain since the day before. During the initial diagnostic an abdominal x-ray study revealed an air-filled colonic section of the bowel under the right hemidiaphragm corresponding to Chilaiditi's sign. The clinical symptoms and laboratory results were mild at this time. After 12 h the patient developed right upper quadrant peritonitis due to a perforated, subdiaphragmatic appendicitis based on Chilaiditi's syndrome. During surgical treatment the cecum and parts of the ascending colon were found to be interposed between the liver and right hemidiaphragm. A right hemicolectomy was performed which led to complete recovery of the patient. In addition to presenting this interesting case this article highlights the regime of the diagnostics and therapy of a complication of the very rare condition of Chilaiditi's syndrome.

  19. [Review of "Appended emergent recipes" recorded in New Chronicle of Wuqiang County of the Qing dynasty].

    Science.gov (United States)

    Kong, Lingqing

    2014-01-01

    In the volume 10 of New Chronicle of the Wuqiang County compiled in the 10(th) year of Daoguang reign (1830), there is an attached "Appended emergent recipes" with a large space devoted to TCM first-aid therapies, including 13,000 Chinese characters under 14 topics. Under each topic, the first-aid measures from Xi yuan ji lu (Collected Records of Washing Away Wrong Cases) are first cited, followed by many practical first-aid methods, thus summarizing emergency medicine and experiences since the Song dynasty, embodying the abundant first-aid therapy of northern China, representing the real level of emergent medicine of that period. It is quite seldom to see so rich emergent measures collected in an overall county chronicle and is therefore of significance for the studies on the history of the versions of the book Xi yuan ji lu. PMID:24774890

  20. Rectal contrast-enhanced computed tomography in the diagnosis of acute appendicitis; Tomografia computarizada con contraste rectal en el diagnostico de la apendicitis aguda

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    To assess the efficacy and utility of computed tomography (CT) in the diagnosis of appendicitis, and to evaluate the reliability of CT findings in right iliac fossa in the confirmation or exclusion of this diagnosis. Over a one-year period, 152 patients presenting clinical signs of appendicitis underwent CT scans. The images were reviewed by two radiologists who considered whether the appendix was normal or enlarged and the existence of other signs of appendicitis for the purpose of determining whether or not the patient presented appendicitis. The definitive diagnoses were established by surgery or by clinical follow-up. The sensitivity of CT for the diagnosis of appendicitis was 81.8%, the specificity was 95.3%, the positive predictive value was 93.1%, the negative predictive value was 87.2% and the reliability was 89.9%. The signs of appendicitis observed were: appendicoliths (sensitivity 30.3% and specificity 98.8%), fluid collections (sensitivity 19.7%, specificity 96.5%), cecal enlargement (sensitivity 21.2%, specificity 97.7%), inflammation of pericecal fat (sensitivity 72.7%, specificity 90.7%), fascial thickening (sensitivity 48.5%, specificity 91.9%) and an appendix measuring more than 6 mm (sensitivity 78.8%, specificity 94.3%). Adenopathy and free peritoneal fluid were not significantly related to appendicitis. The presence of a normal appendix filled with air or contrast material had an elevated negative predictive value with respect to appendicitis. In 35 of the 94 cases with negative CT scans, the images suggested alternative diagnoses. CT is a highly reliable diagnostic method for appendicitis. The observation of an appendix filled with air or contrast material has an elevated negative predictive value. The presence of appendicoliths has an elevated positive predictive value. (Author) 29 refs.

  1. Epiploic appendicitis and omental infarction. Findings in the ultrasonography and computerized tomography; Apendicitis epiploica e infarto omental. Hallazgos en ecografia y tomografia computarizada

    Energy Technology Data Exchange (ETDEWEB)

    Migule, A.; Ripolles, T.; Martinez, M. J.; Morote, V.; Ruiz, A. [Hospital Universitario Dr. Peset. Valencia (Spain)

    2001-07-01

    Describe the findings in the ultrasonography and computerized tomography (CT) of the omental infarction and epiploic appendicitis. The clinical and radiological findings of the patients diagnosed in our hospital with epiploic appendicitis or omental infarctions between August 1994 and March 2001 were assessed retrospectively. We found a high incidence (42 cases) of these two diseases: 30 patients with diagnosis of epiploic appendicitis and 12 with the diagnosis of omental infarction. Four patients were treated surgically, while the remaining 38 were conservatively, without posterior complications. The ultrasonography and CT images is characteristics. making it possible to make a diagnosis of epiploic appendicitis or omental infarction with certainty. It is not necessary to make a differential diagnosis between the two entities because their prognosis and treatment are similar. Their incidence is much more frequent than that previously published. (Author) 19 refs.

  2. Increased levels of deleted in malignant brain tumours 1 (DMBT1) in active bacteria-related appendicitis

    DEFF Research Database (Denmark)

    Kaemmerer, Elke; Schneider, Ursula; Klaus, Christina;

    2012-01-01

    tumours 1 (DMBT1; gp340) is a secreted glycoprotein which is found in the surface lining epithelia of human small and large intestine. DMBT1 is suggested to play a role in enterocyte differentiation and surface protection from intestinal bacteria. The aim of this study was to elucidate DMBT1 expression...... in bacteria-related active intestinal inflammation such as appendicitis. Methods and results:  mRNA and protein levels of DMBT1 were analysed in surgical resections of 50 appendices (active inflammation: n = 25). In non-actively inflamed appendices, inter-individual differences in basal DMBT1 levels...... of enterocytes and some non-epithelial cells were found. In active appendicitis, enterocytic DMBT1 mRNA expression was increased approximately fivefold, which was paralleled by a corresponding increase of cytoplasmic and secreted DMBT1 protein levels. Increased DMBT1 expression was predominant in enterocytes...

  3. Omental Torsion after Laparoscopic Roux-en-Y Gastric Bypass Mimicking Appendicitis: A Case Report and Review of the Literature

    Science.gov (United States)

    Basilicata, Giacinto; Nocito, Antonio

    2016-01-01

    Introduction. Laparoscopic Roux-en-Y gastric bypass (LRYGBP) is a common procedure in obesity surgery. The aim of an antecolic approach is to reduce the rate of internal herniation. Our aim is to make bariatric surgeons aware of another possible complication of antecolic LRYGBP. Methods and Results. We present a case report of omental torsion 24 months after antecolic LRYGBP presenting as an acute abdomen, suggesting appendicitis. During diagnostic laparoscopy, omental infarction due to torsion was observed. Resection of the avital omentum was performed. Discussion. Omental torsion after antecolic LRYGBP is a rare complication. When appearing in the early postoperative phase, it may mimic an anastomotic leakage. It may also occur as late complication, presenting with acute abdomen as an appendicitis. PMID:27019758

  4. Acute appendicitis: prospective evaluation of a diagnostic algorithm integrating ultrasound and low-dose CT to reduce the need of standard CT

    Energy Technology Data Exchange (ETDEWEB)

    Poletti, Pierre-Alexandre; Platon, Alexandra [University Hospital of Geneva, Department of Radiology, Geneva (Switzerland); University Hospital of Geneva, Emergency Center, Geneva (Switzerland); Perrot, Thomas de; Becker, Christoph D. [University Hospital of Geneva, Department of Radiology, Geneva (Switzerland); Sarasin, Francois; Rutschmann, Olivier [University Hospital of Geneva, Emergency Center, Geneva (Switzerland); Andereggen, Elisabeth [University Hospital of Geneva, Emergency Center, Geneva (Switzerland); University Hospital of Geneva, Department of Surgery, Geneva (Switzerland); Dupuis-Lozeron, Elise; Perneger, Thomas [University Hospital of Geneva, Division of Clinical Epidemiology, Geneva (Switzerland); Gervaz, Pascal [University Hospital of Geneva, Department of Surgery, Geneva (Switzerland)

    2011-12-15

    To evaluate an algorithm integrating ultrasound and low-dose unenhanced CT with oral contrast medium (LDCT) in the assessment of acute appendicitis, to reduce the need of conventional CT. Ultrasound was performed upon admission in 183 consecutive adult patients (111 women, 72 men, mean age 32) with suspicion of acute appendicitis and a BMI between 18.5 and 30 (step 1). No further examination was recommended when ultrasound was positive for appendicitis, negative with low clinical suspicion, or demonstrated an alternative diagnosis. All other patients underwent LDCT (30 mAs) (step 2). Standard intravenously enhanced CT (180 mAs) was performed after indeterminate LDCT (step 3). No further imaging was recommended after ultrasound in 84 (46%) patients; LDCT was obtained in 99 (54%). LDCT was positive or negative for appendicitis in 81 (82%) of these 99 patients, indeterminate in 18 (18%) who underwent standard CT. Eighty-six (47%) of the 183 patients had a surgically proven appendicitis. The sensitivity and specificity of the algorithm were 98.8% and 96.9%. The proposed algorithm achieved high sensitivity and specificity for detection of acute appendicitis, while reducing the need for standard CT and thus limiting exposition to radiation and to intravenous contrast media. (orig.)

  5. Acute appendicitis: prospective evaluation of a diagnostic algorithm integrating ultrasound and low-dose CT to reduce the need of standard CT

    International Nuclear Information System (INIS)

    To evaluate an algorithm integrating ultrasound and low-dose unenhanced CT with oral contrast medium (LDCT) in the assessment of acute appendicitis, to reduce the need of conventional CT. Ultrasound was performed upon admission in 183 consecutive adult patients (111 women, 72 men, mean age 32) with suspicion of acute appendicitis and a BMI between 18.5 and 30 (step 1). No further examination was recommended when ultrasound was positive for appendicitis, negative with low clinical suspicion, or demonstrated an alternative diagnosis. All other patients underwent LDCT (30 mAs) (step 2). Standard intravenously enhanced CT (180 mAs) was performed after indeterminate LDCT (step 3). No further imaging was recommended after ultrasound in 84 (46%) patients; LDCT was obtained in 99 (54%). LDCT was positive or negative for appendicitis in 81 (82%) of these 99 patients, indeterminate in 18 (18%) who underwent standard CT. Eighty-six (47%) of the 183 patients had a surgically proven appendicitis. The sensitivity and specificity of the algorithm were 98.8% and 96.9%. The proposed algorithm achieved high sensitivity and specificity for detection of acute appendicitis, while reducing the need for standard CT and thus limiting exposition to radiation and to intravenous contrast media. (orig.)

  6. 阑尾原发肿瘤的CT诊断%CT diagnosis of primary appendical neoplasms

    Institute of Scientific and Technical Information of China (English)

    刘媛; 周纯武; 王爽

    2012-01-01

    目的 评价阑尾原发肿瘤的CT表现.方法 对27例经手术病理证实的阑尾原发肿瘤患者的腹盆部CT进行回顾性分析:记录肿物大小、肿物形态(肿物长短径比例大于1.5者为长管状)、肿物密度(肿物密度分为囊性、实性),囊性肿物囊壁厚度、囊壁有无钙化、肿物浆膜面表现,周围脂肪间隙改变,有无淋巴结转移及远处器官转移.结果 27例阑尾原发肿瘤,其中黏液性囊腺瘤11例、交界恶性囊腺瘤3例,黏液性囊腺癌10例、腺癌3例,良性者多表现为囊性肿物,恶性者伴囊壁增厚、强化,腹水、腹腔假黏液瘤的比例增加.结论 CT是发现阑尾原发肿瘤的有效检查方法,多表现为阑尾囊性肿物,可伴发腹腔假黏液瘤,术前CT检查对正确诊断有帮助.%Objective To evaluate the CT findings of primary appendical neoplasm. Methods CT findings of 27 patients with sugical and pathologically proved were analyzed restrospectly. The size, shape, and density of the neoplasm were recorded. If the neoplasm was cystic density, the thickness of the cystic wall, the calification of the cystic wall were recorded. The periappedical fat in abdominal lymph node was noted. Results The pathological pattens of the 27 neoplasm included mucinous cystadenoma (n = 11), border malignant mucinous cystadenoma ( n = 3). The benign neoplasms were cystic masses. If the cystic wall was thicken, thecystic wall was strenthan, the ascites and celiac false muscus tumor were found in abdomen, then the neoplasms should be malignant. Conclusion CT is an effective method for detecting appendical tumpr. It is helpful for the patient before operative treatment.

  7. Modular Attachment of Appended Boron Lewis Acids to a Ruthenium Pincer Catalyst: Metal-Ligand Cooperativity Enables Selective Alkyne Hydrogenation.

    Science.gov (United States)

    Tseng, Kuei-Nin T; Kampf, Jeff W; Szymczak, Nathaniel K

    2016-08-24

    A new series of bifunctional Ru complexes with pendent Lewis acidic boranes were prepared by late-stage modification of an active hydrogen-transfer catalyst. The appended boranes modulate the reactivity of a metal hydride as well as catalytic hydrogenations. After installing acidic auxiliary groups, the complexes become multifunctional and catalyze the cis-selective hydrogenation of alkynes with higher rates, conversions, and selectivities compared with the unmodified catalyst. PMID:27472301

  8. Usefulness of computed tomography in patients with right inferior abdominal quadrant pain: acute appendicitis and its alternative diagnosis

    International Nuclear Information System (INIS)

    Purpose: To review the tomography findings of the acute appendicitis, their complications and alternative diagnosis. To value the use of helicoidal computed tomography (HCT) in the diagnosis of acute appendicitis and in the study of patients with right inferior abdominal quadrant (RIQ) pain and acute abdomen, for diagnosis and eventual complications, in order to decide treatment. Materials and method: For five months, the populations included in this retrospectively study were all patients delivered for presenting with RIQ pain for a HCT exam. These exams were made with oral and intravenous contrasts, when there were not contraindications. The HCT results were correlated with clinical follow up, surgery and histopathologic exams. Results: Over a total of 100 patients studied, 53 presented tomographic diagnosis of appendicitis, 22 of which presented perforation signs; 27 showed an alternative diagnosis (ovaries follicles, ureteral litiasis, tiphlitis, diverticulitis, colitis, salpingitis), 18 patients did not present tomographic findings to support the clinical symptoms and 2 presented indeterminated results. These data represented a sensibility of 100%, specificity of 95,7%, positive predictive value (PPV) of 96,2% and negative predictive value (NPV) of 100% for the tomography diagnosis of acute appendicitis and a sensibility of 100%, specificity of 81,8%, PPV of 95,1% and NPV of 100% for the tomography diagnosis of the different etiology in patient with right inferior acute abdomen. Conclusion: HCT is extremely useful in the study of patients with acute abdomen with origin in the RIQ, not only to make a diagnosis, but also to evaluate the complications, so as to decide proper treatment. (authors)

  9. Primary appendiceal lymphoma presenting as suspected perforated acute appendicitis: clinical, sonography and CT findings with pathologic correlation

    OpenAIRE

    Guo, Jingjing; Wu, Gang; Chen, Xiaojun; Li, Xiaodong

    2014-01-01

    The gastrointestinal tract is the most common site for extranodal involvement by non-Hodgkin’s lymphoma. However, primary appendiceal lymphomas presenting as perforated acute appendicitis are very rare: they occur in only 0.015% of all gastrointestinal lymphoma cases. The management of this condition is still controversial, and a multimodality approach (e.g., surgery, radiation therapy, and chemotherapy) is the optimal treatment. In these cases, appendiceal non-Hodgkin’s lymphomas typically m...

  10. Spontaneous intra-peritoneal bleeding secondary to warfarin, presenting as an acute appendicitis: a case report and review of literature

    OpenAIRE

    Shah Dharmendra K; Kumar Vikas; Sagar Jayesh; Bhatnagar Ashok

    2006-01-01

    Abstract Background Warfarin is a coumarin anti-coagulant, used widely for the therapeutic and prophylactic anticoagulation. Although, it is considered as a life saving medicine, it is associated with the significant adverse effects including intra-abdominal bleeding, which have been very well documented in literature. However, the presentation of warfarin induced intra-peritoneal bleeding as an acute appendicitis has not been reported in English literature. We report this rare, spontaneous i...

  11. EnD-Seq and AppEnD: sequencing 3' ends to identify nontemplated tails and degradation intermediates.

    Science.gov (United States)

    Welch, Joshua D; Slevin, Michael K; Tatomer, Deirdre C; Duronio, Robert J; Prins, Jan F; Marzluff, William F

    2015-07-01

    Existing methods for detecting RNA intermediates resulting from exonuclease degradation are low-throughput and laborious. In addition, mapping the 3' ends of RNA molecules to the genome after high-throughput sequencing is challenging, particularly if the 3' ends contain post-transcriptional modifications. To address these problems, we developed EnD-Seq, a high-throughput sequencing protocol that preserves the 3' end of RNA molecules, and AppEnD, a computational method for analyzing high-throughput sequencing data. Together these allow determination of the 3' ends of RNA molecules, including nontemplated additions. Applying EnD-Seq and AppEnD to histone mRNAs revealed that a significant fraction of cytoplasmic histone mRNAs end in one or two uridines, which have replaced the 1-2 nt at the 3' end of mature histone mRNA maintaining the length of the histone transcripts. Histone mRNAs in fly embryos and ovaries show the same pattern, but with different tail nucleotide compositions. We increase the sensitivity of EnD-Seq by using cDNA priming to specifically enrich low-abundance tails of known sequence composition allowing identification of degradation intermediates. In addition, we show the broad applicability of our computational approach by using AppEnD to gain insight into 3' additions from diverse types of sequencing data, including data from small capped RNA sequencing and some alternative polyadenylation protocols. PMID:26015596

  12. EnD-Seq and AppEnD: sequencing 3′ ends to identify nontemplated tails and degradation intermediates

    Science.gov (United States)

    Welch, Joshua D.; Slevin, Michael K.; Tatomer, Deirdre C.; Duronio, Robert J.

    2015-01-01

    Existing methods for detecting RNA intermediates resulting from exonuclease degradation are low-throughput and laborious. In addition, mapping the 3′ ends of RNA molecules to the genome after high-throughput sequencing is challenging, particularly if the 3′ ends contain post-transcriptional modifications. To address these problems, we developed EnD-Seq, a high-throughput sequencing protocol that preserves the 3′ end of RNA molecules, and AppEnD, a computational method for analyzing high-throughput sequencing data. Together these allow determination of the 3′ ends of RNA molecules, including nontemplated additions. Applying EnD-Seq and AppEnD to histone mRNAs revealed that a significant fraction of cytoplasmic histone mRNAs end in one or two uridines, which have replaced the 1–2 nt at the 3′ end of mature histone mRNA maintaining the length of the histone transcripts. Histone mRNAs in fly embryos and ovaries show the same pattern, but with different tail nucleotide compositions. We increase the sensitivity of EnD-Seq by using cDNA priming to specifically enrich low-abundance tails of known sequence composition allowing identification of degradation intermediates. In addition, we show the broad applicability of our computational approach by using AppEnD to gain insight into 3′ additions from diverse types of sequencing data, including data from small capped RNA sequencing and some alternative polyadenylation protocols. PMID:26015596

  13. Appending High-Resolution Elevation Data to GPS Speed Traces for Vehicle Energy Modeling and Simulation

    Energy Technology Data Exchange (ETDEWEB)

    Wood, E.; Burton, E.; Duran, A.; Gonder, J.

    2014-06-01

    Accurate and reliable global positioning system (GPS)-based vehicle use data are highly valuable for many transportation, analysis, and automotive considerations. Model-based design, real-world fuel economy analysis, and the growing field of autonomous and connected technologies (including predictive powertrain control and self-driving cars) all have a vested interest in high-fidelity estimation of powertrain loads and vehicle usage profiles. Unfortunately, road grade can be a difficult property to extract from GPS data with consistency. In this report, we present a methodology for appending high-resolution elevation data to GPS speed traces via a static digital elevation model. Anomalous data points in the digital elevation model are addressed during a filtration/smoothing routine, resulting in an elevation profile that can be used to calculate road grade. This process is evaluated against a large, commercially available height/slope dataset from the Navteq/Nokia/HERE Advanced Driver Assistance Systems product. Results will show good agreement with the Advanced Driver Assistance Systems data in the ability to estimate road grade between any two consecutive points in the contiguous United States.

  14. A fluorescent sensing membrane for iodine based on intramolecular excitation energy transfer of anthryl appended porphyrin

    Institute of Scientific and Technical Information of China (English)

    LONG LiPing; YOU MingXu; WANG Hao; WANG YongXiang; YANG RongHua

    2009-01-01

    A single anthryl appended meso-tetraphenylporphyrin (TPP) dyed has been synthesized and applied in fluorescence sensing of iodine based on the intramolecular excitation energy transfer. The molecular recognition of the sensor is based on the interaction of iodine with inner anthracene moiety of the dyad, while the signal reporter for the recognition process is the TPP fluorescence quenching. Because the emission spectrum of anthracene is largely overlapped with the Soret band absorption of TPP, in-tremolecular excitation energy transfer interaction occurs between the donor, anthracene and acceptor, TPP. This energy transfer leads to TPP fluorescence emission by excitation of anthracene. The sensor was constructed by immobilizing the dyad in a plasticized poly(vinyl chloride) (PVC) membrane. The sensing membrane shows higher sensitivity compared to the sensors by using anthracene, TPP, or a mixture of anthracene and TPP as sensing materials. Under the optimum conditions, iodine in a sample membrane shows satisfactory response characteristics including good reproducibility, reversibility end stability, as well as the short response time of less than 60 s. Except for Cr2O2-7 and MnO-4, other common metal ions and anions in foodstuff do not interfere with iodine determination. The proposed method was applied in the determination of iodine in table salt samples. The results agree well with those obtained by other methods.

  15. A fluorescent sensing membrane for iodine based on intramolecular excitation energy transfer of anthryl appended porphyrin

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    A single anthryl appended meso-tetraphenylporphyrin (TPP) dyad has been synthesized and applied in fluorescence sensing of iodine based on the intramolecular excitation energy transfer. The molecular recognition of the sensor is based on the interaction of iodine with inner anthracene moiety of the dyad, while the signal reporter for the recognition process is the TPP fluorescence quenching. Because the emission spectrum of anthracene is largely overlapped with the Soret band absorption of TPP, intramolecular excitation energy transfer interaction occurs between the donor, anthracene and acceptor, TPP. This energy transfer leads to TPP fluorescence emission by excitation of anthracene. The sensor was constructed by immobilizing the dyad in a plasticized poly(vinyl chloride) (PVC) membrane. The sensing membrane shows higher sensitivity compared to the sensors by using anthracene, TPP, or a mixture of anthracene and TPP as sensing materials. Under the optimum conditions, iodine in a sample solution can be determined from 2.04 to 23.6 mmol·L-1 with a detection limit of 33 nmol·L-1. The sensing membrane shows satisfactory response characteristics including good reproducibility, reversibility and stability, as well as the short response time of less than 60 s. Except for Cr2O72- and MnO4-, other common metal ions and anions in foodstuff do not interfere with iodine determination. The proposed method was applied in the determination of iodine in table salt samples. The results agree well with those obtained by other methods.

  16. Lessons to be learned: a case study approach--acute appendicitis masquerading as macroamylasaemia.

    Science.gov (United States)

    Ganesh, Muniappan; Salam, Imroz

    2008-05-01

    Macroamylasaemia is a condition in which serum amylase is elevated in the presence of a low to normal urinary amylase and normal renal function. It is rare but can masquerade as other clinical disorders. Discussed here is a case report of a patient who presented initially with abdominal pain (later recognized as being due to gangrenous appendicitis) and in whom there was a very high serum amylase level, leading to an erroneous initial diagnosis and management as acute pancreatitis. The CT scan of the abdomen was normal without any evidence of pancreatitis. Subsequently, the renal amylase:creatinine clearance ratio (C(am)/C(cr)) was found to be low, being characteristic and diagnostic of macroamylasaemia; the latter was, in turn, the cause for the elevated serum amylase level. The underlying macroamylasaemia had thus masqueraded as pancreatitis. The patient underwent appendicectomy and hence made an excellent recovery. It is vitally important to recognize this condition in order to avoid both an incorrect diagnosis and inappropriate treatment/management.

  17. The role of DNA amplification and cultural growth in complicated acute appendicitis

    Directory of Open Access Journals (Sweden)

    Francesca Tocchioni

    2016-09-01

    Full Text Available Bacterial growth of peritoneal fluid specimens obtained during surgical procedures for acute appendicitis may be useful to optimize further antibiotic therapy in complicated cases. DNA amplification represents a fast technique to detect microbial sequences. We aimed to compare the potential of DNA amplification versus traditional bacterial growth culture highlighting advantages and drawbacks in a surgical setting. Peritoneal fluid specimens were collected during surgery from 36 children who underwent appendectomy between May and December 2012. Real-time polymerase chain reaction (RT-PCR and cultures were performed on each sample. RT-PCR showed an amplification of 16S in 18/36 samples, Escherichia coli (in 7 cases, Pseudomonas aeruginosa (3, Fusobacterium necrophorum (3, Adenovirus (2, E.coli (1, Klebsiella pneumoniae (1, Serratia marcescens/Enterobacter cloacae (1. Bacterial growth was instead observed only in four patients (3 E.coli and 1 P.aeruginosa and Bacteroides ovatus. Preoperative C-reactive protein and inflammation degree, the most reliable indicators of bacterial translocation, were elevated as expected. DNA amplification was a quick and useful method to detect pathogens and it was even more valuable in detecting aggressive pathogens such as anaerobes, difficult to preserve in biological cultures; its drawbacks were the lack of biological growths and of antibiograms. In our pilot study RT-PCR and cultures did not influence the way patients were treated.

  18. Primary ovarian leiomyoma associated with endometriotic cyst presenting with symptoms of acute appendicitis: a case report

    Directory of Open Access Journals (Sweden)

    Puljiz Zvonimir

    2009-07-01

    Full Text Available Abstract Background Ovarian leiomyoma is a rare benign tumor that accounts for 0.5 to 1% of all benign ovarian tumors. It probably arises from smooth muscle cells in the ovarian hilar blood vessels but there are other possible origins including cells in the ovarian ligament, smooth muscle cells or multipotential cells in the ovarian stroma, undifferentiated germ cells, or cortical smooth muscle metaplasia. Additionally, smooth muscle metaplasia of endometriotic stroma, smooth muscle present in mature cystic teratomas, and smooth muscle in the walls of mucinous cystic tumor may explain their occurrence in the ovary in some cases. Case presentation A 31-year-old woman was admitted to our surgical emergency service with a one-day history of appendicitis-like symptoms. Upon laparotomy, there was a solid, oval left-sided ovarian tumor located behind the uterus. The tumor was sent to the pathology department. A diagnosis of primary ovarian leiomyoma associated with an endometriotic cyst was established. Conclusion The origin of ovarian leiomyoma is still unresolved. In our case, the tumor probably arose from smooth muscle cells derived from myofibroblasts that originate from metaplastic ovarian stromal cells present in the rim of the endometriotic cyst. Despite its rarity, ovarian leiomyoma should be considered in the differential diagnosis of ovarian spindle cell tumors. Appropriate diagnosis may require additional immunohistochemical analysis in some cases.

  19. Cooperative insertion of CO2 in diamine-appended metal-organic frameworks

    Science.gov (United States)

    McDonald, Thomas M.; Mason, Jarad A.; Kong, Xueqian; Bloch, Eric D.; Gygi, David; Dani, Alessandro; Crocellà, Valentina; Giordanino, Filippo; Odoh, Samuel O.; Drisdell, Walter S.; Vlaisavljevich, Bess; Dzubak, Allison L.; Poloni, Roberta; Schnell, Sondre K.; Planas, Nora; Lee, Kyuho; Pascal, Tod; Wan, Liwen F.; Prendergast, David; Neaton, Jeffrey B.; Smit, Berend; Kortright, Jeffrey B.; Gagliardi, Laura; Bordiga, Silvia; Reimer, Jeffrey A.; Long, Jeffrey R.

    2015-03-01

    The process of carbon capture and sequestration has been proposed as a method of mitigating the build-up of greenhouse gases in the atmosphere. If implemented, the cost of electricity generated by a fossil fuel-burning power plant would rise substantially, owing to the expense of removing CO2 from the effluent stream. There is therefore an urgent need for more efficient gas separation technologies, such as those potentially offered by advanced solid adsorbents. Here we show that diamine-appended metal-organic frameworks can behave as `phase-change' adsorbents, with unusual step-shaped CO2 adsorption isotherms that shift markedly with temperature. Results from spectroscopic, diffraction and computational studies show that the origin of the sharp adsorption step is an unprecedented cooperative process in which, above a metal-dependent threshold pressure, CO2 molecules insert into metal-amine bonds, inducing a reorganization of the amines into well-ordered chains of ammonium carbamate. As a consequence, large CO2 separation capacities can be achieved with small temperature swings, and regeneration energies appreciably lower than achievable with state-of-the-art aqueous amine solutions become feasible. The results provide a mechanistic framework for designing highly efficient adsorbents for removing CO2 from various gas mixtures, and yield insights into the conservation of Mg2+ within the ribulose-1,5-bisphosphate carboxylase/oxygenase family of enzymes.

  20. Lessons to be learned: a case study approach--acute appendicitis masquerading as macroamylasaemia.

    Science.gov (United States)

    Ganesh, Muniappan; Salam, Imroz

    2008-05-01

    Macroamylasaemia is a condition in which serum amylase is elevated in the presence of a low to normal urinary amylase and normal renal function. It is rare but can masquerade as other clinical disorders. Discussed here is a case report of a patient who presented initially with abdominal pain (later recognized as being due to gangrenous appendicitis) and in whom there was a very high serum amylase level, leading to an erroneous initial diagnosis and management as acute pancreatitis. The CT scan of the abdomen was normal without any evidence of pancreatitis. Subsequently, the renal amylase:creatinine clearance ratio (C(am)/C(cr)) was found to be low, being characteristic and diagnostic of macroamylasaemia; the latter was, in turn, the cause for the elevated serum amylase level. The underlying macroamylasaemia had thus masqueraded as pancreatitis. The patient underwent appendicectomy and hence made an excellent recovery. It is vitally important to recognize this condition in order to avoid both an incorrect diagnosis and inappropriate treatment/management. PMID:18595630

  1. The Role of DNA Amplification and Cultural Growth in Complicated Acute Appendicitis

    Science.gov (United States)

    Tocchioni, Francesca; Tani, Chiara; Bartolini, Laura; Moriondo, Maria; Nieddu, Francesco; Pecile, Patrizia; Azzari, Chiara; Messineo, Antonio; Ghionzoli, Marco

    2016-01-01

    Bacterial growth of peritoneal fluid specimens obtained during surgical procedures for acute appendicitis may be useful to optimize further antibiotic therapy in complicated cases. DNA amplification represents a fast technique to detect microbial sequences. We aimed to compare the potential of DNA amplification versus traditional bacterial growth culture highlighting advantages and drawbacks in a surgical setting. Peritoneal fluid specimens were collected during surgery from 36 children who underwent appendectomy between May and December 2012. Real-time polymerase chain reaction (RT-PCR) and cultures were performed on each sample. RT-PCR showed an amplification of 16S in 18/36 samples, Escherichia coli (in 7 cases), Pseudomonas aeruginosa (3), Fusobacterium necrophorum (3), Adenovirus (2), E.coli (1), Klebsiella pneumoniae (1), Serratia marcescens/Enterobacter cloacae (1). Bacterial growth was instead observed only in four patients (3 E.coli and 1 P.aeruginosa and Bacteroides ovatus). Preoperative C-reactive protein and inflammation degree, the most reliable indicators of bacterial translocation, were elevated as expected. DNA amplification was a quick and useful method to detect pathogens and it was even more valuable in detecting aggressive pathogens such as anaerobes, difficult to preserve in biological cultures; its drawbacks were the lack of biological growths and of antibiograms. In our pilot study RT-PCR and cultures did not influence the way patients were treated. PMID:27777701

  2. Informative content of clinical symptoms of acute appendicitis in different terms of pregnancy

    Directory of Open Access Journals (Sweden)

    Kutovoy A.B.

    2015-09-01

    Full Text Available With the purpose to evaluate diagnostic efficacy of some clinical symptoms of acute appendicitis 75 women in different terms of pregnancy were examined. Informative content of such symptoms as Kocher- Volkovich, Rovsing, Bartomje - Michelson, Sitkovsky, Gabay, Brendo, Michelson, Ivanov was studied. Pain syndrome was fixed in all examined women. Pain localization was various and depended on the pregnancy term. During the I trimester of pregnancy the most often pain was manifestated in epigastrium and right lower quadrant, rarely in other abdomen regions. In the II trimester in majority of cases pain occurred in right lower quadrant. During III trimester pain prevailed in right upper quadrant of abdomen. Analyzing informative component of researching symptoms there was noted significant decrease (р<0,05; р<0,01; р<0,001 of their diagnostic value with growth of pregnancy term. Therefore Kocher – Volkovich and Rovsing symptoms were the most informative in the I trimester of pregnancy. Diagnostic efficacy of Brendo(67,3%, Michelson(55,7%, Ivanov(59,6% symptoms was higher than that of Kocher – Volkovich (36,5%, Rovsing (28,8%, Sitkovsky (51,9%, Bartomje – Michelson (55,7% symptoms, their value was diminishing together with increase of pregnancy terms.

  3. Endothelial Fas-Ligand in Inflammatory Bowel Diseases and in Acute Appendicitis.

    Science.gov (United States)

    Kokkonen, Tuomo S; Karttunen, Tuomo J

    2015-12-01

    Fas-mediated induction of apoptosis is a major factor in the selection of lymphocytes and downregulation of immunological processes. In the present study, we have assessed endothelial Fas-ligand (FasL) expression in normal human ileum, appendix, and colon, and compared the expression levels with that in inflammatory bowel disease and in acute appendicitis. In a normal appendix, endothelial FasL levels were constant in almost half of the mucosal vessels; but, in the normal ileum and colon, endothelial FasL was practically restricted to areas in close proximity to lymphatic follicles, and was expressed mainly in the submucosal aspect of the follicles in the vessels with high endothelium. In samples from subjects with either Crohn's disease or ulcerative colitis, the extent of endothelial FasL expression was elevated in the submucosa and associated with an elevated number of lymphoid follicles. In inflammatory bowel disease, ulcers and areas with a high density of mononuclear cells expressing FasL also showed an elevated density of blood vessels with endothelial FasL expression. Although the function of endothelial FasL remains unclear, such a specific expression pattern suggests that endothelial FasL expression has a role in the regulation of lymphocyte access to the peripheral lymphoid tissues, including the intestinal mucosa. PMID:26374830

  4. The validity and reliability of iridology in the diagnosis of previous acute appendicitis as evi-denced by appendectomy

    Directory of Open Access Journals (Sweden)

    L. Frank

    2013-01-01

    Full Text Available Iridology is defined as a photographic science that identifies pathological and functional changes within organs via biomicroscopic iris assessment for aberrant lines, spots, and discolourations. According to iridology, the iris does not reflect changes  during  anaesthesia,  due  to  the  drugs inhibitory  effects  on  nerves  impulses,  and  in cases of organ removal, it reflects the pre-surgical condition.The profession of Homoeopathy is frequently associated with iridology and in a recent survey (2009  investigating  the  perceptions  of  Masters of  Technology  graduates  in  Homoeopathy  of University of Johannesburg, iridology was highly regarded as a potential additional skill requirement for assessing the health status of the patient.This  study  investigated  the  reliability  of iridology  in  the  diagnosis  of  previous  acute appendicitis, as evidenced by appendectomy. A total of 60 participants took part in the study. Thirty of the 60 participants had an appendectomy due to acute appendicitis, and 30 had had no prior history  of  appendicitis.  Each  participant’s  right iris  was  documented  by  photography  with  the use  of  a  non-mydriatic  retinal  camera  that  was reset for photographing the iris. The photographs were then randomized by an external person and no identifying data made available to the three raters.  The  raters  included  the  researcher,  who had little experience in iridology and two highly experienced  practising  iridologists.  Data  was obtained  from  the  analyses  of  the  photographs wherein  the  presence  or  absence  of  lesions (implying acute appendicitis was indicated by the raters. None of the three raters was able to show a significant  success  rate  in  identifying  correctly the  people  with  a  previous  history  of  acute appendicitis and resultant appendectomies

  5. Influence of body habitus and use of oral contrast on reader confidence in patients with suspected acute appendicitis using 64 MDCT.

    Science.gov (United States)

    Anderson, Stephan W; Rhea, James T; Milch, Holly N; Ozonoff, Al; Lucey, Brian C; Soto, Jorge A

    2010-11-01

    The purpose of this study is to evaluate how body habitus affects reader confidence in diagnosing acute appendicitis and appendiceal visualization using 64 MDCT technology with and without oral contrast. We conducted a HIPAA compliant, IRB approved study of adult patients presenting to the Emergency Department with nontraumatic abdominal pain. Subjects were randomized to two groups: 64 MDCT scans performed with oral and intravenous contrast or scans performed solely with intravenous contrast. Three radiologists established their confidence about the presence of appendicitis as well as recording whether the appendix was visualized. Reader confidence in diagnosing acute appendicitis was compared between the two groups for the three readers. The impact of patient BMI and estimated intra-abdominal fat on reader confidence in diagnosing appendicitis was determined. Finally, a comparison of the effect of BMI and intra-abdominal fat on appendiceal visualization between the two groups was carried out. Three hundred three patients were enrolled in this study. There was a statistically significant difference in confidence based on BMI for reader 2, group 1 in diagnosing appendicitis. No further statistically significant differences in reader confidence for diagnosing appendicitis based on BMI or intra-abdominal fat were identified. There was no influence of BMI or intra-abdominal fat on appendiceal visualization. Increasing BMI was seen to improve reader confidence for one of three readers in patients that received both oral and intravenous contrast. No further effects of BMI or intra-abdominal fat on confidence in diagnosing or excluding appendicitis were seen. Neither BMI nor intra-abdominal fat were seen to influence appendiceal visualization.

  6. Differentiation between right tubo-ovarian abscess and appendicitis using CT-A diagnostic challenge

    Energy Technology Data Exchange (ETDEWEB)

    Eshed, I., E-mail: iriseshed@gmail.com [Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University, Tel Aviv (Israel); Halshtok, O. [Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University, Tel Aviv (Israel); Erlich, Z. [Computer Science Department, Open University, Tel Aviv (Israel); Mashiach, R. [Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University, Tel Aviv (Israel); Hertz, M.; Amitai, M.M.; Portnoy, O.; Guranda, L. [Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University, Tel Aviv (Israel); Hiller, N. [Department of Radiology, Hadassah-Hebrew University Medical Center, Mount Scopus (Israel); Apter, S. [Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University, Tel Aviv (Israel)

    2011-11-15

    Aim: To determine CT features that can potentially differentiate right tubo-ovarian abscess (TOA) from acute appendicitis (AA; including abscess formation). Materials and methods: The abdominal computed tomography (CT) images of 48 patients with right-sided TOA (average age 39.3 {+-} 9.8 years) and 80 patients (average age 53.5 {+-} 19.9 years) with AA (24 with peri-appendicular abscess) were retrospectively evaluated. Two experienced radiologists evaluated 12 CT signs (including enlarged, thickened wall ovary, appendix diameter and wall thickness, peri-appendicular fluid collection, adjacent bowel wall thickening, fat stranding, free fluid, and extraluminal gas) in consensus to categorize the studies as either TOA or AA. The diagnosis and the frequency of each of the signs were correlated with the surgical and clinical outcome. Results: Reviewers classified 92% cases correctly (TOA = 85%, AA = 96.3%), 3% incorrectly (TOA = 6.3%, AA = 1.3%); 5% were equivocal (TOA = 8.3%, AA = 2.5%). In the peri-appendicular abscess group reviewers were correct in 100%. Frequent findings in the TOA group were an abnormal ovary (87.5%), peri-ovarian fat stranding (58.3%), and recto-sigmoid wall thickening (37.5%). An abnormal appendix was observed in 2% of TOA patients. Frequent findings in the AA group were a thickened wall (32.5%) and distended (80%) appendix. Recto-sigmoid wall thickening was less frequent in AA (12.5%). The appendix was not identified in 45.8% of the TOA patients compared to 15% AA. Conclusions: In the presence of a right lower quadrant inflammatory mass, peri-ovarian fat stranding, thickened recto-sigmoid wall, and a normal appearing caecum, in young patients favour the diagnosis of TOA. An unidentified appendix does not contribute to the differentiation between TOA and peri-appendicular abscess.

  7. Pregnancy Outcomes and Surgical Management of Pregnancy Complicated By Appendicitis: Obstetrician View

    Directory of Open Access Journals (Sweden)

    Deniz Şimşek

    2015-08-01

    Full Text Available Objective: To evaluate the pregnancy outcomes of patients who underwent appendectomy during pregnancy. Materials and Methods: Patients who underwent appendectomy between years 2010 and 2014 were retrospectively evaluated. All patients’ pregnancy outcomes were followed-up by using university registry system and telephone interview. Patients were evaluated regarding age, gestational age, clinical and laboratory examinations, imaging studies, mean time interval between emergency department and operation, mean operative time, pregnancy outcome and pathologic results of the appendix. Results: Thirty-nine patients were included in the study. Sixteen of 39 patients were in the first, 15 of them in the second and 8 of them were in the third trimester of the pregnancy. Three patients underwent laparoscopic appendectomy and the rest underwent laparotomy. In pathologic evaluation of the appendix, seven patients (17% had normal appendix, 4 patients had perforated appendix, one patient had neuro-endocrine tumor and rest of the patients had appendicitis. Two missed abortion occurred after operation, rest of the patients had live birth. Six of them were preterm and 31 had term birth. Twelve patients delivered through vaginal birth and the rest via caesarean section. Twenty patients were in the first half of the pregnancy (group 1 and 19 patients were in the second half of the pregnancy (group 2. There were no significant differences between the groups in operation time and mean time interval between emergency administration and operation. Conclusion: Delayed operation and negative appendectomy can cause adverse pregnancy outcomes. Expectant management in suspected cases may decrease negative appendectomy rates but can also lead to perforation. Computed tomography and MRI ought to be considered if ultrasonography is inconclusive. Tocolytic regimens can be administered to prevent threatened preterm labor. Obstetric indications were valid for delivery mode.

  8. T helper type 17 pathway suppression by appendicitis and appendectomy protects against colitis.

    Science.gov (United States)

    Cheluvappa, R; Luo, A S; Grimm, M C

    2014-02-01

    Appendicitis followed by appendectomy (AA) at a young age protects against inflammatory bowel disease (IBD). We wanted to characterize the role of the T helper type 17 (Th17) system involved in this protective effect. AA was performed on 5-week-old male BALB/c mice and distal-colon samples were harvested. Mice with two laparotomies each served as sham-sham (SS) controls. RNA was extracted from four individual colonic samples per group (AA and SS groups) and each sample microarray-analysed and reverse transcription-polymerase chain reaction (RT-PCR)-validated. Gene-set enrichment analysis (GSEA) showed that the Th17 recruitment factor gene CCL20 was significantly suppressed at both 3 days post-AA and 28 days post-AA. Although Th17 cell development differentiation factor genes TGF-β2 and TGF-β3 were significantly up-regulated 3 days post-AA, GSEA 28 days post-AA showed that AA down-regulated 29 gene-sets associated with TGF-β1, TGF-β2 and TGF-β3 in contrast to none up-regulated with any of these genes. GSEA showed substantial down-regulation of gene-sets associated with Th17 lymphocyte recruitment, differentiation, activation and cytokine expression in the AA group 28 days post-AA. We conclude that Th17-system cytokines are kept under control by AA via down-regulation of proinflammatory CCL20, a rapid down-regulation of pro-Th17 cell differentiation genes TGF-β2 and TGF-β3, suppression of RORC-associated gene-sets, increased protective STAT1 expression and suppression of 81 'pro-Th17' system gene-sets. AA suppresses the Th17 pathway leading to colitis amelioration. Further characterization of Th17-associated genes and biological pathways will assist in the development of better therapeutic approaches in IBD management. PMID:24666024

  9. A STUDY TO ASSESS THE PROPORTION AND ASSOCIATION OF APPENDICITIS WITH POSITIONAL VARIATION IN A SOUTH INDIAN RURAL TERTIARY CARE CENTER

    Directory of Open Access Journals (Sweden)

    Sandeep Kumar David

    2016-03-01

    Full Text Available CONTEXT The commonest position of appendix vermiformis according to the literature is retrocaecal. While during surgery there was found to have variation. Several studies done to assess the position of appendix vermiformis in patients with acute appendicitis has given a conflicting results. Depending on the position the symptom complex also changes, producing different problems and differential diagnosis. AIM This study assess the position of appendix vermiformis in patients with inflamed appendix in the patients undergoing surgery for acute appendicitis at Dr. SM CSI Medical College, Karakonam. DESIGN METHOD AND ANALYSIS The study is a retrospective study done over 2 years in 109 patients who underwent appendicectomy at Dr. SMCSI Medical College. The prevalence of appendicitis among different age groups, and the different position were studied. RESULTS Of the 109 patients 71 were females and 38 males. In the study population 21-40 years age group had the highest frequency of appendicitis. Subcaecal position was seen in 49.5 % of the patients followed by 28.4%. In both the sex group sub caecal position is the commonest position with 57.9% and 45.1% respectively in male and female patients. CONCLUSION Among the patients with acute appendicitis subcaecal position was the commonest position

  10. Comparison of imaging strategies with conditional versus immediate contrast-enhanced computed tomography in patients with clinical suspicion of acute appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Atema, J.J.; Gans, S.L.; Boermeester, M.A. [Academic Medical Centre, Department of Surgery (G4-142), Amsterdam (Netherlands); Randen, A. van; Stoker, J. [Academic Medical Centre, Department of Radiology, Amsterdam (Netherlands); Lameris, W. [Academic Medical Centre, Department of Surgery (G4-142), Amsterdam (Netherlands); Spaarne Hospital, Department of Surgery, Hoofddorp (Netherlands); Es, H.W. van; Heesewijk, J.P.M. van [St Antonius Hospital, Department of Radiology, Nieuwegein (Netherlands); Ramshorst, B. van [St Antonius Hospital, Department of Surgery, Nieuwegein (Netherlands); Bouma, W.H. [Gelre Hospital, Department of Surgery, Apeldoorn (Netherlands); Hove, W. ten [Gelre Hospital, Department of Radiology, Apeldoorn (Netherlands); Keulen, E.M. van [Tergooi Hospital, Department of Radiology, Hilversum (Netherlands); Dijkgraaf, M.G.W. [Academic Medical Centre, Clinical Research Unit, Amsterdam (Netherlands); Bossuyt, P.M.M. [Academic Medical Center, Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Amsterdam (Netherlands)

    2015-08-15

    To compare the diagnostic accuracy of conditional computed tomography (CT), i.e. CT when initial ultrasound findings are negative or inconclusive, and immediate CT for patients with suspected appendicitis. Data were collected within a prospective diagnostic accuracy study on imaging in adults with acute abdominal pain. All patients underwent ultrasound and CT, read by different observers who were blinded from the other modality. Only patients with clinical suspicion of appendicitis were included. An expert panel assigned a final diagnosis to each patient after 6 months of follow-up (clinical reference standard). A total of 422 patients were included with final diagnosis appendicitis in 251 (60 %). For 199 patients (47 %), ultrasound findings were inconclusive or negative. Conditional CT imaging correctly identified 241 of 251 (96 %) appendicitis cases (95 %CI, 92 % to 98 %), versus 238 (95 %) with immediate CT (95 %CI, 91 % to 97 %). The specificity of conditional CT imaging was lower: 77 % (95 %CI, 70 % to 83 %) versus 87 % for immediate CT (95 %CI, 81 % to 91 %). A conditional CT strategy correctly identifies as many patients with appendicitis as an immediate CT strategy, and can halve the number of CTs needed. However, conditional CT imaging results in more false positives. (orig.)

  11. MSCT Diagnosis of Acute Appendicitis%多层螺旋CT对急性阑尾炎的诊断

    Institute of Scientific and Technical Information of China (English)

    张雪红; 刘红宇; 张国华; 符惠宏

    2011-01-01

    Objective To analyze the diagnostic value of multi-slice spiral CT( MSCT) for acute appendicitis. Methods 58 cases of acute appendicitis conformed by surgery and clinic were collected,CT findings such as appendix size, shape and change around the cecum were retrospective analyzed. Results CT showed abnormal appendix ,including enlargement, wall thickening, stone cavity fluid, etc in 38 cascs;inflammatory changes around the appendix ,including speckled and stripcd fuzzy shadows within fat around the appendix, a little of ascites, the right cone fascial thickening , the front of psoas major muscle fuzzy ,the right perirenal fascial thickening; 2 cases with gas cavity ,1 case with stone cavity, 12 cases with the local cecum wall thickening. Conclusion MSCT has important value in the diagnosis of acute appendicitis.%目的 分析急性阑尾炎的多层螺旋CT(MSCT)诊断价值.方法 对58例经手术、临床证实的急性阑尾炎的阑尾大小、形态及盲肠周围改变等CT资料进行回顾性分析.结果 38例显示异常阑尾(肿大增粗、壁增厚、腔内结石积液等),46例显示阑尾周围炎性改变(阑尾周围脂肪内斑点状及条纹状模糊影、腹腔少量积液、右侧侧锥筋膜增厚、腰大肌前缘模糊、右侧肾周筋膜增厚),腔外气体2例,腔外结石1例,局限性盲肠壁增厚12例.结论 MSCT在急性阑尾炎的诊断中有重要的价值.

  12. The Comparison of Open and Laparoscopic Appendectomy: Is There any Outcome Difference Between Non-Complicated and Complicated Appendicitis?

    Directory of Open Access Journals (Sweden)

    Ünal Bıçakcı

    2011-09-01

    Full Text Available Objective: The assessment of laparoscopic appendectomy (LA and open appendectomy (OA in patients with noncomplicated (NCA and complicated appendicitis (CA was aimed for. Material and Methods: Of 279 patients with appendectomy, 135 had NCA (48.3% (49 underwent LA (86M, 49F, median 9 years and144 had CA (51.7% (23 underwent LA (98M, 46F, median 11 years. Outcome measures: Wound infection (WI, intraabdominal abscess (IA, postoperative ileus (PI, requirement of reoperation (RO, time of surgery (TOS, length of stay (LOS, duration of postoperative pain (PP, nasogastric tube (NT, intraperitoneal drainage (ID were recorded.Results: Between OA and LA groups, there was no statistical significance in WI(3/86 vs 0/49, IA(2/86 vs 0/49, RO(2/86 vs 2/49, and PI rate (1/86 vs 2/49 in NCA group (p>0.05. The LOS(3±1.4 vs 4±1.3, NT (1.2±0.9 vs 1.8±0.6 days and PP(0.9±0.9 vs 2.3±1.1 days were lower in LA than OA (p0.05. In CA, patients with LA had less WI(0/23 vs 18/121 (p<0.05. NT (2±0.8 vs 2.7±1.5, PP (2.1±1.2 vs 3.2±1.5 and ID (3.1±2.3 vs 4.4±1.4 were lower in LA than OA (p<0.05.Conclusion: Laparoscopic appendectomy decreases wound infection, nasogastric tube duration, intraperitoneal drainage and pain in complicated appendicitis. The Laporoscopic approach is superior in complicated and noncomplicated appendicitis.

  13. A new look at an old dogma: wound complications in two methods of skin closure in uncomplicated appendicitis

    Directory of Open Access Journals (Sweden)

    Hamid Ghaderi

    2010-04-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Appendicitis is more common during the second and third decade of life and appendectomy scar is important in terms of cosmetic issues. The scar is an important factor in the patient's satisfaction. Conventional teaching has an emphasis on the closure of skin incision with "separate" sutures. The aim of this study was to reconsider this dogma."n"nMethods: Among 321 patients with acute appendicitis who came to the emergency unit of Imam Khomeini Hospital in Tehran, Iran since april 2007 till april 2008, 278 (86.6% patients had uncomplicated appendicitis and were enrolled in our clinical trial. The patients were randomly assigned to two groups of interrupted suture closure (n=139 and subcuticular suture closure (n=139. Anesthesia method and surgical technique were similar between the two groups. All patients were followed up post-operatively (four weeks for the presence of infectious drainage, pain, erythema, swelling and warmness at the surgical site."n"nResults: The patients' sex and their mean age were not statistically different between the groups. There was no significant difference in the frequency of surgical site complications between the two groups (five cases in the "interrupted" group and

  14. Fluorinated Boronic Acid-Appended Bipyridinium Salts for Diol Recognition and Discrimination via (19)F NMR Barcodes.

    Science.gov (United States)

    Axthelm, Jörg; Görls, Helmar; Schubert, Ulrich S; Schiller, Alexander

    2015-12-16

    Fluorinated boronic acid-appended benzyl bipyridinium salts, derived from 4,4'-, 3,4'-, and 3,3'-bipyridines, were synthesized and used to detect and differentiate diol-containing analytes at physiological conditions via (19)F NMR spectroscopy. An array of three water-soluble boronic acid receptors in combination with (19)F NMR spectroscopy discriminates nine diol-containing bioanalytes--catechol, dopamine, fructose, glucose, glucose-1-phosphate, glucose-6-phosphate, galactose, lactose, and sucrose--at low mM concentrations. Characteristic (19)F NMR fingerprints are interpreted as two-dimensional barcodes without the need of multivariate analysis techniques.

  15. Acute appendicitis during pregnancy:analysis of 23 cases%妊娠期合并急性阑尾炎23例诊治分析

    Institute of Scientific and Technical Information of China (English)

    赵智毅; 王晓亮

    2013-01-01

    Objective To explore diagnosis and treatment of acute appendicitis during pregnancy. Methods The clinic data of 23 pregnant women with acute appendicitis from June 2004 to June 2012 were retrospectively analyzed. Results 21 cases underwent operation and 2 cases were given conservative treatment. Four cases were acute simple appendicitis, 15 cases acute suppurative appendicitis and 2 cases acute gangrenous appendicitis with pathological examination after surgery. Of them, 1 case suffered from surgical wound infection after surgery. Conclusion For acute appendicitis during pregnancy which is harmful to pregnant women and fetus, it is critical to carry out surgery as soon as possible after diagnosis was made.%目的 探讨妊娠期急性阑尾炎的诊断及治疗方案.方法回顾性分析我院2004年6月至2012年6月收治的妊娠期急性阑尾炎23例的临床资料.结果 手术治疗21例,保守治疗2例;术后病理检查:单纯性阑尾炎4例,化脓性阑尾炎15例,坏疽性阑尾炎2例;切口感染1例.结论 妊娠期急性阑尾炎对孕妇及胎儿都会产生不利影响,明确诊断后,应尽早手术治疗.

  16. Comparison and Efficacy of LigaSure and Rubber Band Ligature in Closing the Inflamed Cecal Stump in a Rat Model of Acute Appendicitis

    OpenAIRE

    Chun-Chieh Yeh; Chia-Ing Jan; Horng-Ren Yang; Po-Han Huang; Long-Bin Jeng; Wen-Pang Su; Hui-Chen Chen

    2015-01-01

    Safety of either LigaSure or rubber band in closing inflamed appendiceal stump in acute appendicitis has been less investigated. In this study, cecal ligation followed by resecting inflamed cecum was performed to mimic appendectomy in a rat model of acute appendicitis. Rats were sacrificed immediately (Group A) and 7 days (Group B) after cecal resection, respectively. The cecal stumps were closed by silk ligature (S), 5 mm LigaSure (L), or rubber band (R). Seven days after cecal resection, th...

  17. Gangrenous appendicitis presenting as acute abdominal pain in a patient on automated peritoneal dialysis: a case report

    Directory of Open Access Journals (Sweden)

    Ekart Robert

    2012-09-01

    Full Text Available Abstract Introduction Presentations of abdominal pain in patients on peritoneal dialysis deserve maximal attention and careful differential diagnosis on admittance to medical care. In this case report a gangrenous appendicitis in a patient on automated peritoneal dialysis is presented. Case presentation We report the case of a 38-year-old Caucasian man with end-stage renal disease who was on automated peritoneal dialysis and developed acute abdominal pain and cloudy peritoneal dialysate. Negative microbiological cultures of the peritoneal dialysis fluid and an abdominal ultrasonography misleadingly led to a diagnosis of culture negative peritonitis. It was decided to remove the peritoneal catheter but the clinical situation of the patient did not improve. An explorative laparotomy was then carried out; diffuse peritonitis and gangrenous appendicitis were found. An appendectomy was performed. Myocardial infarction and sepsis developed, and the outcome was fatal. Conclusion A peritoneal dialysis patient with abdominal pain that persists for more than 48 hours after the usual antibiotic protocol for peritoneal dialysis-related peritonitis should immediately alert the physician to the possibility of peritonitis caused by intra-abdominal pathology. Not only peritoneal catheter removal is indicated in patients whose clinical features worsen or fail to resolve with the established intra-peritoneal antibiotic therapy but, after 72 hours, an early laparoscopy should be done and in a case of correct indication (intra-abdominal pathology an early explorative laparotomy.

  18. Oxygen binding and activation by the complexes of PY2- and TPA-appended diphenylglycoluril receptors with copper and other metals

    NARCIS (Netherlands)

    Sprakel, VSI; Feiters, MC; Klaucke, WM; Klopstra, M; Brinksma, J; Feringa, BL; Karlin, KD; Nolte, RJM; Sprakel, Vera S.I.; Feiters, Martin C.; Meyer-Klaucke, Wolfram; Karlin, Kenneth D.; Nolte, Roeland J.M.; Feringa, Bernard

    2005-01-01

    The copper( I) complexes of diphenylglycoluril basket receptors 1 and 2, appended with bis(2-ethylpyridine) amine (PY2) and tris(2-methylpyridine) amine (TPA), respectively, and their dioxygen adducts were studied with low-temperature UV-vis and X-ray absorption spectroscopy (XAS). The copper(I) com

  19. A diagnostic dilemma: Left-sided appendicitis in a 10 year old boy with previously undiagnosed intestinal malrotation. A case report

    Directory of Open Access Journals (Sweden)

    Ashvini Shekhar

    2015-01-01

    Conclusion: Left sided acute appendicitis is a diagnostic dilemma, thus often leading to management delays. It is pertinent to remember that malrotation of the gut is more common than previously thought, and not just a disease of infancy. It is advisable to consider imaging studies while balancing the risk-benefit-ratio of radiation exposure, especially in paediatric cases to cinch the diagnosis.

  20. Conservative treatment and nursing of acute appendicitis%阑尾炎的保守治疗和护理

    Institute of Scientific and Technical Information of China (English)

    董桂霞

    2013-01-01

    Objective:To explore the method of appendicitis in conservative treatment and effective nursing measures. Methods:a retrospective analysis of our hospital for conservative treatment of 90 cases of acute appendicitis in patients with clinical data, conservative treatment with combination of TCM and Western medicine, and the comprehensive nursing measures. Results:90 patients were cured, 1 cases turned to operation without treatment, among them, 63 cases of conservative treatment after 7 days cure, 27 cases were cured with conservative treatment for 14 days;the average hospital stay was 7.1 days. Conclusion:application of conservative treatment of integrated traditional Chinese and Western medicine, not only eliminates the operation on the patients with fear, and avoid serious complications caused by operation and anesthesia. Nursing science, system contributes to acute appendicitis in conservative treatment of patients, shorten the hospitalization time, reduce the economic burden.%目的:探讨阑尾炎保守治疗的方法及有效护理措施。方法:回顾性分析我院行保守治疗的90例急性阑尾炎患者临床资料,采用中西医结合的保守治疗方法,并采用综合护理措施。结果90例患者均痊愈出院,无1例转为手术治疗,其中,63例保守治疗7日后痊愈,27例保守治疗14天后痊愈;平均住院时间为7.1天。结论应用中西医结合的保守治疗,既消除了患者对手术的恐惧,又避免了手术和麻醉带来的严重并发症。科学、系统的护理措施有助于急性阑尾炎保守治疗患者的痊愈,缩短患者住院时间,降低经济负担。

  1. Comparison of ultrasonography and computed tomography in the diagnosis of acute appendicitis; Comparacion de la ecografia y la tomografia computarizada en el diagnostico de la apendicitis aguda

    Energy Technology Data Exchange (ETDEWEB)

    Cura, J. L. del; Oleaga, L.; Grande, D.; Farina, M. A.; Isusi, M. [Hospital de Basurto. Bilbao (Spain)

    2001-07-01

    The compare the efficacy of ultrasonography and computed tomography (CT) in cases of suspected appendicitis. To study to what extent age, sex and habits of the patients, as well as the clinical context, influence the diagnostic yield of these two technique. Over a one-year period, 152 patients underwent ultrasonography and CT because of the clinical suspicion of appendicitis. The studies were carried out independently, and the results of each in terms of the presence or absence of appendicitis were unknown to the specialists performing the other. The final diagnoses were established by surgical treatment or clinical follow-up. The sensitivity of CT for the diagnosis of appendicitis was 82%, the specificity was 95%, the positive predictive value was 93%, the negative predictive value was 87% and the reliability was 90%. Ultrasonography has a sensitivity of 83%, a specificity of 97%, a positive predictive value of 95%, a negative predictive value of 88% and a reliability of 91%. Ultrasound was more efficient in patients in which there was a high clinical suspicion and in children, while the results with CT were better in patients in which the clinical diagnosis was less clear. The incidence of false negatives and positives was higher with ultrasound, while CT was more frequently able to identify a normal appendix. Sex and habits had no influence on the respective efficacies, although the performance of ultrasound was simplified in thin patients and that of CT in obese individuals. Ultrasonography and CT are highly reliable in cases of suspected appendicitis, especially when this diagnosis is conformed. Ultrasound is recommended as the technique of choice in children and in patients in which the clinical suspicion is strong. The yield of CT is somewhat greater when the clinical signs and symptoms are less clear. However, the efficacy of both techniques ultimately depends on the expertise of the specialist who interprets them. (Author) 62 refs.

  2. Mandatory imaging cuts costs and reduces the rate of unnecessary surgeries in the diagnostic work-up of patients suspected of having appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Lahaye, M.J.; Lambregts, D.M.J.; Mutsaers, E.; Beets-Tan, R.G.H. [Maastricht University Medical Centre, Department of Radiology, Maastricht (Netherlands); Essers, B.A.B. [Maastricht University Medical Centre, Department of Epidemiology and Medical Technology, Maastricht (Netherlands); Breukink, S.; Beets, G.L. [Maastricht University Medical Centre, Department of Surgery, Maastricht (Netherlands); Cappendijk, V.C. [Jeroen Bosch Hospital, Department of Radiology, ' s Hertogenbosch (Netherlands)

    2015-05-01

    To evaluate whether mandatory imaging is an effective strategy in suspected appendicitis for reducing unnecessary surgery and costs. In 2010, guidelines were implemented in The Netherlands recommending the mandatory use of preoperative imaging to confirm/refute clinically suspected appendicitis. This retrospective study included 1,556 consecutive patients with clinically suspected appendicitis in 2008-2009 (756 patients/group I) and 2011-2012 (800 patients/group II). Imaging use (none/US/CT and/or MRI) was recorded. Additional parameters were: complications, medical costs, surgical and histopathological findings. The primary study endpoint was the number of unnecessary surgeries before and after guideline implementation. After clinical examination by a surgeon, 509/756 patients in group I and 540/800 patients in group II were still suspected of having appendicitis. In group I, 58.5% received preoperative imaging (42% US/12.8% CT/3.7% both), compared with 98.7% after the guidelines (61.6% US/4.4% CT/ 32.6% both). The percentage of unnecessary surgeries before the guidelines was 22.9%. After implementation, it dropped significantly to 6.2% (p<0.001). The surgical complication rate dropped from 19.9% to 14.2%. The average cost-per-patient decreased by 594 EUR from 2,482 to 1,888 EUR (CL:-1081; -143). Increased use of imaging in the diagnostic work-up of patients with clinically suspected appendicitis reduced the rate of negative appendectomies, surgical complications and costs. (orig.)

  3. Synthesis and Study on the Complexation of Dithidiaza 21-Cown-7- Bearing Appended Coumarin or 1-Aminonaphthene as Sidearms

    Institute of Scientific and Technical Information of China (English)

    SONG Hua-Can; MOU De-Hai; CHEN Yi-Wen; XU Zun-Le

    2003-01-01

    @@ The high toxicity of many transition and post-transition metal ions, especially Hg2+ and Pb2 + , is well recognized and a lot of attention has been paid to control contamination of water supplies by toxic metal ions and to monitor the level of these metal ions in the environment. For the application purpose in controlling and monitoring the concentrations of specific metal ions in a complex matrix continuously and remotely by using ion-selective sensory devices, chemical sensors based on the synthetic fluoroionophores and chromoionophores capable of signaling complexation of metal ions have been reported, [1~ 5], and a series of dithidiaza 21-rown-7 bearing appended coumarin or 1-aminonaphthene as sidearms was synthesized. [6

  4. A case of plastron appendicitis mimicking malignant cecal tumor in flourodeoxyglucose-positron emission tomography/computed tomography study

    International Nuclear Information System (INIS)

    In recent years, flourodeoxyglucose-positron emission tomography/computed tomography (FDG PET/CT) has been used intensively in the field of oncology. However, an increase in FDG uptake has been observed both in malignant tissues, and inflammatory processes. Therefore false-positive results have appeared. We present a 70-year-old male patient who presented to the hospital with right lower quadrant pain. A right lower quadrant mass was observed with conventional methods, and PET/CT was performed which revealed a hypermetabolic mass in the right lower quadrant. The patient was referred to the surgery with a suspect malignant mass whose histopathological report indicated plastron appendicitis. Although FDG PET/CT is a reliable method in the evaluation of oncological cases, false-positivities should be taken into consideration in inflammatory processes

  5. Evaluation of New Dihydrophthalazine-Appended 2,4-Diaminopyrimidines against Bacillus anthracis: Improved Syntheses Using a New Pincer Complex

    Directory of Open Access Journals (Sweden)

    Nagendra Prasad Muddala

    2015-04-01

    Full Text Available The synthesis and evaluation of ten new dihydrophthalazine-appended 2,4-diaminopyrimidines as potential drugs to treat Bacillus anthracis is reported. An improved synthesis utilizing a new pincer catalyst, dichlorobis[1-(dicyclohexylphosphanyl-piperidine]palladium(II, allows the final Heck coupling to be performed at 90 °C using triethylamine as the base. These milder conditions have been used to achieve improved yields for new and previously reported substrates with functional groups that degrade or react at the normal 140 °C reaction temperature. An analytical protocol for separating the S and R enantiomers of two of the most active compounds is also disclosed. Finally, the X-ray structure for the most active enantiomer of the lead compound, (S-RAB1, is given.

  6. The Diagnostic Value of CT in Perforating Appendicitis%CT诊断穿孔性阑尾炎的价值研究

    Institute of Scientific and Technical Information of China (English)

    刘耀基

    2015-01-01

    目的:探讨穿孔性阑尾炎与非穿孔性阑尾炎的CT鉴别诊断价值。方法回顾性分析70例经术后病理证实为急性阑尾炎患者的临床资料,穿孔组与非穿孔组各35例,分析两组CT表现。结果穿孔组阑尾平均直径(13.28±3.59)mm、阑尾腔外粪石、阑尾腔外气体、阑尾周围脓肿、阑尾壁局限性强化缺损、盆腔炎改变、阑尾周围炎(轻-重)、阑尾周围炎(中-重)(8.57%、25.71%、17.14%、54.29%、62.86%、100%、85.71%)明显高于非穿孔组(P<0.05)。结论 CT是诊断穿孔性阑尾炎的一种有效以及快速的诊断方法,具有较高的鉴别与诊断价值。%Objective To evaluate the differential diagnosis value of CT in perforating appendicitis and non-perforating appendicitis. Methods Clinical data of 70 patients with acute appendicitis confirmed by pathology were studied, divided in to perforating appendicitis group and non-perforating gappendicitis group, each group 35 cases, CT ifndings were analyzed. Results The mean diameter of perforating appendicitis group was(13.28±3.59)mm, outer appendiceal lumen bezoar,outer appendiceal lumen gas, periappendiceal abscess,the appendix wall limitations strengthen defects,pelvic inlfammatory change, inlfammation around the appendix(light-weight), inlfammation around the appendix(in-weight)(8.57%, 25.71%, 17.14%, 54.29%, 62.86%, 100%, 85.71%)was signiifcantly higher than that in the non-perforating group(P<0.05). Conclusion CT is an effective and rapid diagnostic method for perforating appendicitis, with high identiifcation and diagnostic value.

  7. Rhenium complexes of chromophore-appended dipicolylamine ligands: syntheses, spectroscopic properties, DNA binding and X-ray crystal structure

    Energy Technology Data Exchange (ETDEWEB)

    Mullice, L.A.; Buurma, N.J.; Pope, S.J.A. [Cardiff Univ., School of Chemistry (United Kingdom); Laye, R.H. [Sheffield Univ., Dept. of Chemistry (United Kingdom); Harding, L.P. [Huddersfield Univ., School of Biological and Chemical Sciences (United Kingdom)

    2008-12-15

    The syntheses of two chromophore-appended dipicolylamine-derived ligands and their reactivity with penta-carbonyl-chloro-rhenium have been studied. The resultant complexes each possess the fac-Re(CO){sub 3} core. The ligands L{sup 1} 1-[bis(pyridine-2-yl-methyl)amino]methyl-pyrene and L{sup 2} 2-[bis(pyridine-2-yl-methyl)amino]methyl-quinoxaline were isolated via a one-pot reductive amination in moderate yield. The corresponding rhenium complexes were isolated in good yields and characterised by {sup 1}H NMR, MS, IR and UV-Vis studies. X-Ray crystallographic data were obtained for fac-{l_brace}Re(CO){sub 3}(L{sup 1}){r_brace}(BF{sub 4}), C{sub 34}H{sub 26}BF{sub 4}N{sub 4}O{sub 3}Re: monoclinic, P2(1)/c, a 18.327(2) Angstroms, {alpha} = 90.00 degrees, b 14.1537(14) Angstroms, {beta}96.263(6) degrees, c = 23.511(3) Angstroms, {gamma} 90.00 Angstroms, 6062.4(11) (Angstroms){sup 3}, Z=8. The luminescence properties of the ligands and complexes were also investigated, with the emission attributed to the appended chromophore in each case. Isothermal titration calorimetry suggests that fac-{l_brace}Re(CO){sub 3}(L{sup 1}){r_brace}(BF{sub 4}) self-aggregates cooperatively in aqueous solution, probably forming micelle-like aggregates with a cmc of 0.18 mM. Investigations into the DNA-binding properties of fac-{l_brace}Re(CO){sub 3}(L{sup 1}){r_brace}(BF{sub 4}) were undertaken and revealed that fac-{l_brace}Re(CO){sub 3}(L{sup 1}){r_brace}(BF{sub 4}) binding to fish sperm DNA (binding constant 1.5 {+-} 0.2 * 10{sup 5} M{sup -1}, binding site size 3.2 {+-} 0.3 base pairs) is accompanied by changes in the UV-Vis spectrum as typically observed for pyrene-based intercalators while the calorimetrically determined binding enthalpy (-14 {+-} 2 kcal mol{sup -1}) also agrees favourably with values as typically found for intercalators. (authors)

  8. A prospective randomized controlled multicenter trial comparing antibiotic therapy with appendectomy in the treatment of uncomplicated acute appendicitis (APPAC trial

    Directory of Open Access Journals (Sweden)

    Paajanen Hannu

    2013-02-01

    Full Text Available Abstract Background Although the standard treatment of acute appendicitis (AA consists of an early appendectomy, there has recently been both an interest and an increase in the use of antibiotic therapy as the primary treatment for uncomplicated AA. However, the use of antibiotic therapy in the treatment of uncomplicated AA is still controversial. Methods/design The APPAC trial is a randomized prospective controlled, open label, non-inferiority multicenter trial designed to compare antibiotic therapy (ertapenem with emergency appendectomy in the treatment of uncomplicated AA. The primary endpoint of the study is the success of the randomized treatment. In the antibiotic treatment arm successful treatment is defined as being discharged from the hospital without the need for surgical intervention and no recurrent appendicitis during a minimum follow-up of one-year (treatment efficacy. Treatment efficacy in the operative treatment arm is defined as successful appendectomy evaluated to be 100%. Secondary endpoints are post-intervention complications, overall morbidity and mortality, the length of hospital stay and sick leave, treatment costs and pain scores (VAS, visual analoque scale. A maximum of 610 adult patients (aged 18–60 years with a CT scan confirmed uncomplicated AA will be enrolled from six hospitals and randomized by a closed envelope method in a 1:1 ratio either to undergo emergency appendectomy or to receive ertapenem (1 g per day for three days continued by oral levofloxacin (500 mg per day plus metronidazole (1.5 g per day for seven days. Follow-up by a telephone interview will be at 1 week, 2 months and 1, 3, 5 and 10 years; the primary and secondary endpoints of the trial will be evaluated at each time point. Discussion The APPAC trial aims to provide level I evidence to support the hypothesis that approximately 75–85% of patients with uncomplicated AA can be treated with effective antibiotic therapy avoiding unnecessary

  9. A diagnostic dilemma: Left-sided appendicitis in a 10 year old boy with previously undiagnosed intestinal malrotation. A case report

    OpenAIRE

    Ashvini Shekhar; Rasika Hendahewa; Gamini Premaratne

    2015-01-01

    Introduction: Intestinal malrotation is a congenital rotational anomaly that occurs as a result of an arrest of normal rotation of the embryonic gut, said to occur in 1 in 6000 live births. Due to the abnormal caecal and appendix position, diagnosis of acute appendicitis becomes more challenging, thus leading to diagnostic and operative intervention delays. Our aim is to highlight the diagnostic challenges in this clinical scenario. Presentation of case: We present a case of a 10 year old ...

  10. Comparison and Efficacy of LigaSure and Rubber Band Ligature in Closing the Inflamed Cecal Stump in a Rat Model of Acute Appendicitis

    Directory of Open Access Journals (Sweden)

    Chun-Chieh Yeh

    2015-01-01

    Full Text Available Safety of either LigaSure or rubber band in closing inflamed appendiceal stump in acute appendicitis has been less investigated. In this study, cecal ligation followed by resecting inflamed cecum was performed to mimic appendectomy in a rat model of acute appendicitis. Rats were sacrificed immediately (Group A and 7 days (Group B after cecal resection, respectively. The cecal stumps were closed by silk ligature (S, 5 mm LigaSure (L, or rubber band (R. Seven days after cecal resection, the LigaSure (BL and silk subgroups (BS had significantly less intra-abdominal adhesion and better laparotomy wound healing than rubber band subgroup (BR. The initial bursting pressure at cecal stump was comparable among the three methods; along with tissue healing process, both BL and BS provided a higher bursting pressure than BR 7 days after appendectomy. BL subgroup had more abundant hydroxyproline deposition than BS and BR subgroup. Furthermore, serum TNF-α in BR group kept persistently increasing along with time after cecal resection. Thus, the finding that LigaSure but not rubber band is safe in sealing off the inflamed cecal stump in rat model of acute appendicitis suggests the possibility of applying LigaSure for appendectomy via single port procedure or natural orifice transluminal endoscopic surgery (NOTES.

  11. Acute Appendicitis in Infancy:A Report of 84 Cases%婴幼儿急性阑尾炎(附84例分析)

    Institute of Scientific and Technical Information of China (English)

    宋育麟; 江泽熙; 余浠临; 鲁建生

    1982-01-01

    Acute appendicitis in infancy is not uncommon.Misdiagnosis is frequent as infants are unable to state their symptoms or cooperate with the physicians at examination.Of the 84 infant patients reported here,28(33.3%) had perforated appendices.It is essential to differentiate gastroenteritis from appendicitis so as to reach a correct diagnosis as early as possible.This report reviews our experience with acute appendicitis in infants for the past 10 years.%@@ 当前外科技术虽已进展至心血管、器官移植及胎儿外科时代,但小儿,特别是婴幼儿急性阑尾炎的诊断,仍为临床工作中的重要实际问题.我院自1972年~1981年底共收治3岁以下急性阑尾炎84例,占同期小儿阑尾炎1809例的4.64%.44例入院时延误诊断,占52.4%.穿孔者28例,占33.3%.本文就诊断及治疗问题进行讨论.

  12. Alfa-2-glicoproteína rica en leucina urinaria en pacientes con apendicitis aguda (Urinary leucine-rich alpha-2-glycoprotein in patients with acute appendicitis

    Directory of Open Access Journals (Sweden)

    Heberto Machado-Montero

    2015-04-01

    Full Text Available The objective of research was to determine diagnostic efficacy of urinary concentrations of leucine-rich alpha-2-glycoprotein (A2GRL in patients with acute appendicitis. There were included patients with high suspicion of acute appendicitis (group A; cases, n = 30. In group B (controls, n = 30 were included patients with non-surgical abdominal pain who attended to Hospital Central “Dr. Urquinaona”, Maracaibo, Zulia. General characteristics, urinary concentrations of A2GRL and diagnostic efficacy of assay were evaluated. Mean age of patients in group A was 36.3 +/- 8.8 years-old and in group B was 35.8 +/- 9.6 years-old (p = ns. There were not found significant differences in sex distribution, weight and height between groups (p = ns. Urinary concentrations of A2GRL were significantly higher in group A (1543.8 +/- 762.7 ng/mL compared with mean value in patients of group B (774.1 +/- 356.1 ng/mL; p < 0.0001. A2GRL presented a value below curve 0.81. A cut-off value of 1000 ng/mL, showed sensivity 73.3%, specificity 70.9%, positive predictive value 72.4% and negative predictive value 72.4%. It is concluded that urinary concentrations of A2GRL have a high diagnostic efficacy in patients with acute appendicitis

  13. Comparison and efficacy of LigaSure and rubber band ligature in closing the inflamed cecal stump in a rat model of acute appendicitis.

    Science.gov (United States)

    Yeh, Chun-Chieh; Jan, Chia-Ing; Yang, Horng-Ren; Huang, Po-Han; Jeng, Long-Bin; Su, Wen-Pang; Chen, Hui-Chen

    2015-01-01

    Safety of either LigaSure or rubber band in closing inflamed appendiceal stump in acute appendicitis has been less investigated. In this study, cecal ligation followed by resecting inflamed cecum was performed to mimic appendectomy in a rat model of acute appendicitis. Rats were sacrificed immediately (Group A) and 7 days (Group B) after cecal resection, respectively. The cecal stumps were closed by silk ligature (S), 5 mm LigaSure (L), or rubber band (R). Seven days after cecal resection, the LigaSure (BL) and silk subgroups (BS) had significantly less intra-abdominal adhesion and better laparotomy wound healing than rubber band subgroup (BR). The initial bursting pressure at cecal stump was comparable among the three methods; along with tissue healing process, both BL and BS provided a higher bursting pressure than BR 7 days after appendectomy. BL subgroup had more abundant hydroxyproline deposition than BS and BR subgroup. Furthermore, serum TNF-α in BR group kept persistently increasing along with time after cecal resection. Thus, the finding that LigaSure but not rubber band is safe in sealing off the inflamed cecal stump in rat model of acute appendicitis suggests the possibility of applying LigaSure for appendectomy via single port procedure or natural orifice transluminal endoscopic surgery (NOTES). PMID:25699264

  14. Extensive retroperitoneal and right thigh abscess in a patient with ruptured retrocecal appendicitis: An extremely fulminant form of a common disease

    Institute of Scientific and Technical Information of China (English)

    Chi-Hsun Hsieh; Yu-Chun Wang; Horng-Ren Yang; Ping-Kuei Chung; Long-Bin Jeng; Ray-Jade Chen

    2006-01-01

    As a disease commonly encountered in daily practice,acute appendicitis is usually diagnosed and managed easily with a low mortality and morbidity rate.However, acute appendicitis may occasionally become extraordinarily complicated and life threatening. A56-year-old man, healthy prior to this admission, was brought to the hospital due to spiking high fever, poor appetite, dysuria, progressive right flank and painful swelling of the thigh for 3 d. Significant inflammatory change of soft tissue was noted, involving the entire right trunk from the subcostal margin to the knee joint. Painful disability of the right lower extremity and apparent signs of peritonitis at the right lower abdomen were disclosed. Laboratory results revealed leukocytosis and an elevated C-reactive protein level. Abdominal CT revealed several communicated gas-containing abscesses at the right retroperitoneal region with mass effect, pushing the duodenum and the pancreatic head upward, compressing and encasing inferior vena cava,destroying psoas muscle and dissecting downward into the right thigh. Laparotomy and right thigh exploration were performed immediately and about 500 mL of frank pus was drained. A ruptured retrocecal appendix was the cause of the abscess. The patient fully recovered at the end of the third post-operation week. This case reminds us that acute appendicitis should be treated carefully on an emergency basis to avoid serious complications.CT scan is the diagnostic tool of choice, with rapid evaluation followed by adequate drainage as the key to the survival of the patient.

  15. Syntheses, characterization, and anti-cancer activities of pyridine-amide based compounds containing appended phenol or catechol groups

    Indian Academy of Sciences (India)

    Afsar Ali; Deepak Bansal; Nagendra K Kaushik; Neha Kaushik; Neha Kaushik; Eun Ha Choi; Rajeev Gupta

    2014-07-01

    Several pyridine-amide compounds appended with phenol/catechol groups are synthesized. These compounds consist of protected or deprotected phenol/catechol groups and offer pyridine, amide, and phenol/catechol functional groups. All compounds have been well-characterized by various spectroscopic methods, elemental analysis, thermal studies, and crystallography. The biological activities of all compounds were investigated while a few compounds significantly decreased the metabolic viability, growth and clonogenicity of T98G cells in dose dependent manner. Accumulation of ROS was observed in T98G cells, which displayed a compromised redox status as evident from increased cellular Caspase 3/7 activity and formation of micronuclei. The in silico pharmacokinetic studies suggest that all compounds have good bioavailability, water solubility and other drug-like parameters. A few compounds were identified as the lead molecules for future investigation due to their: (a) high activity against T98G brain, H-460 lung, and SNU-80 thyroid cancer cells; (b) low cytotoxicity in non-malignant HEK and MRC-5 cells; (c) low toxic risks based on in silico evaluation; (d) good theoretical oral bioavailability according to Lipinski ‘rule of five’ pharmacokinetic parameters; and (e) better drug-likeness and drug-score values.

  16. Diagnosis and treatment of colon cancer complicated with appendicitis%结肠癌并发阑尾炎16例诊治分析

    Institute of Scientific and Technical Information of China (English)

    李署湘

    2008-01-01

    Objective To explore missing diagnosis measurement for the prevention or reduction of colon cancer complication of appendicitis and treatment method of both complications. Methods Recall analysis for the reason of 16 cases of patients who suffered from missing diagnosis of colon cancer are treated and treatment method before the operation of appendicitis. Resnlts 10 cases of tumor in caecum,5 cases of up colon,1 ease of liver bend- ing;5 cases of tumor unbroken serosa diameter 2~4cm,3 cases of diameter >4cm; 1 ease of tumor extensive transference synechia, 5 cases of appendicitis swollen surface pus, 7 cases of end congestion, 4 cases of inflammation ooze bad subcutaneous ulcer. Conclusion The improvement of acknowledgement to the colon cancer complication of appendicitis,consultation for the suspected patients for illnesshistory in detail, completion of various tiems of check,better check belly cutting open under operation, check right colon so as to be an effective method for prevention of missing diagnosis to colon cancer complication appendicitis and take different methods de- pending on the operation.%目的 探讨预防或减少结肠癌并发阑尾炎的漏诊措施及两者并存的治疗方法.方法 对16例阑尾炎术前漏诊结肠癌的原因和治疗方法进行回顾性分析.结果 肿瘤位于盲肠10例,升结肠5例,肝曲1例.肿瘤未破浆膜直径4 cm 3例;肿瘤广泛转移粘连1例.阑尾肿胀表面脓苔5例,头端充血7例,炎性渗出坏疽4例.结论 对可疑结肠癌并发阑尾炎者需详细询问病史、体格检查,完善各项检查,手术时最好取剖腹探查切口,常规探查右半结肠,是防止结肠癌并发阑尾炎漏诊的有效方法,治疗应根据术中情况采取不同手术方法.

  17. Ultrasonographic Value in the Diagnosis and Classification of Appendicitis in Children%超声检查对小儿阑尾炎的诊断和临床分型的价值探讨

    Institute of Scientific and Technical Information of China (English)

    谭光栋

    2015-01-01

    Objective To study Ultrasonographic value in the diagnosis and classification of appendicitis in children. Methods 15 patients with children appendicitis by surgery or clinical pathological diagnosis, and ultrasonographic clinical data were retrospectively analyzed, and analyzed ultrasonic image characteristics and pathological classification. Results 15 cases first diagnosis in children appendicitis, ultrasonic diagnosis 14 cases of 93.33% (14/15), 4 cases simple appendicitis, 7 cases suppurative appendicitis, 3 cases gangrenous appendicitis, 1 case appendix abscess, 1 case was misdiagnosed as primary peritonitis. Conclusion Ultrasonographic can definitive diagnosis of children appendicitis and its classification, can be used for diagnostic methods of clinical examination.%目的探讨超声检查对小儿阑尾炎的诊断和临床分型的价值。方法回顾性分析经本院临床及手术病理确诊、且同时进行彩超诊断15例小儿阑尾炎患者的临床资料,观察小儿阑尾炎超声图像特征及病理分型。结果15例初诊小儿阑尾炎患儿中,超声诊断14例93.33%(14/15),其中单纯性阑尾炎4例,化脓性阑尾炎7例,坏疽性阑尾炎3例,阑尾脓肿1例,1例误诊为原发性腹膜炎。结论超声检查能明确诊断小儿阑尾炎及其分型,可作为临床首选检查诊断方法。

  18. Faecal retention: a common cause in functional bowel disorders, appendicitis and haemorrhoids--with medical and surgical therapy.

    Science.gov (United States)

    Raahave, Dennis

    2015-03-01

    The present studies explored whether faecal retention in the colon is a causative factor in functional bowel disease, appendicitis, and haemorrhoids. Faecal retention was characterized by colon transit time (CTT) after radio-opaque marker ingestion and estimation of faecal loading on abdominal radiographs at 48 h and 96 h. Specific hypotheses were tested in patients (n = 251 plus 281) and in healthy random controls (n = 44). A questionnaire was completed for each patient, covering abdominal and anorectal symptoms and without a priori grouping. Patients with functional bowel disorders, predominantly women, had a significantly increased CTT and faecal load compared to controls. The CTT was significantly and positively correlated with segmental and total faecal loading. The faecal load was equal at 48 h and 96 h, mirroring the presence of permanent faecal reservoirs. In these first clinical studies to correlate bowel symptoms with CTT and colon faecal loading, abdominal bloating was significantly correlated with faecal loading in the right colon, total faecal load, and CTT. Abdominal pain was significantly and positively correlated to distal faecal loading and significantly associated with bloating. A new phenomenon with a high faecal load and a normal CTT was observed in a subset of patients (n = 90), proving faecal retention as hidden constipation. The CTT and faecal load were significantly higher in the right-side compared to the left and distal segments. Within the control group of healthy persons, the right-sided faecal load was significantly greater than the left and distal load. The CTT and faecal load significantly positively correlated with a palpable mass in the left iliac fossa and meteorism. Cluster analysis revealed that CTT and faecal load positively correlated with a symptom factor consisting of bloating, proctalgia and infrequent defecation of solid faeces. On the other hand, CTT and faecal load negatively correlated with a symptom factor comprising

  19. Design, synthesis, physicochemical studies, solvation, and DNA damage of quinoline-appended chalcone derivative: comprehensive spectroscopic approach toward drug discovery.

    Science.gov (United States)

    Kumar, Himank; Chattopadhyay, Anjan; Prasath, R; Devaraji, Vinod; Joshi, Ritika; Bhavana, P; Saini, Praveen; Ghosh, Sujit Kumar

    2014-07-01

    The present study epitomizes the design, synthesis, photophysics, solvation, and interaction with calf-thymus DNA of a potential antitumor, anticancer quinoline-appended chalcone derivative, (E)-3-(anthracen-10-yl)-1-(6,8-dibromo-2-methylquinolin-3-yl)prop-2-en-1-one (ADMQ) using steady state absorption and fluorescence spectroscopy, molecular modeling, molecular docking, Fourier-transform infrared spectroscopy (FTIR), molecular dynamics (MD) simulation, and gel electrophoresis studies. ADMQ shows an unusual photophysical behavior in a variety of solvents of different polarity. The dual emission has been observed along with the formation of twisted intramolecular charge transfer (TICT) excited state. The radiationless deactivation of the TICT state is found to be promoted strongly by hydrogen bonding. Quantum mechanical (DFT, TDDFT, and ZINDO-CI) calculations show that the ADMQ is sort of molecular rotor which undergoes intramolecular twist followed by a complete charge transfer in the optimized excited state. FTIR studies reveals that ADMQ undergoes important structural change from its native structure to a β-hydroxy keto form in water at physiological pH. The concentration-dependent DNA cleavage has been identified in agarose gel DNA electrophoresis experiment and has been further supported by MD simulation. ADMQ forms hydrogen bond with the deoxyribose sugar attached with the nucleobase adenine DA-17 (chain A) and result in significant structural changes which potentially cleave DNA double helix. The compound does not exhibit any deleterious effect or toxicity to the E. coli strain in cytotoxicity studies. The consolidated spectroscopic research described herein can provide enormous information to open up new avenues for designing and synthesizing chalcone derivatives with low systematic toxicity for medicinal chemistry research.

  20. 小儿急性化脓性阑尾炎150例治疗分析%Clinical Analysis of Pediatric Acute Suppurative Appendicitis of 150 Cases

    Institute of Scientific and Technical Information of China (English)

    安俊军; 张生格

    2015-01-01

    Objective To summarize diagnosis and treatment of infantile suppurative appendicitis, in order to im-prove the comprehensive understanding of infantile suppurative appendicitis,reduce the occurrence of postoperative com-plications.Methods 860 cases of appendicitis in children with clinical medical records of the statistics, of which the clinical data of 150 cases of children with purulent appendicitis were retrospectively analyzed.Results All 150 cases were performed surgical treatment, 62 cases of traditional laparotomy, laparoscopic surgery in 88 cases, 2 cases of lapa-roscopic transfer laparotomy.Preoperative diagnosis and postoperative diagnosis of 138 cases of appendicitis, coincidence rate was 92.0% .Postoperative complications in 11 cases, mergers were recovered and discharged, no deaths.Conclusions Children with acute suppurative appendicitis small age of perforation rate is high, the clinician should be detailed history, careful physical examination, reasonable use of auxiliary examination, comprehensive analy-sis, as far as possible the diagnosis of early diagnosis, timely surgical treatment, reduce the incidence rate of perforation, reduce the occurrence of postoperative complications.%目的:总结小儿化脓性阑尾炎的临床诊治,提高临床医师对于小儿化脓性阑尾炎的全面认识,做到早诊断,早治疗,并减少术后并发症的发生。方法对收治的860例阑尾炎患儿临床病历资料进行统计,其中150例化脓性阑尾炎患儿的临床资料进行回顾性分析、总结。结果本组150例均行手术治疗,行传统开腹手术62例,腹腔镜手术88例,腹腔镜中转开腹2例,术后阑尾标本行病理检查:化脓性阑尾炎150例,平均就诊时间为32.5 h,临床症状表现为:腹痛、发热、恶心与呕吐、腹泻、肠梗阻、腹部压痛等,术前诊断与术后诊断均为阑尾炎者138例,符合率为92.0%。术后合并并发症11例,均痊愈出院,

  1. A bio-inspired design strategy: Organization of tryptophan-appended naphthalenediimide into well-defined architectures induced by molecular interactions

    Science.gov (United States)

    Avinash, M. B.; Govindaraju, T.

    2011-06-01

    The chemistry of molecular assemblies involves weak yet complex non-covalent interactions, and the molecular organization of the π-conjugated material is crucial in determining the performance of an organic electronic device. Herein we demonstrate a bioinspired design strategy to tune the self-assembly of naphthalenediimides (NDIs) by minute structural variations, π-π stacking, hydrophobic interactions and metal interactions. We address some of the limitations associated with current design strategies, such as restriction to a specific molecular interaction or the difficulty in controlling the assembly due to several complicated intermolecular interactions. Hydrophobic-effect-induced J-type aggregation and sodium-interaction-induced H-type aggregation of tryptophan-appended NDIs have been illustrated. 1H NMR spectra further reveal sodium cation-π interactions in tryptophan-appended NDIs, while NMR and IR spectroscopic studies confirm the structural variations associated with the molecular assembly. In summary, the molecular organization has been successfully transformed from nanospheres to particles, nanobelts, fibers and fractals. Such drastic changes in the morphology are clear and striking evidence of the importance of non-trivial weak non-covalent forces.The chemistry of molecular assemblies involves weak yet complex non-covalent interactions, and the molecular organization of the π-conjugated material is crucial in determining the performance of an organic electronic device. Herein we demonstrate a bioinspired design strategy to tune the self-assembly of naphthalenediimides (NDIs) by minute structural variations, π-π stacking, hydrophobic interactions and metal interactions. We address some of the limitations associated with current design strategies, such as restriction to a specific molecular interaction or the difficulty in controlling the assembly due to several complicated intermolecular interactions. Hydrophobic-effect-induced J-type aggregation

  2. ¿Son necesarias las ayudas imaginológicas para el diagnóstico de apendicitis? Are imaging procedures necessary for diagnosing appendicitis?

    Directory of Open Access Journals (Sweden)

    Luis Francisco Pérez Montagut

    2004-02-01

    Full Text Available Hay un aumento de la utilización de los estudios imaginológicos en la evaluación de los pacientes con dolor abdominal agudo. El ultrasonido y la tomografía computarizada tienen gran valor en pacientes con sospecha de apendicitis aguda. La tomografía tiene una mayor sensibilidad y una alta especificidad. La mayor utilidad de ambos estudios se obtiene en el grupo de pacientes en quienes después de la evaluación inicial la probabilidad de apendicitis es indeterminada. Se puede concluir de los estudios clínicos que no hay pruebas del beneficio de la ecografía como estudio rutinario en pacientes con sospecha de apendicitis. Diagnostic imaging is being increasingly used in the assessment of acute non-traumatic abdominal pain. Ultrasound and computed tomography investigations are of great value in patients with suspected appendicitis. Computed tomography seems to have a higher sensitivity than ultrasound and a high specificity. Both of them are most useful in patients who have an indeterminate probability of disease after the initial evaluation. From clinical studies it can be concluded that there is no proven benefit of routine ultrasound scanning of the appendix in patients with suspected acute appendicitis.

  3. 急性阑尾炎术后切口感染的防治%Prevention of wound infection after acute appendicitis

    Institute of Scientific and Technical Information of China (English)

    张崇广; 王文江

    2016-01-01

    目的:探讨综合措施预防急性阑尾炎术后切口感染的效果。方法选取2008年1月~2014年12月我院接受急性阑尾炎手术患者363例作为研究对象,从术前刷手、皮肤消毒等到术中操作以及术后围手术期处理的各个环节进行回顾性分析。结果本组患者仅发生切口感染3例,感染发生率为0.8%。结论采取综合方法预防阑尾术后切口感染,明显降低切口感染率,效果满意。%Objective To explore effective comprehensive measures of acute appendicitis postoperative infection prevention.Methods 363 cases of acute appendicitis from preoperative surgical scrub,skin disinfection until surgery operations and all aspects of perioperative treatment were analyzed retrospectively.Results Wound infection occurred in this group only three cases,the infection rate was 0.8%.Conclusion We take an integrated approach to the prevention of wound infection after appendectomy,signiifcantly reduced wound infection rate,results were satisfactory.

  4. Transumbilical Laparo-Assisted Appendectomy: A Safe Operation for the Whole Spectrum of Appendicitis in Children—A Single-Centre Experience

    Directory of Open Access Journals (Sweden)

    D. Codrich

    2013-01-01

    Full Text Available The paper reports the results of a retrospective review of the medical charts of 203 patients admitted to a pediatric surgical unit with a diagnosis of acute appendicitis between January 2006 and December 2010 when a transumbilical laparoscopic-assisted appendectomy (TULAA was introduced as a new surgical technique. Among 203 admitted patients, 7 (3.5% had a localized appendiceal abscess and were treated with antibiotics. All of them responded to antibiotics and underwent TULAA interval appendectomy 8 weeks later. 196 patients (96.5% underwent immediate surgery. In 12/181 (6.6% urgent cases, conversion to laparotomy was necessary, in 3 patients because of bowel distension and in 9 for retrocecal position of appendix. In all 181 TULAA completed procedures, one trocar was used in 151 cases (89.4%, two trocars in 16 (9.4%, and three trocars in 2 (1.2%. The mean operative time for single port TULAA was 52′ Complications included 5 wound infections and 5 intra-abdominal abscesses, all managed conservatively. In conclusion, TULAA is a safe, minimally invasive approach with acute appendicitis, regardless of the perforation status, and can be recommended in the pediatric urgical settings.

  5. 超声检查对不同病理类型阑尾炎的诊断价值%The value of ultrasonography in the diagnosis and classifi cation of appendicitis

    Institute of Scientific and Technical Information of China (English)

    余俊丽; 刘广健; 艳玲; 刘小银; 程文捷; 陈瑶; 覃斯; 王韦力

    2015-01-01

    性阑尾炎、急性坏疽性阑尾炎与慢性阑尾炎患者的超声表现差异均有统计学意义[管壁层次不清:91.11%(41/45)与54.55%(18/33)比较,P=0.003;93.33%(14/15)与54.55%(18/33)比较, P=0.045。管腔扩张:64.44%(29/45)与27.27%(9/33)比较,P=0.007;80.00%(12/15)与27.27%(9/33)比较,P=0.007];在合并阑尾区积液方面,急性坏疽性阑尾炎与慢性阑尾炎患者的超声表现差异有统计学意义[53.33%(8/15)与6.06%(2/33)比较,P=0.006]。结论超声检查对阑尾炎尤其是急性化脓性和急性坏疽性阑尾炎有较高的诊断价值。超声测量阑尾宽度、管壁厚度及对管壁层次、管腔扩张程度及阑尾区有无积液等特征的观察对鉴别诊断慢性阑尾炎与急性化脓性阑尾炎、急性坏疽性阑尾炎有一定的价值;阑尾宽度对鉴别诊断急性坏疽性阑尾炎与急性单纯性阑尾炎有意义。超声检查对鉴别诊断急性化脓性与急性坏疽性阑尾炎、急性单纯性阑尾炎与慢性阑尾炎及慢性阑尾炎急性发作的价值有限。%ObjectiveTo assess the diagnostic value of ultrasonography in the diagnosis and pathological classifi cation of appendicitis with pathological results.MethodsThe study included 111 cases who confi rmed by surgery and pathology in the Six Affi liated Hospital of Sun Yat-sen University from June2012 to December 2013. The image characteristics of ultrasonic images performed before surgery were analyzed retrospectively. The cases were divided into five groups based on the pathology: 6 acute simple appendicitis, 45 acute suppurative appendicitis, 15 acute gangrenous appendicitis, 33 chronic appendicitis, and 12 acute attack of chronic appendicitis. The length, width and wall thickness of the appendicitis measured by preoperative ultrasound between various pathological type were compared with Kruskal-Wallis statistical methord, and also used the same method to compared the one which had

  6. Apendicite aguda: análise institucional no manejo peri-operatório Acute appendicitis: institutional evaluation in the peri-operative managment

    Directory of Open Access Journals (Sweden)

    Orli Franzon

    2009-06-01

    avançado o estágio de evolução da apendicite, maior a prevalência de complicações.BACKGROUND: Acute appendicitis is one of the most common cause of acute abdomen and is responsible for high morbidity. Correct diagnosis remains a challenge, thus accurate perioperative assessment is important in planning surgical therapy. AIM: To evaluate institutional findings in perioperative workup, operative approach and adverse outcomes in patients who underwent open surgical intervention for acute appendicitis. METHOD: A prospective chart was performed of 88 adults patients undergoing open appendectomy. Variables compared were imaging methods and laboratory evaluation, pathologic findings and early complications. Statistical analysis was performed by SPSS 8.0 and EpiInfo6.0. RESULTS: Thirty patients underwent ultrassonography (56,7% females and five computorized tomography (all women. The differencial white cell count was directly related to more advanced phases regarding increased of "stabs", segmented and eosinophyls/lymphocytes decrease (P>0,005. Sixty (67% patients used antibiotic therapy and 38,33% of them had perforated appendicitis. Was found 23,8% of complications, 11,4% was wound infections and patients with perforated appendicitis. CONCLUSION: Females demand more imaging methods. The differencial white cell count in complicated appendicitis has an increment in less mature neutrophils and reduction of the eosinophils and lymphocytes. Advanced phases has increase risk of early complications mainly superficial wound infections and shows more prevalence in using.

  7. Click chemistry-assisted, bis-cholesteryl-appended, isosorbide-based, dual-responsive organogelators and their self-assemblies.

    Science.gov (United States)

    Balamurugan, R; Zhang, Y-S; Fitriyani, S; Liu, J-H

    2016-06-21

    A new series of symmetric, bis-cholesteryl-appended, isosorbide derivatives (BCIE, BCIC2 and BCIC4) were designed as gelators to respond to changes in their environment and were synthesized successfully. Among these derivatives, BCIE can gel a wide variety of organic solvents (23 solvents), suggesting that BCIE acts as a more versatile gelator than BCIC2 and BCIC4. The CGC of the gels varies from 1.53 mM in 1-hexanol to 23 mM in pyridine. The results of the gelation ability in different solvents revealed that changing the linking group (ester/carbamate) attached to the cholesteryl units can produce a dramatic change in the gelation behavior of the compounds. The morphology of the as-formed organogels can be regulated by changing the types of organic solvents. The results from electron microscopy studies revealed that the gelator molecule self-assembled into different aggregates, from wrinkled fibers to dense fibers, with the change of solvents. The gels of BCIE in 1-hexanol and 1-octanol exhibited strong CD (circular dichroism) signals, indicating that the gelation induced supramolecular chirality in these gel systems. Secondary forces of van der Waals and π-π stacking (from both 1,2,3-triazole and aromatic units) played important roles in the aggregation of compounds in the solvents according to FTIR and variable temperature (1)H-NMR analysis, and a mechanism for the gel formation was proposed. The gel-to-sol phase transition can be triggered by the addition of trifluoroacetic acid (TFA), and the gel state was obtained slowly (after 1 day) when neutralizing with triethyl amine (TEA), which indicated that the sol ⇄ gel phase transitions are tunable by pH, which is further supported by (1)H-NMR and SEM analysis. In addition, the gel stability of BCIE was investigated using Cu(2+), Cd(2+), Ag(2+), Fe(3+), Hg(2+), Mg(2+), Pd(2+), Al(3+) and Zn(2+), and the results showed that the gel-to-sol phase transition process could be selectively controlled by interaction

  8. 超声在急性阑尾炎临床诊断和分型中的临床意义%Clinical Signi.cance of Ultrasound in Acute Appendicitis Diagnosis and Pathological Typing

    Institute of Scientific and Technical Information of China (English)

    盛建超

    2012-01-01

    Objective To study the significance of ultrasound in acute appendicitis diagnosis and pathological typing.Methods A retrospective review of 168 cases of emergency patients with acute abdomen with operation in the years April 2010 ~ November 2011 was done with comparison between preoperative ultrasonography diagnosis results and postoperative pathological examination results.Results Simple appendicitis ultrasound diagnostic accuracy rate was 97.1%,suppurative appendicitis accuracy rate was 95.2%,gangrenous appendicitis ultrasound accuracy rate was 100%,the overall diagnostic accuracy rate was 97.1%.Appendiceal ultrasonography of appendicitis group shows that the appendiceal diameter,length,wall thickness were higher than that of non-acute-appendicitis patients(P < 0.01).Conclusion Ultrasonography on acute appendicitis diagnosis accuracy rate is very high,which has important diagnostic value,and should be preferred as auxiliary diagnostic method.%目的 探讨超声在急性阑尾炎诊断及病理分型中的作用和意义.方法 回顾2010年4月~2011 年11月急诊就诊的急腹症患者168例,均进行手术治疗,比较术前超声检查诊断结果 与术后病理检查结果 的差异.结果 单纯性阑尾炎超声诊断准确率为97.1%,化脓性阑尾炎准确率为95.2%,坏疽性阑尾炎准确率为100%,超声总的诊断准确率为97.1%;阑尾炎组的阑尾超声结果 显示其阑尾直径、长度、管壁厚度均高于非阑尾炎急腹症患者(P<0.01).结论 超声检查对急性阑尾炎诊断准确率很高,具有重要的诊断价值,应作为首选辅助诊断方法.

  9. Concerning on the Appending and the Ownership of Something Appended---A supplement to the original acquisition institution of the ownership in our country's property Law%论添附与添附物的所有权归属--对我国《物权法》所有权原始取得制度的一项补充

    Institute of Scientific and Technical Information of China (English)

    王明锁

    2015-01-01

    添附是罗马法以来民法物权中所有权原始取得的重要方式,但我国《物权法》对此却没有规定。传统民法理论中,有关添附的见解并不一致。我国民法理论中将加工、混合、附合都列入添附的范畴,但在社会经济生活中,甄别添附、加工、混合、附合各自的涵义和相互关系及其规范调整的社会现象却各有不同。一般来说,加工应当是独立的一种所有权原始取得制度,与生产无异;而所谓的附合、混合则完全可以被添附吸纳。依据各概念蕴含的不同含义拟定相关法律条文,不仅能有效对有关社会生活实际进行规范适用,而且还可形成简洁清晰的添附制度,此外也可促进完善我国物权法所有权取得方法,并于将来编纂民法典时参考,具有重要的理论价值和实践意义。%Appending is an important way in the original ownership in civil law real right since Roman law. However, there is no rules about it in the property law of our country. Views about appending varies in the traditional civil law theories. In our country's civil law theory, processing, mixing, and adhesion are all listed in appending. But by observating and reviewing the social economic practical life, we can find that processing should be an independent institution of original ownership, which is the same as production, through identifying their respective connotation of appending, processing, mixing, and adhesion ,the relationship among them as well as the social phenomenon adjusted by its norms. The so-called adhesion and mixing can be absorbed completely by appending. If relevant laws can be formulated according to this, then the related social life would be applied effectively. It can not only form a simple and clear appending institution but also can promote the methods of ownership acquisition of our country's property law. In addition, it can be for reference when we compile the civil code

  10. Reliability of diagnostic imaging techniques in suspected acute appendicitis: proposed diagnostic protocol; Indicacion de las tecnicas de diagnostico por la imagen en la sospecha de apendicitis aguda: propuesta de protocolo diagnostico

    Energy Technology Data Exchange (ETDEWEB)

    Cura del, J. L.; Oleaga, L.; Grande, D.; Vela, A. C.; Ibanez, A. M. [Hospital de Basureto. Bilbao (Spain)

    2001-07-01

    To study the utility of ultrasound and computed tomography (CT) in case of suspected appendicitis. To determine the diagnostic yield in terms of different clinical contexts and patient characteristics. to assess the costs and benefits of introducing these techniques and propose a protocol for their use. Negative appendectomies, complications and length of hospital stay in a group of 152 patients with suspected appendicitis who underwent ultrasound and CT were compared with those of 180 patients who underwent appendectomy during the same time period, but had not been selected for the first group: these patients costs for each group were calculated. In the first group, the diagnostic value of the clinical signs was also evaluated. The reliability of the clinical signs was limited, while the results with ultrasound and CT were excellent. The incidence of negative appendectomy was 9.6% in the study group and 12.2% in the control group. Moreover, there were fewer complications and a shorter hospital stay in the first group. Among men, however, the rate of negative appendectomy was lower in the control group. The cost of using ultrasound and CT in the management of appendicitis was only slightly higher than that of the control group. Although ultrasound and CT are not necessary in cases in which the probability of appendicitis is low or in men presenting clear clinical evidence, the use of these techniques is indicated in the remaining cases in which appendicitis is suspected. In children, ultrasound is the technique of choice. In all other patients, if negative results are obtained with one of the two techniques, the other should be performed. (Author) 49 refs.

  11. 急性阑尾炎早期动态演变中的超声监测%Dynamic evolution of acute appendicitis monitored by ultrasonography

    Institute of Scientific and Technical Information of China (English)

    黄崑; 梁松年; 郭荣利; 赵一; 王学梅

    2012-01-01

    Objective To explore the clinic application value of color Doppler ultrasound in the diagnosis of acute appendicitis at different stages. Methods Two hundred and forty-six patients with acute appendicitis were examined by color Doppler ultrasound and classified according to the different stages. Results 232 patients were diagnosed by color Doppler ultrasound,and the accurate rate was 94.31%.Within 12 h, 20 patients were diagnosed by color Doppler ultrasound,and the accurate rate was 83.33%.During 12 h and 24 h, 59 patients were diagnosed by color Doppler ultrasound,and the accurate rate was 92.19%. During 24 h and 72 h, 118 patients were diagnosed by color Doppler ultrasound, and the accurate rate was 96.72%. Beyond 72 h, 35 patients were diagnosed by color Doppler ultrasound, and the accurate rate was 97.22%. Conclusion The appearance of color Doppler ultrasound in different phases of the acute appendicitis is good to diagnose the acute appendicitis and direct the clinic treatment.%目的 探讨彩色多普勒超声对不同时期急性阑尾炎诊断中的价值.方法 246例诊断急性阑尾炎患者急诊行彩色多普勒超声检查,明确阑尾炎的表现形式,按不同的发病时间分类,并与手术结果进行对照研究.结果 246例急性阑尾炎患者中,经超声准确诊断者232例,诊断符合率94.31%,其中发病时间12h内的阑尾炎患者24例,超声准确诊断20例,诊断符合率83.33%,12~24 h内的阑尾炎患者64例,超声准确诊断59例,诊断符合率92.19%;24~72 h内的阑尾炎患者122例,超声准确诊断118例,诊断符合率96.72%;超过72 h的阑尾炎患者36例,超声准确诊断35例,诊断符合率97.22%.结论 彩色多普勒超声在不同时期急性阑尾炎中的特征性表现,有利于明确诊断阑尾炎严重程度,指导临床治疗.

  12. Association between tonsillectomy, adenoidectomy, and appendicitis Asociación entre amigdalectomía, adenoidectomía y apendicitis

    Directory of Open Access Journals (Sweden)

    J. C. Andreu Ballester

    2005-03-01

    Full Text Available Introduction: tonsillectomy, with or without adenoidectomy, is one of the most frequent surgical procedures generally performed, especially in young patients. Several studies suggest that there is a relationship between tonsillectomy and altered MALT immune system. Objective: to examine the possible association between tonsillectomy or adenoidectomy and the risk of subsequent appendicitis. Material and method: a cross-sectional study was performed in 650 patients admitted to the emergency department of a general hospital in Valencia, Spain. Previous history of tonsillectomy and/or adenoidectomy was related to a history of appendectomy. A descriptive study and an analysis of the relationship between previous operations and appendicitis was performed. A multivariable analysis controlled for age and sex was also performed, including the possible interaction of the gender variable. The independent effect of each of the procedures (tonsillectomy, adenoidectomy was tested. Results: the 25.5% of patients had undergone tonsillectomy and 11.5% adenoidectomy; 17.5% had had an appendectomy. On average, women were operated on more frequently than men. In the bivariate analysis, both tonsillectomy and adenoidectomy were significantly associated with subsequent appendectomy. In the multivariate analysis, this association was only maintained for tonsillectomy (OR: 3.23; 95% CI: 2.11-4.94. A stratified analysis controlling for sex showed a modification of this effect, with a higher association in women (OR: 5.20; 95% CI: 2.91-9.28 than in men (OR: 1.74; 95% CI: 0.90-3.39. Conclusions: a clear association has been found, especially in women, between previous tonsillectomy and subsequent acute appendicitis. Due to a lack of data on acute appendicitis there should be further studies to explain the findings of this study, as this could be the first described risk factor of acute appendicitis.Introducción: la amigdalectomía, sola o acompañada de adenoidectom

  13. Estudo da transmigração bacteriana na apendicite experimental em coelhos A study about bacterial transmigration in experimental Appendicitis in rabbits

    Directory of Open Access Journals (Sweden)

    ECF RAMOS

    2000-01-01

    Full Text Available Introdução: A queda extrínseca dos mecanismos de defesa de um hospedeiro é vista classicamente como uma infecção, que resulta na aquisição de um tecido normal, de um novo microorganismo, cuja virulência é fundamental para a sua patogenia.Na década de 50, estudos comprovaram que bactérias e endotoxinas podem ultrapassar a barreira intestinal e atingir a circulação, demonstrando ainda, que a flora intestinal representa uma importante fonte para o desenvolvimento da infecção sistêmica. Objetivo: o presente estudo visa avaliar a ocorrência de transmigração bacteriana em apendicite experimental induzida em coelhos, mediante a oclusão completa do apêndice vermiforme. Métodos: foram utilizados 24 coelhos brancos, da linhagem Nova Zelândia, com peso corporal variando de 2500 a 3000 gramas, sendo então divididos em 2 grupos. Os animais do Grupo I foram submetidos a laparotomia mediana e retirada de fragmentos do baço, rim esquerdo, pulmão direito, linfonodo abdominal, conteúdo da luz do apêndice vermiforme e sangue da veia porta para cultura. Os animais do Grupo II foram submetidos a laparotomia mediana e oclusão completa do apêndice vermiforme para a indução de apendicite e, após 24 horas, realizada a coleta do material nos moldes do Grupo I. Resultados: No Grupo controle (Grupo I, não se observou o crescimento de bactérias nas amostras analisadas. No Grupo experimento (Grupo II, observou-se o crescimento de Escherichia coli em todos os animais. Conclusão: Ocorreu transmigração bacteriana após 24 horas de observação em coelhos com apendicite experimental.The present study aims to evaluate the occurrence of the bacterial transmigration in induced ezxperimental appendicitis in rabbitis through complete oclusion of the vermiform appendix. 24 New Zealand white rabbits with a body weight ranging from 2500 to 3000 grams were used. They were divided into 2 groups. The animals from group I were submitted to a median

  14. Apendicite aguda isquêmica em coelhos: um novo modelo com estudo histopatológico Acute ischaemic appendicitis in rabbits: new model with histopathological study

    Directory of Open Access Journals (Sweden)

    Fernando Costa Nunes

    2004-06-01

    Full Text Available OBJETIVO: Avaliar a isquemia parcial ou total do apêndice vermiforme de coelhos, através da ligadura com fio inabsorvível dos vasos do meso apêndice bem como a obstrução mecânica, através da ligadura com fio inabsorvível da base do apêndice a 1 cm do ceco, na patogênese da apendicite aguda. Avaliar a histologia do apêndice (normal e acometido. Estudar a flora bacteriana residente no apêndice vermiforme (normal e acometido e do exsudato peritoneal. MÉTODO: Foram utilizados 72 coelhos (Oryctogalus cuniculos, machos, da linhagem Nova Zelândia, com peso médio de 3.000 gramas. Foram divididos em grupos: piloto (A, flora bacteriana (B, controle (H e experimento (C, D, E, F e G com períodos de observação de 96 horas e 192 horas. Fez-se a ligadura dos vasos do meso apêndice com fio inabsorvível nos grupos (D, E, F e G e da base do apêndice vermiforme a 1 cm do ceco, no grupo (C. No grupo experimento (D, E, F e G foi praticado o modelo isquêmico. No grupo experimento (C foi realizada a obstrução mec��nica e no grupo controle (H foi feita somente a simulação da cirurgia. RESULTADOS: Ocorreu apendicite aguda no grupo experimento (C,D,E,F, e G. CONCLUSÕES: O método utilizado causa apendicite aguda com alterações anatomopatológicas distintas. A bactéria residente encontrada na flora fisiológica do suco entérico do apêndice vermiforme e no exsudato peritoneal foi Escherichia coli.BACKGROUND: To evaluate partial or total ischemia, through ligature with an unabsorbed thread of vessels from the vermiform appendix of rabbits, as well as the mechanical obstruction, through ligature with an unabsorbed thread at the basis of the vermiform appendix, at 1 cm from the cecum, in the pathogenesis of acute appendicitis. To evaluate the histology of the appendix (normal and affected. To study the resident bacterium flora in the appendix (normal and affected and the peritonitis exudate. METHODS: Seventy- two male rabbits (Oryctogalus

  15. Clinical treatment experience of 48 cases of elderly patients with acute appendicitis%老年急性阑尾炎48例临床治疗体会

    Institute of Scientific and Technical Information of China (English)

    鲍克平

    2014-01-01

    目的:总结老年急性阑尾炎治疗经验及临床疗效。方法:2012年8月-2014年1月收治老年阑尾炎患者48例,其中10例阑尾周围脓肿,应用抗生素治疗1周,症状未见好转,行脓肿切开引流术,坏疽性阑尾炎行急诊阑尾切除和腹腔引流术治疗,9例急性化脓性阑尾炎和28例急性单纯性阑尾炎行急诊阑尾切除手术治疗。结果:本组48例急性阑尾炎患者经过治疗,47例患者伤口愈合良好,1例并发糖尿病导致伤口感染,经换药后延迟愈合,经过2~6个月的随访,48例患者均无粘连性肠梗阻和腹腔内出血及残余脓肿形成。结论:老年人急性阑尾炎症状不典型,需要仔细检查,根据患者阑尾炎的具体情况来选择相应的治疗方法,才能达到较好的临床效果。%Objective:To sum up the treatment experience and clinical effect of patients with acute appendicitis.Methods:48 patients with acute appendicitis were selected from August 2012 to January 2014.Among 10 cases of appendiceal abscess were treated by antibiotics for 1 week,but their symptoms had not been better,so they were treated by abscess incision drainage.The gangrenous appendicitis were given emergency appendectomy and peritoneal drainage treatment.9 cases of acute suppurative appendicitis and 28 cases of acute simple appendicitis were given emergency appendectomy operation treatment.Results:In 48 patients with acute appendicitis,the wound of 47 patients healed well,1 patient complicated with diabetes leaded to wound infection,and healed after dressing change.After 2~6 months follow-up.48 patients were free of adhesive ileus,intraperitoneal hemorrhage and residual abscess formation.Conclusion:Elderly patients with acute appendicitis have atypical symptoms,need careful examination.In order to achieve good clinical results,the corresponding treatment methods should be choosen according to the specific situation of patients with appendicitis.

  16. Home-care After Apperdoctomy for Early Acutc Appendicitis in Children%阑尾炎术后的门诊治疗

    Institute of Scientific and Technical Information of China (English)

    牛文英; 张金哲

    1992-01-01

    Owing to the fact that the postoperative course of simple acute appendicitis is always uneventful,the rationality of home-care after appendectomy has been considered.100 random cases were collected on the following criteria,age above 4 years,history shorter than 24 heurs,general condition good and free from toxic symptoms,localized tenderness in R.L.Q.without distension,no mass by either rectal or abdominal examination,and no gross perforation of appendix or frank pus found in peritoneal cavity at operation.All cases met the above criteria were admitted and treated under the following regimen including:free from bed,eral feeding and oral medication,no infusion or injection,imitating the home-life care according to the age.Another 116 random cases of the sanle criteria were admitted as controls,but treated under the conventional inpatient regimen in eluding:I.v.drip for a day or two,antibiotics for a week,and routine hospital nursing care until discharge.All the 216 cases were discharged uneventfully.There was no significant difference between these 2 groups.The conclusion is naturally that the simple and early acute appendicitis in children would be better sent home after appendectomy to enjoy the family care.It is not only good for mother and child,but also good for the hospital and society in solving the shortage of the pediatric surgical beds.%作者报告采用模拟门诊治疗,前瞻性观察急性阑尾炎未穿孔的100例患儿,并与同期同祥条件常规住院治疗的116例阑尾炎相比较,说明该类息儿术后出院,在门诊继续治疗是可行的,并且是安全可靠的.

  17. 综合护理对急性阑尾炎患者的影响分析%Analysis on the Influence of Comprehensive Nursing Care on the Patients With Acute Appendicitis

    Institute of Scientific and Technical Information of China (English)

    刘寒梅

    2015-01-01

    目的:分析综合护理对急性阑尾炎患者的影响。方法将86例急性阑尾炎患者随机分为A组(综合护理)和B组(常规护理),各43例,分析两组护理效果。结果A组SAS评分、SDS评分及并发症发生率较B组低。结论给予急性阑尾炎患者综合护理可有效缓解患者不良情绪,减少并发症发生。%Objective To analyze the effect of comprehensive nursing care on the patients with acute appendicitis. Methods 86 cases of acute appendicitis were randomly divided into group A (Comprehensive Nursing) and group B (routine nursing),each of 43 cases,analyzed the nursing effect of the two groups. Results In group A,SAS score,SDS score and the incidence of complications were lower than that of B group. Conclusion Comprehensive nursing care given to patients with acute appendicitis patients can effectively al eviate the bad mood and reduce complications.

  18. Prednisolone-appended alpha-cyclodextrin: alleviation of systemic adverse effect of prednisolone after intracolonic administration in 2,4,6-trinitrobenzenesulfonic acid-induced colitis rats.

    Science.gov (United States)

    Yano, H; Hirayama, F; Arima, H; Uekama, K

    2001-12-01

    The titled compound is a cyclodextrin derivative in which prednisolone 21-succinate (PDsuc) is covalently bound to one of the secondary hydroxyl groups of alpha-cyclodextrin (alpha-CyD) via an ester linkage. In this study, the PDsuc-appended alpha-CyD ester conjugate (PDsuc/alpha-CyD conjugate) was intracolonically administered to rats with 2,4,6-trinitrobenzensulfonic acid-induced colitis, and its antiinflammatory and systemic adverse effects were compared with those of prednisolone (PD) alone and the PD/2-hydroxypropyl-beta-CyD complex (PD/HP-beta-CyD complex), which is a noncovalent inclusion complex. Colonic damage score, ratio of distal colon wet weight to body weight, and myeloperoxidase activity were evaluated as measures of the therapeutic effect of PD, whereas the ratio of thymus wet weight to body weight was evaluated as a measure of the side effect of PD. The local antiinflammatory activity increased in the order of PD alone approximately PDsuc/alpha-CyD conjugate keeps the local concentration in the colon at a low but constant level. The results suggest that the PDsuc/alpha-CyD conjugate can alleviate the systemic adverse effect of PD while maintaining the therapeutic activity of PD. This kind of knowledge will be useful in the rational design of steroid prodrugs for the colon-specific drug delivery system. PMID:11745769

  19. Solid inclusion complexes of oleanolic acid with amino-appended β-cyclodextrins (ACDs): Preparation, characterization, water solubility and anticancer activity.

    Science.gov (United States)

    Ren, Yufeng; Liu, Ying; Yang, Zhikuan; Niu, Raomei; Gao, Kai; Yang, Bo; Liao, Xiali; Zhang, Jihong

    2016-12-01

    Oleanolic acid (OA) is a pentacyclic triterpenoid acid of natural abundance in plants which possesses important biological activities. However, its medicinal applications were severely impeded by the poor water solubility and resultant low bioavailability and potency. In this work, studies on solid inclusion complexes of OA with a series of amino-appended β-cyclodextrins (ACDs) were conducted in order to address this issue. These complexes were prepared by suspension method and were well characterized by NMR, SEM, XRD, TG, DSC and Zeta potential measurement. The 2:1 inclusion mode of ACDs/OA complexes was elucidated by elaborate 2D NMR (ROESY). Besides, water solubility of OA was dramatically promoted by inclusion complexation with ACDs. Moreover, in vitro anticancer activities of OA against human cancer cell lines HepG2, HT29 and HCT116 were significantly enhanced after formation of inclusion complexes, while the apoptotic response results indicated their induction of apoptosis of cancer cells. This could provide a novel approach to development of novel pharmaceutical formulations of OA. PMID:27612690

  20. 急性阑尾炎术后切口感染的相关因素分析及对策%Related factor sanalysis and countermeasure for postoperative wound infection in acute appendicitis

    Institute of Scientific and Technical Information of China (English)

    周思军

    2014-01-01

    目的:探讨引起急性阑尾炎术后切口感染的危险因素,并提出相应的干预对策。方法以2008年1月~2014年7月我院行手术治疗的578例急性阑尾炎患者为研究对象,采用病例对照研究的方法分析引起术后切口感染的危险因素。结果我院急性阑尾炎术后切口感染的发生率为6.06%,单因素分析共筛选出7个因素与切口感染有关;多因素分析结果显示,病程长、阑尾逆行切除、手术时间长、病理类型为化脓性或坏疽穿孔性是急性阑尾炎患者术后切口感染的危险因素,O R值分别为5.692、2.402、0.998、0.078。结论根据病情选择合理术式、在疾病早期实施手术、缩短手术时间以降低术后切口感染的发生率。%Objective To explore the causes of postoperative wound infection in acute appendicitis and propose appropriate interventions .Methods 578 cases of acute appendicitis with surgical incision in our hospital from Jan‐uary 2008 to July 2014 were chose as the objects of this study ,a case‐control study was used to analysis the related factors of postoperative wound infection in acute appendicitis .Results The incidence of postoperative wound in‐fection in acute appendicitis in our hospital was 6 .06% ;7 factors related to the incision infection were screened by univariate analysis;the result of Logistic regression analysis showed that long course of disease ,appendix retrogra‐ded removing ,long operation time and suppurative gangrenous perforated appendicitis were the related factors of in‐cision infection ,the OR value was 5 .692 ,2 .402 ,0 .998 ,0 .078 ,respectively .Conclusions reasonable type of sur‐gery ,implement operation at the early period of the disease ,shorten the operation time should be used to reduce the incidence of postoperative infection .

  1. 老年性右半结肠癌并发急性阑尾炎18例临床分析%The Clinical Analysis of 18 Cases of Senile Right Colon Cancer with Acute Appendicitis

    Institute of Scientific and Technical Information of China (English)

    谷欣; 李汝红

    2011-01-01

    Objective To investigate the misdiagnosis causes and preventive measures of senile right colon cancer with acute appendicitis. Method Retrospective study was used to analyze the experience of 18 cases of senile right colon cancer with acute appendicitis in Kunming Yan'an Hospital from January 2008 to January 2010. Result 18 patients with right colon cancer were misdiagnosed as acute and chronic appendicitis or appendix abscess on admission, and were confirmed as colon cancer with acute simple appendicitis by pathological examination. Conclusion Right colon cancer has no typical clinical manifestations and is easily misdiagnosed because it often complicated with acute appendicitis, so it is critical to reduce the misdiagnosis rate by learning the history carefully, taking physical examination and laboratory examinations, and exploring the cecum and ascending colon during operation.%目的 探讨老年性结肠癌并发急性阑尾炎误诊、漏诊原因及预防措施.方法 回顾性分析昆明市延安医院2008年1月至2010年1月右半结肠癌并发急性阑尾炎18例的临床资料.结果 本组18例右半结肠癌患者人院时均误诊为急、慢性阑尾炎或阑尾周围脓肿,最终经病理证实为结肠腺癌合并急性单纯阑尾炎.本组18例病例中失访3例;随访15例,随访率83.33%,95%可信区间为65.66%~87.94%,其中死亡3例.结论 右半结肠癌本身临床表现不典型,与急性阑尾炎并存易误诊、漏诊,因此仔细询问病史和体格检查,以及行相关的辅助检查、术中对盲肠、升结肠进行探查是减少漏诊误诊的关键.

  2. To explore the necessity of peritoneal lavage in acute appendicitis operation%小儿急性阑尾炎手术中腹腔冲洗的必要性探讨

    Institute of Scientific and Technical Information of China (English)

    王建尧; 刘磊; 王斌; 叶明; 冯奇; 陈子民; 叶晓烁; 吴宙光

    2016-01-01

    目的:通过对比各型小儿阑尾炎术中行腹腔冲洗与未行腹腔冲洗的疗效,探讨术中行腹腔冲洗的必要性。方法收集本院近3年内收治的急性阑尾炎病例共350例,其中 A 组为单纯性阑尾炎,行腹腔镜阑尾切除术;B、C 组为化脓性阑尾炎未穿孔,B 组行腹腔镜阑尾切除+腹腔引流术,C 组行腹腔镜阑尾切除+腹腔冲洗+腹腔引流术;D、E 组为坏疽穿孔性阑尾炎,D 组行腹腔镜阑尾切除+腹腔引流术,E 组行腹腔镜阑尾切除+腹腔冲洗+腹腔引流术。术后对患者资料进行详细统计和相应分析。结果急性单纯性阑尾炎行腹腔镜阑尾切除术后患儿预后良好。急性化脓性阑尾炎组术中行腹腔冲洗后,术后患儿肛门排气排便时间、直肠刺激症状、间断腹痛情况明显增加,且术后腹腔脓肿的发生率明显增多,术后5 d 血常规白细胞稍高,1例并发右侧膈下脓肿,平均住院时间较未冲洗组明显延长;相反,急性坏疽穿孔性阑尾炎组,术中行腹腔冲洗后,患儿术后肛门排气排便时间缩短,术后腹腔残余感染、直肠刺激症状、间断腹痛情况降低,术后腹腔脓肿等并发症的发生率降低,术后5 d 血白细胞较未冲洗组稍低。术后患儿恢复相对较快,住院时间短。结论小儿急性阑尾炎术中冲洗治疗应根据具体情况选择合适的方法,术中调节体位,充分显露脓腔,引流彻底,引流管位置适宜;急性化脓性阑尾炎未穿孔者不需行腹腔冲洗,而急性坏疽穿孔性阑尾炎则需术中行腹腔冲洗。%Objetive To explore the necessity of peritoneal lavage in the operation by comparing post-operative results of various types of acute appendicitis.Methods A total of 350 cases of acute appendicitis in our hospital were collected in 3 years.A group include appendicitis which undergo laparoscopic appendectomy. B,C group which

  3. Acute appendicitis in an incarcerated crural hernia: analysis of our experience Apendicitis aguda en una hernia crural incarcerada: análisis de nuestra experiencia

    Directory of Open Access Journals (Sweden)

    P. Priego

    2005-10-01

    Full Text Available Introduction: the finding of the vermiform appendix within a crural hernia (Amyand's hernia is a rare entity whose incidence is not described in the literature. Objective: the aim of this study was to report our hospital's experience in this kind of pathology. Material and methods: between 1993 and 2004, 4,572 acute appendicitis and 372 incarcerated crural hernia cases have been operated on in our hospital. We studied 6 cases of incarcerated crural hernia with vermiform appendix inside. We analyzed in retrospect the following parameters: age, sex, personal history, clinical manifestations, preoperative diagnosis, surgical technique, mean hospital stay, and outcome. Results: all patients were women with a mean age of 78.8 years. Most frequent clinical manifestations included pain and a mass in the right inguinocrural region, of variable intensity and duration. No clinical, laboratory, or radiographic signs help in reaching a correct preoperative diagnosis. General anesthesia and a crural approach are used in most surgical operations. In all cases an appendectomy was performed via the hernia sac, thus proving the presence of acute appendicitis in four of them (66.67%. A prosthetic mesh was used in 3 cases, and one case of wound infection was found. In the other cases we sutured the hernia ring using prolene. Conclusion: the finding of the appendix in an incarcerated crural hernia is a rare entity in old women that is difficult to diagnose preoperatively. Treatment includes appendectomy and herniorraphy. The use of prosthetic mesh is controversial.Introducción: la presencia del apéndice vermiforme en el interior de un saco herniario crural (hernia de Amyand constituye una entidad poco frecuente y cuya incidencia no está descrita en la literatura. Objetivo: el objetivo del trabajo es presentar la experiencia de nuestro hospital en este tipo de patología. Material y métodos: entre 1993 y 2004 se han intervenido en nuestro centro 4.572 pacientes

  4. Appendicular pseudodiverticula and acute appendicitis: Our 12-year experience Pseudodivertículos apendiculares y apendicitis aguda: Nuestra experiencia en 12 años

    Directory of Open Access Journals (Sweden)

    María del Carmen Manzanares-Campillo

    2011-11-01

    Full Text Available Introduction: the presence of diverticula and their complications in the cecal appendix is an uncommon disease. We present a series of 13 patients with this condition, and perform a review of the literature. Patients and method: we carried out a retrospective study of patients undergoing appendectomy for acute appendicitis in the last twelve years in our department. The pathological examination of these episodes revealed 13 cases with a diagnosis of diverticular disease, all of them consisting of pseudodiverticula. Their clinical manifestations, laboratory results, imaging tests, and histology were analyzed, and findings were compared to those in the previous literature. Results: the incidence of diverticular disease in our setting was 13 cases (0.8% among 1634 appendectomies for acute appendicitis. Diverticulitis was found in 8 patients (61.5%, and diverticulosis (38.5% in 5. Appendicular perforation was more common in patients with diverticular disease (53.8% as compared to those without this condition (31.1%. Conclusions: complicated diverticular disease in the vermiform appendix of adult patients may result in insidious, recurrent manifestations that may confound preoperative diagnosis. A higher risk for appendicular perforation renders appendectomy the therapy of choice, even prophylactically when the condition is incidentally identified preoperatively.Introducción: la presencia de divertículos y sus complicaciones en el apéndice cecal constituyen una entidad infrecuente. Presentamos una serie de 13 pacientes con esta patología y realizamos una revisión de la literatura. Pacientes y método: realizamos un estudio retrospectivo de los pacientes apendicectomizados por apendicitis aguda en los últimos doce años en nuestro servicio. El examen anatomopatológico de estos episodios reveló el diagnóstico de 13 casos con enfermedad diverticular, todos ellos pseudodivertículos. Se analizaron la clínica, pruebas analíticas, de imagen y la

  5. Cholesterol lowering effects of mono-lactose-appended β-cyclodextrin in Niemann–Pick type C disease-like HepG2 cells

    Science.gov (United States)

    Motoyama, Keiichi; Hirai, Yumi; Nishiyama, Rena; Maeda, Yuki; Higashi, Taishi; Ishitsuka, Yoichi; Kondo, Yuki; Irie, Tetsumi; Era, Takumi

    2015-01-01

    Summary The Niemann–Pick type C disease (NPC) is one of inherited lysosomal storage disorders, emerges the accumulation of unesterified cholesterol in endolysosomes. Currently, 2-hydroxypropyl-β-cyclodextrin (HP-β-CyD) has been applied for the treatment of NPC. HP-β-CyD improved hepatosplenomegaly in NPC patients, however, a high dose of HP-β-CyD was necessary. Therefore, the decrease in dose by actively targeted-β-CyD to hepatocytes is expected. In the present study, to deliver β-CyD selectively to hepatocytes, we newly fabricated mono-lactose-appended β-CyD (Lac-β-CyD) and evaluated its cholesterol lowering effects in NPC-like HepG2 cells, cholesterol accumulated HepG2 cells induced by treatment with U18666A. Lac-β-CyD (degree of substitution of lactose (DSL) 1) significantly decreased the intracellular cholesterol content in a concentration-dependent manner. TRITC-Lac-β-CyD was associated with NPC-like HepG2 cells higher than TRITC-β-CyD. In addition, TRITC-Lac-β-CyD was partially localized with endolysosomes after endocytosis. Thus, Lac-β-CyD entered NPC-like HepG2 cells via asialoglycoprotein receptor (ASGPR)-mediated endocytosis and decreased the accumulation of intracellular cholesterol in NPC-like HepG2 cells. These results suggest that Lac-β-CyD may have the potential as a drug for the treatment of hepatosplenomegaly in NPC disease. PMID:26664628

  6. Cholesterol lowering effects of mono-lactose-appended β-cyclodextrin in Niemann–Pick type C disease-like HepG2 cells

    Directory of Open Access Journals (Sweden)

    Keiichi Motoyama

    2015-11-01

    Full Text Available The Niemann–Pick type C disease (NPC is one of inherited lysosomal storage disorders, emerges the accumulation of unesterified cholesterol in endolysosomes. Currently, 2-hydroxypropyl-β-cyclodextrin (HP-β-CyD has been applied for the treatment of NPC. HP-β-CyD improved hepatosplenomegaly in NPC patients, however, a high dose of HP-β-CyD was necessary. Therefore, the decrease in dose by actively targeted-β-CyD to hepatocytes is expected. In the present study, to deliver β-CyD selectively to hepatocytes, we newly fabricated mono-lactose-appended β-CyD (Lac-β-CyD and evaluated its cholesterol lowering effects in NPC-like HepG2 cells, cholesterol accumulated HepG2 cells induced by treatment with U18666A. Lac-β-CyD (degree of substitution of lactose (DSL 1 significantly decreased the intracellular cholesterol content in a concentration-dependent manner. TRITC-Lac-β-CyD was associated with NPC-like HepG2 cells higher than TRITC-β-CyD. In addition, TRITC-Lac-β-CyD was partially localized with endolysosomes after endocytosis. Thus, Lac-β-CyD entered NPC-like HepG2 cells via asialoglycoprotein receptor (ASGPR-mediated endocytosis and decreased the accumulation of intracellular cholesterol in NPC-like HepG2 cells. These results suggest that Lac-β-CyD may have the potential as a drug for the treatment of hepatosplenomegaly in NPC disease.

  7. 多层螺旋CT(MSCT)在异位阑尾炎诊断中的临床价值%Value of Multi-slice Spiral CT in the Diagnosis of Heterotopia Appendicitis

    Institute of Scientific and Technical Information of China (English)

    裴守科

    2015-01-01

    目的探讨MSCT (多层螺旋CT)超薄层扫描和后处理技术在异位阑尾炎诊断中的临床价值。方法18例异位阑尾炎患者行MSCT,并经计算机后处理工作站行多平面重组(Multiplanar reconstruction,MPR)、曲面重组(Curved planar reformation,CPR),回顾性分析其类型,对异位阑尾炎CT表现进行分析、总结,并与手术及病理结果对照。结果18例患者中高位肝下阑尾5例,低位阑尾7例,盲肠后腹膜外阑尾(腰部阑尾)2例,左下腹位阑尾4例。结论 MSCT超薄层扫描及后处理技术可以多方位显示异位阑尾解剖关系及病变周边情况,提高对异位阑尾炎术前诊断准确率。%Objective To evaluate the clinical value of Multi-slice spiral CT (MSCT) in the diagnosis of Heterotopia Appendicitis. Methods 18 patients with Heterotopia Appendicitis underwent preoperative contrast-enhanced MSCT.Images were transfer ed to the workstation and then processed with multiplanar reconstruction (MPR),curved planar reformation (CPR).CT manifestations were analysed and compared with surgical and pathological findings. Results 18 patients with Heterotopia Appendicitis , 5 have under liver high Appendix ,and 7 have low Appendix, 2 for waist Appendix, and 4 for the bot om left of abdomen Appendix. Conclusion MSCT and MPR/CPR can provide an advantage of showing the appendix multi-directional y that can improve the diagnosis accuracy of Heterotopia Appendicitis .

  8. Multiwell Assay for the Analysis of Sugar Gut Permeability Markers: Discrimination of Sugar Alcohols with a Fluorescent Probe Array Based on Boronic Acid Appended Viologens.

    Science.gov (United States)

    Resendez, Angel; Panescu, Priera; Zuniga, Ruth; Banda, Isaac; Joseph, Jorly; Webb, Dominic-Luc; Singaram, Bakthan

    2016-05-17

    With the aim of discerning between different sugar and sugar alcohols of biomedical relevance, such as gut permeability, arrays of 2-component probes were assembled with up to six boronic acid-appended viologens (BBVs): 4,4'-o-BBV, 3,3'-o-BBV, 3,4'-o-BBV, 4,4'-o,m-BBV, 4,7'-o-PBBV, and pBoB, each coupled to the fluorophore 8-hydroxypyrene, 1,3,6-trisulfonic acid trisodium salt (HPTS). These probes were screened for their ability to discriminate between lactulose, l-rhamnose, 3-O-methyl-d-glucose, and xylose. Binding studies of sugar alcohols mannitol, sorbitol, erythritol, adonitol, arabitol, galactitol, and xylitol revealed that diols containing threo-1,2-diol units have higher affinity for BBVs relative diols containing erythro-1,2 units. Those containing both threo-1,2- and 1,3-syn diol motifs showed high affinity for boronic acid binding. Fluorescence from the arrays were examined by principle component analysis (PCA) and linear discriminant analysis (LDA). Arrays with only three BBVs sufficed to discriminate between sugars (e.g., lactulose) and sugar alcohols (e.g., mannitol), establishing a differential probe. Compared with 4,4'-o-BBV, 2-fold reductions in lower limits of detection (LOD) and quantification (LOQ) were achieved for lactulose with 4,7-o-PBBV (LOD 41 μM, LOQ 72 μM). Using a combination of 4,4'-o-BBV, 4,7-o-PBBV, and pBoB, LDA statistically segregated lactulose/mannitol (L/M) ratios from 0.1 to 0.5, consistent with values encountered in small intestinal permeability tests. Another triad containing 3,3'-o-BBV, 4,4'-o-BBV, and 4,7-o-PBBV also discerned similar L/M ratios. This proof-of-concept demonstrates the potential for BBV arrays as an attractive alternate to HPLC to analyze mixtures of sugars and sugar alcohols in biomedical applications and sheds light on structural motifs that make this possible. PMID:27116118

  9. Synthesis, structural characterization and antimicrobial activities of diorganotin(IV) complexes with azo-imino carboxylic acid ligand: Crystal structure and topological study of a doubly phenoxide-bridged dimeric dimethyltin(IV) complex appended with free carboxylic acid groups

    Science.gov (United States)

    Roy, Manojit; Roy, Subhadip; Devi, N. Manglembi; Singh, Ch. Brajakishor; Singh, Keisham Surjit

    2016-09-01

    Diorganotin(IV) complexes appended with free carboxylic acids were synthesized by reacting diorganotin(IV) dichlorides [R2SnCl2; R = Me (1), Bu (2) and Ph (3)] with an azo-imino carboxylic acid ligand i.e. 2-{4-hydroxy-3-[(2-hydroxyphenylimino)methyl]phenylazo}benzoic acid in presence of triethylamine. The complexes were characterized by elemental analysis, IR and multinuclear NMR (1H, 13C and 119Sn) spectroscopy. The structure of 1 in solid state has been determined by X-ray crystallography. Crystal structure of 1 reveals that the compound crystallizes in monoclinic space group P21/c and is a dimeric dimethyltin(IV) complex appended with free carboxylic acid groups. In the structure of 1, the Sn(IV) atoms are hexacoordinated and have a distorted octahedral coordination geometry in which two phenoxy oxygen atoms and the azomethine nitrogen atom of the ligand coordinate to each tin atom. One of the phenoxy oxygen atom bridges the two tin centers resulting in a planar Sn2O2 core. Topological analysis is used for the description of molecular packing in 1. Tin NMR spectroscopy study indicates that the complexes have five coordinate geometry around tin atom in solution state. Since the complexes have free carboxylic acids, these compounds could be further used as potential metallo-ligands for the synthesis of other complexes. The synthesized diorganotin(IV) complexes were also screened for their antimicrobial activities and compound 2 showed effective antimicrobial activities.

  10. Etiotropic Exploration And Diagnosis of the Cases Mimicking Appendicitis in Childhood%小儿酷似阑尾炎病例的诊断与病因探讨

    Institute of Scientific and Technical Information of China (English)

    高解春; 金百祥

    1988-01-01

    From 1985 to 1986,the pathological examination of 479 appendices removed from children with a preoperative diagnosis of acute appendicitis disclosed a normal appendix in 60 children(12.5%).In 17 of them,a different factor was found to be responsible for the symptoms,Among patients in whom no gross pathology could be discovered at operation,the peritoneal culture was positive in 48%,yielding a broad range of organisms(75% Gram-positive coccus). Acute primary peritonitis of mild form is,perhops,considered to give rise to confusion with acute appendicitis.%报道479例阑尾切除术,60例为阑尾正常的酷似阑尾炎病例.除17例外,43例病因不明.其中25例作了腹腔液细菌培养,阳性率为48%,而且阳性者中75%为革兰氏阳性球菌,提示其病因可能为不典型的原发性腹膜炎.

  11. Appendicitis in an obturator hernia.

    Science.gov (United States)

    Camerlinck, Michael; Vanhoenacker, Filip; De Vuyst, Dimitri; Quanten, Inge

    2011-04-01

    We present a case of a 79-year-old female with a history of pain at the right groin for 9 days. Computer tomography of the pelvis showed herniation of the appendix through the obturator canal with a huge abscess surrounding the right hip joint. Laparotomy was performed and histopathology confirmed a perforated necrotic tip of the herniated appendix. An obturator hernia is a rare hernia of the pelvic floor. It is most common in old, emaciated, multiparous women and can cause groin pain with extension to the medial aspect of the thigh. In case of incarceration of bowel, patients also present with obstruction. Isolated incarceration of the appendix, however, does not cause obstruction. The diagnosis of an obturator hernia is often delayed, due to a non-specific clinical presentation. CT scan may offer the clue to the correct diagnosis and should be performed in case of a possible obturator hernia.

  12. Postinfectious encephalitis (21 cases appended)

    Institute of Scientific and Technical Information of China (English)

    丰宏林; 孙伟; 王文秋; 王德生

    2003-01-01

    Objective To report 21 cases of postinfectious encephatitis according to ICD-NA, postinfectious/parainfectious encephalitis is an independent disease.Methods Using the uniform criteria provided by The Council of State and Territorial Epidemiologists (CSTE) and Centers for Disease Control and Prevention (CDC), we diagnosed postinfectious encephalitis among patients admitted to The First Hospital of Harbin Medical University and analyzed the characteristics of these cases. Results All the patients had histories of preceding infection, and most of them suffered from mental and conscious disorders. Adrenocortical hormone was effective.Conclusions Postinfectious encephalitis is an independent disease. According to this article, about 10% patients with encephalitis admitted to our hospital are postinfectious.

  13. Necrotizing Fasciitis Post- Acute Appendicitis

    OpenAIRE

    Fernandes, C; Dâmaso, C; Duarte, R.; Cardoso, D; Casella, P.

    2011-01-01

    A Fasceíte Necrotizante (FN) é um processo infeccioso da fascia profunda, de evolução rápida e progressiva com necrose secundária do tecido celular subcutâneo. Os autores apresentam um caso de FN da parede abdominal, como complicação extremamente rara de apendicite aguda. Trata-se de uma criança, apendicectomizada por apendicite aguda gangrenada, que evolui para quadro infeccioso grave, com dor e processo inflamatório da parede abdominal. Após diagnóstico, foi submetido a desbridamento cir...

  14. 急性阑尾炎超声与64排螺旋 CT 检查对比分析%The comparative analysis between ultrasound and 64-slice spiral CT examination in acute appendicitis

    Institute of Scientific and Technical Information of China (English)

    王振芳; 岳学旺; 毕言刚; 李飞; 张仕状

    2014-01-01

    目的:探讨超声与64排螺旋 CT 平扫检查在诊断急性阑尾炎中的应用价值。方法收集经手术、病理证实或经保守治疗好转确诊急性阑尾炎的患者65例,术前或治疗前均做了 B 超和 CT 检查,对急性阑尾炎病理改变的显示情况及诊断符合率进行对比分析。结果65例阑尾炎病变,在 CT 图像上正确诊断58例,诊断符合率为89.23%,超声图像正确诊断48例,诊断符合率为73.85%,2种检查方法诊断符合率具有统计学差异(χ2=5.11,P =0.024)。结论多排螺旋 CT 与超声相比在诊断急性阑尾炎方面有较高的诊断符合率。%Objective To investigate the application of ultrasound and 64-slice spiral CT in the diagnosis of acute appendicitis. Methods Sixty-five patients with pathologically or clinally confirmed acute appendicitis were underwent ultrasound and CT examina-tion before operation or conservative treatment.Compared with pathology,the accuracy of CT and B-ultrasound imaging were ana-lyzed.Results Fifty-eight cases were correctly diagnosed by CT and 48 cases were correctly diagnosed by ultrasound,the accuracy was 89.23% (58/65)and 73.85% (48/65),respectively.There was a statistically significant difference between two groups (χ2 =5.1 1,P =0.024).Conclusion The accuracy of multi-slice spiral CT is higher than ultrasound in the diagnosis of acute appendicitis.

  15. 皮纹横切口阑尾切除术治疗阑尾炎疗效探讨%To Explore the Effect of Dermatoglyph Crosscutting Mouth Appendectomy Treatment Appendicitis

    Institute of Scientific and Technical Information of China (English)

    韩顺昌

    2015-01-01

    目的:探讨皮纹横切口阑尾切除术治疗阑尾炎的治疗效果。方法选取我院于2012年10月~2014年10月收治的86例阑尾炎患者,使用单双号方法将其分成实验组和对照组,对照组采用传统阑尾切除术进行治疗,实验组使用皮纹横切口阑尾切除术治疗,分析并对比两组患者治疗后的临床效果。结果通过对两组患者施以不同治疗方法可知,实验组治疗后的临床效果明显优于对照组,P<0.05,差异具有统计学意义。结论通过研究发现,皮纹横切口阑尾切除术治疗阑尾炎临床效果明显,不仅临床效果好,而且并发症少,更为安全有效。%Objective To explore the effect dermatoglyph crosscutting mouth appendectomy treatment appendicitis.Methods Selected 86 cases of appendicitis patients from 2012 October to 2014 October in our hospital, divided into the experimental group and the control group use of single and double methods, control group using conventional appendectomy treatment, the experimental group use the dermatoglyph crosscutting appendectomy treatment, analyze and compare the clinical effect of two groups of patients after treatment.ResultsBy means of two groups of patients with different treatment methods, the experimental group clinical effect was better than control group after treatment, the difference had statistical significance (P<0.05).Conclusion The research shows that dermatoglyph crosscutting mouth appendectomy appendicitis clinical treatment effect is obvious, not only clinical effect is good, but also fewer complications and more safety..

  16. Clinical analysis of pregnancy with appendicitis perioperative quality nursing%妊娠合并阑尾炎围手术期实施优质护理的临床分析

    Institute of Scientific and Technical Information of China (English)

    吴佳琼

    2015-01-01

    objectiveTo study the using quality of pregnancy with appendicitis perioperative nursing clinical effect.MethodsFrom June 2013 to June 2013, 66 cases of pregnancy with appendicitis patients as the research object, according to different nursingmethodsare divided into two groups, 33 cases in each group, control group routine nursing, the observation group of high quality nursing, compared two groups nursing effect. Results Observation group nursing effect is better than that of control group, two groups of operation cooperation degree, the nurses' confidence in observation group were higher than control group, SAS scores, the incidence of disputes nurse observation group is lower than the control group, P < 0.05, significant difference.ConclusionGood nursing applied in perioperative patients with pregnancy with appendicitis, effectively improve patients mentality, improve nursing quality and promote postoperative recovery, ensure the safety of maternal and child health.%目的:研究妊娠合并阑尾炎围手术期采用优质护理的临床效果。方法:选择2013年6月~2015年6月66例妊娠合并阑尾炎患者作为研究对象,根据护理方式不同分为两组,每组33例,对照组实施常规护理,观察组实施优质护理,分析比较两组护理效果。结果:观察组护理效果优于对照组,两组手术配合度、对护士的信任度观察组均高于对照组,SAS评分、护患纠纷发生率观察组低于对照组,P<0.05,差异显著。结论:优质护理应用于妊娠合并阑尾炎围手术期患者,有效改善患者心态,提升护理质量,促进术后恢复,保证母婴健康安全。

  17. 高频电刀对阑尾炎切口愈合影响的临床研究%Clinical study on the effect of high frequency electric knife for appendicitis incision healing

    Institute of Scientific and Technical Information of China (English)

    刘强

    2014-01-01

    目的:探讨高频电刀对阑尾炎切口愈合的影响。方法:分析2011年1月~2013年5月开腹阑尾炎手术病例286例,其中使用高频电刀组164例(电刀组),未使用电刀组122例(对照组)。观察2组病人术后切口愈合的情况。结果:电刀组有25例(15.24%),对照组有6例(4.91%)切口愈合延迟。统计数据经x2检验,电刀组与对照组的差异有统计学意义(x2=7.72,P<0.01)。结论:高频电刀可使阑尾炎手术切口愈合延迟率明显增加,临床医生应该严格控制使用电刀,能不用的尽量不用,以减少对切口愈合的影响。%Objective :To investigate the influence of appendicitis incision healing of high -frequency electric knife .Methods :analysis 286 cases of abdominal appendicitis operations from 2011 January to 2013 May ,including the use of a high -frequency electric knife group of 164 cases (electric knife group) and non -use of electric knife group of 122 cases (control group) .Wound healing was observed in 2 groups of patients condition .Results:The results of electric knife group of 25 cases (15 .24% ) ,6 cases in the control group (4 .91% ) delayed wound healing .The statistical data by x2 test , the difference was statistically significant electric knife group and the control group (x2 = 7 .72 ,P< 0 .01) .Conclusion:the high frequency electricity knife can make the appendicitis operation delayed wound healing rate obviously ,clinicians should strictly control the use of electric knife in order to re-duce the effect of wound healing .

  18. 健康教育对老年急性阑尾炎患者的影响研究%Study on Health Education Influence on Elderly Patients With Acute Appendicitis

    Institute of Scientific and Technical Information of China (English)

    于静

    2015-01-01

    目的:研究健康教育对老年急性阑尾炎患者的影响。方法搜集本院2014年1月~2015年1月老年急性阑尾炎40例,依据数字随机法进行分组。给予对照组常规护理,共20例;在此基础上给予研究组健康教育,共20例。观察比较两组效果。结果两组比较,研究组住院天数短(P<0.05),知识知晓评分高(P<0.05),满意度高(P<0.05)。结论健康教育可有效提高老年急性阑尾炎患者知识知晓评分,缩短住院天数。%Objective Health education influence on elderly patients with acute appendicitis is to be studied.Methods To choose 40 elderly patients with acute appendicitis who were treated in hospital from January 2014 to January 2015 and separated them into control group and study group according to random digit table. 20 patients in control group were given conventional care, while 20 patients in study group were given additional health education. Then make a comparison on treatment efects between two groups.ResultsCompared to patients in control group, patients’ in study group hospitalization days was shorter (P< 0.05).Heir knowledge mastery assessment score was higher (P< 0.05) and satisfaction rate was higher (P< 0.05) in study group .Conclusion For elderly patients with acute appendicitis,health education is efective to improve patients’ assessment scores of knowledge mastery and reduce their hospitalization days.

  19. 大比例尺地形图房屋楼层信息自动添加的实现%Realization of Automatic Appending of Floor Information to Large- Scale Topographic Map

    Institute of Scientific and Technical Information of China (English)

    李强

    2012-01-01

    Number of floors is the extended attribute data defined in CASS software of the Southern Company. Using AutoLisp lan- guage as the programming tool, this paper writes LISP program according to CASS floor number, and realizes smart idenfication and automatic appending of floor number attributes of buildings, which reduces the work load of manual input.%房屋的楼层信息是南方CASS软件定义的扩展属性数据,文章以AutoLISP语言为工具,针对CASS楼层扩展属性编写LISP程序,实现了计算机智能识别并自动添加房屋楼层信息,在一定程度上减少人工逐个添加的工作量。

  20. Multislice CT scanning with three-dimensional reconstruction in early diagnosis of atypical appendicitis%多层螺旋CT三维重建对不典型阑尾炎的早期诊断价值

    Institute of Scientific and Technical Information of China (English)

    钱雷敏; 戈军刚; 黄建明

    2016-01-01

    Objective To investigate the value of multislice spiral CT (MSCT)with three-di-mensional reconstruction in early diagnosis of acute appendicitis with atypical clinical features.Methods The clinical data of 108 patients preoperatively diagnosed as suspected appendicitis were retrospec-tively analyzed,and 58 patients were subjected to MSCT scan (MSCT group),the remaining were not given (non-MSCT group).Results In MSCT group,53 patients with acute appendicitis were confined by surgery and histopathology. The positive predictive value for pre-appendectomy MSCT was 91.5%.Five patients were misdiagnosed:1 case of adhesive ileum obstruction,1 case of right pyosal-pinx with pelvic inflammatory disease,1 case of Meckel diverticulitis with fish bone penetrating inj ury and 2 cases of cecum and ascending colon diverticulitis.The confirmed diagnostic rate of non-MSCT group was 78.0%.Eleven misdiagnoses were detected by exploratory laparotomy or postoperative CT scan:3 cases of duodenal bulbar ulcer perforation,2 cases of cecum tumor,2 cases of right lower ure-teral calculi with hydronephrosis,1 case of right ovarian cyst torsion,1 case of right corpus luteum rupture,1 case of ectopic pregnancy in isthmus of right uterine tube and 1 case of mesenteric lymphad-enitis.Conclusions MSCT scan with three-dimensional reconstruction of the appendix can improve early diagnosis level of atypical appendicitis,decrease the misdiagnosis rate and thereby provide signif-icant clinical benefit.%目的 探讨多层螺旋CT(multislice spiral CT,MSCT)三维重建对临床表现不典型阑尾炎的早期诊断价值.方法 回顾性分析2011年1月至2014年12月收治的108例不典型阑尾炎手术病人的临床资料,对两组在性别比、年龄、主诉、伴随症状、体征和白细胞计数等方面资料进行统计,其中经MSCT检查的病人58例,为MSCT组,50例为非MSCT组.结果 53例术前MSCT检查的不典型阑尾炎经手术、病理证实为

  1. Assessing Murphy Sequence as a Clinical Element in Acute Appendicitis Diagnosis Valoración de la secuencia de Murphy como elemento clínico de diagnóstico en la apendicitis aguda

    Directory of Open Access Journals (Sweden)

    César Jorge Castro Rodríguez

    2011-04-01

    Full Text Available Background: At present, the presence or lack of agreement between clinical diagnosis and evidence when exploring the abdominal cavity and performing excision of the pathological piece in cases of acute appendicitis, has become an increasingly contested issue. Objective: To characterize the presentation of Murphy Sequence in patients who underwent acute appendicitis surgery. Methods: Descriptive study on a case series of patients who underwent acute appendicitis surgery in the General University Hospital of Cienfuegos between March and September 2006. Variables analyzed: age, sex, skin color, evolution duration and order of appearance of symptoms, presentation of Murphy Sequence, complementary tests and pathological diagnosis. Results: The average age for cases where Murphy Sequence was not presented was 34 years old, predominantly brown skinned males. The sequence was not completed in 96, 8% of cases, mainly those found in catarrhal stage. Laparoscopy was not performed in 69.7% of patients and, within this group, 97.7% of patients did not complete the sequence. In 51.9% of the cases, the first symptom was epigastric pain that then moved to the right iliac fossa. A broad spectrum of values of white blood cells was found in cases of catarrhal appendicitis. Conclusions: in 96.8% of cases Murphy Sequence was absent. Even in cases of long evolutions, these symptoms were not related to the disease stages.Fundamento: actualmente es creciente la polémica sobre la determinación de presencia o carencia de concordancia entre diagnóstico clínico y evidencias al explorar la cavidad abdominal y realizar exéresis de la pieza patológica en la apendicitis aguda. Objetivo: valorar la presentación de la secuencia de Murphy como elemento clínico de diagnóstico en la apendicitis aguda. Métodos: estudio descriptivo, de

  2. O uso da ultra-sonografia no diagnóstico e evolução da apendicite aguda Ultrasonography in the diagnosis and evolution of acute appendicitis

    Directory of Open Access Journals (Sweden)

    Arquimedes Artur Zorzetto

    2003-03-01

    Full Text Available OBJETIVO: Aproximadamente 35% das apendicites agudas têm diagnóstico clínico pré-operatório duvidoso ou incorreto, particularmente grávidas e crianças. A ultra-sonografia, em virtude do seu baixo custo e facilidade de acesso, tem-se mostrado um método diagnóstico importante. Este estudo propôs-se a demonstrar os principais achados de imagem das diversas fases da apendicite, com o objetivo de auxiliar o ultra-sonografista no diagnóstico precoce desta afecção. MATERIAIS E MÉTODOS: São relatados 14 casos de ultra-sonografias abdominais realizadas no período de janeiro a julho de 2001, em pacientes que se apresentavam com quadro de abdome agudo. O exame foi realizado com transdutores de 3,5 MHz e 7,5 MHz. RESULTADOS: O estudo ultra-sonográfico antes da perfuração demonstra apêndice não compressível, com espessamento e perda focal da definição das paredes. Após a perfuração, o apêndice pode não ser visualizado ao exame de ultra-sonografia, sendo evidenciadas alterações secundárias como efeito de massa, formação de plastrão, liquefação e formação de abscesso, além de ar dentro da coleção. CONCLUSÃO: O diagnóstico precoce da apendicite é essencial para minimizar a morbidade, que se mantém elevada se ocorrer perfuração. Apresentações atípicas resultam em confusão diagnóstica e retarde no tratamento. As principais dificuldades e erros são apendicite retrocecal, apendicite focal ou perfurada.OBJECTIVE: Approximately 35% of the patients with acute appendicitis have a doubtful or incorrect preoperatory diagnosis, particularly in pregnant women and children. Ultrasonography has demonstrated to be an important means of diagnosis due to its low cost and easy access. This study is intended to show the main imaging findings of the many phases of appendicitis, thus helping the ultrasonographist to establish an early diagnosis. MATERIALS AND METHODS: From January to June 2001, 14 patients with acute abdominal

  3. Achados principais de exames laboratoriais no diagnóstico de apendicite aguda: uma avaliação prospectiva Main findings in laboratory tests diagnosis of acute appendicitis: a prospective evaluation

    Directory of Open Access Journals (Sweden)

    Rafael Nunes Goulart

    2012-06-01

    Full Text Available RACIONAL: Apendicite aguda é a doença abdominal cirúrgica mais comum nas unidades de emergência. Embora o diagnóstico seja clínico, a realização de exames complementares pode ser útil na dúvida diagnóstica. OBJETIVO: Avaliar as principais alterações de exames laboratoriais em pacientes com apendicite aguda, assim como sua relação com a fase evolutiva da doença. MÉTODOS: Avaliação prospectiva de pacientes com diagnóstico de apendicite aguda submetidos ao tratamento cirúrgico. RESULTADOS: Cento e setenta e nove pacientes participaram deste estudo, a maioria do sexo masculino. A idade média foi de 26 anos. Em relação à contagem de leucócitos, 46,9% apresentavam valores BACKGROUND: Acute appendicitis is the most common surgical abdominal disease in the emergency room. Although the diagnosis is clinical the complementary tests may be useful in doubt. AIM: To evaluate the main laboratory tests in patients with acute appendicitis, as well as its relationship with the evolutionary stage of the disease. METHODS: Prospective evaluation of patients with acute appendicitis who underwent surgical treatment. RESULTS: A total of 179 patients participated in this study, most were male. The mean age was 26 years. For leukocyte count 46.9% had values ​​<15.000mm3. The mean percentage of polymorphonuclear cells was 81,7%, 1,2% of sticks, 1% eosinophils, lymphocytes 12,8% and 2,9% monocytes. C-reactive protein was required for 54 patients. It was <10 mg/dl in 19, between 10 and 50 mg/dl in 24 and greater than or equal to 50 mg/dl in 11. Regarding the evolutionary phase 64% patients had early stage (stages 1 and 2, 16,2% stage 3 and 35 stage 4. A total of 57% of patients with white blood cell count greater than or equal to 20.000/mm3 had appendicular perforation (p<0,05. The percentage of polymorphonuclear leukocytes from patients with early stages was lower than the later stages (79,8% and 85,1%, respectively, with p<0,05. Patients

  4. Structural, Electronic, and Computational Studies of Heteroleptic Cu(I) Complexes of 6,6'-Dimesityl-2,2'-bipyridine with Ferrocene-Appended Ethynyl-2,2'-bipyridine Ligands.

    Science.gov (United States)

    Barnsley, Jonathan E; Scottwell, Synøve Ø; Elliott, Anastasia B S; Gordon, Keith C; Crowley, James D

    2016-08-15

    Optical characterization and computational modeling of three ferrocene-appended ethynyl-2,2'-bipyridine ligands and the associated heteroleptic copper(I) complexes of 6,6'-dimesityl-2,2'-bipyridine are reported. These dyes have been studied using electrochemical analysis, electronic absorption, and Raman and resonance Raman spectroscopies, coupled with density functional theoretical approaches. For the complexes, optical spectra are dominated by a low energy copper(I) centered metal to ligand charge transfer (MLCT) transition; this is modulated by the presence of pendant ferrocene units and the extent of conjugation of the ferrocenyl bipyridine backbone. Electronic tuning due to ferrocene is shown to result in a redshift of the MCLT transition of up to ∼0.2 eV, while an elongation of conjugation appears to result in an increased MLCT intensity of around 50%. PMID:27459334

  5. 急性化脓性阑尾炎切口感染的危险因素分析及预防对策%Risk factors analysis and preventative measures of wound infection after surgery of acute suppurative appendicitis

    Institute of Scientific and Technical Information of China (English)

    林振平; 何玉凤

    2014-01-01

    Objective To analyze the risk factors of wound infection after the surgery of acute suppurative appendicitis and explore effective preventive measures. Methods Clinical data of 219 patients with acute suppurative appendicitis admitted to our hospital from January 2011 to February 2014 were analyzed retrospectively and the postoperative wound infection situation was observed. Risk factors of postoperative wound infection were analyzed and preventative experience was summarized. Results Of the 219 patients with acute suppurative appendicitis, 16 patients had postoperative wound infection, with the wound infection rate of 7.3%. After symptomatic treatment, the wound reached stage Ⅱ healing. The wound infection rates were statistically different between different ages, underlying diseases, preoperative application of antibiotics and operative time (P 0.05). Conclusion Elder age, underlying diseases, absence of preoperative antibiotics and operative time are risk factors of acute suppurative appendicitis. Preoperative rational application of antibiotics, intraoperative rational operation, shortening of operative time and strengthening of postoperative observation are the key to preventing wound infection.%目的:分析急性化脓性阑尾炎患者术后切口感染的危险因素,探讨有效的预防对策。方法回顾性分析我院2011年1月~2014年2月间收治的219例急性化脓性阑尾炎患者的临床资料,观察术后切口感染情况,对术后切口感染的危险因素进行分析,总结预防经验。结果本组219例急性化脓性阑尾炎患者,术后切口感染16例,切口感染率为7.3%。经对症处理后,切口达到Ⅱ期愈合。切口感染率在不同年龄、合并基础疾病、术前应用抗生素以及手术时间方面的差异有统计学意义(P<0.05),而不同性别、切口长度及术后抗生素应用时间方面的差异无统计学意义(P>0.05)。结论高龄、合并有基础疾病、

  6. 皮纹横切口阑尾切除术治疗阑尾炎疗效探讨%Curative Effect of Dermatoglyph Crosscutting Mouth Appendectomy in Appendicitis

    Institute of Scientific and Technical Information of China (English)

    王辉

    2015-01-01

    目的:探讨皮纹横切口阑尾切除术治疗阑尾炎的疗效。方法选取于2013年5月~2014年5月在我院就诊的阑尾炎患者共126例,随机分为观察组与对照组,两组各63例。其中,观察组运用经麦氏点皮纹横切口行阑尾手术,而对照组运用常规麦氏切口阑尾炎手术。观察两组患者的术后下床时间、肛门排气时间以及疤痕长度,并进行分析。结果观察组患者术后下床时间为(13.3±2.1)min,低于对照组的(23.6±2.5)min,且组间差异具有统计学意义(P<0.05);观察组患者术后肛门排气时间为(17.6±4.2)min,低于对照组的(25.6±7.2) min,且组间差异具有统计学意义(P<0.05);观察组患者疤痕长度为(1.2±0.5)cm,低于对照组的(5.2±1.3)cm,且组间差异具有统计学意义(P<0.05)。结论皮纹横切口阑尾切除术在治疗阑尾炎上,取得了良好的效果。%Objective Explore the curative effect of dermatoglyph crosscutting appendectomy appendicitis treatment.Methods Selected from May 2013 to May 2014 in our hospital,a total of 126 patients with appendicitis,were randomly divided into observation group and control group. The observation group used by mcintosh point line dermatoglyph crosscutting appendix operation,control group using conventional mcintosh appendicitis surgical incision. Observed the two groups of patients with postoperative bed time,anus exhaust time,and the length of the scar.ResultsObservation group of patients with postoperative time for bed was(13.3±2.1)min,was significantly lower than the control group,and statistically significant difference between the groups(P< 0.05). Observation group of patients with postoperative anal exhaust time was(17.6±4.2)min,significantly lower than the control group,and statistically significant difference between the groups(P< 0.05). Observation group of patients with scar length was(1.2±0.5)cm,significantly lower than

  7. 急性化脓性阑尾炎术后切口感染25例的临床分析%Clinical analysis of 25 cases of postoperative wound infection in acute suppurative appendicitis

    Institute of Scientific and Technical Information of China (English)

    杨军

    2015-01-01

    Objective:To explore the related factors of postoperative wound infection in patients with acute suppurative appendicitis,to provide a reference for the prevention and treatment of wound infection.Methods:25 patients with postoperative wound infection in acute suppurative appendicitis were selected,analysis of clinical data.Results:Patients were cured and discharged after operation after two weeks.Conclusion:Obesity,appendix pathological type,operation time,incision,surgery, abdominal cavity placed drainage is one of the influencing factors of infection of incisional wound,and reasonable application of antibiotics,postoperative early dressing,postoperative incision infrared physiotherapy also prevents the infection of incisional wound the necessary and effective measures.%目的:探讨导致急性化脓性阑尾炎术后切口感染的相关影响因素,为切口感染的预防、治疗提供参考。方法:收治急性化脓性阑尾炎行阑尾切除术术后切口感染患者25例,分析临床资料。结果:患者均于术后2周治愈出院。结论:肥胖、阑尾的病理类型、手术时间、切口选择、手术方式、腹腔内放置引流是切口感染的影响因素,合理应用抗生素、术后早期换药、术后切口红外线理疗也是预防切口感染的必要的有效措施。

  8. The NOTA study: non-operative treatment for acute appendicitis: prospective study on the efficacy and safety of antibiotic treatment (amoxicillin and clavulanic acid) in patients with right sided lower abdominal pain

    Science.gov (United States)

    Giorgini, Eleonora; Biscardi, Andrea; Villani, Silvia; Clemente, Nicola; Senatore, Gianluca; Filicori, Filippo; Antonacci, Nicola; Baldoni, Franco; De Werra, Carlo; Di Saverio, Salomone

    2011-01-01

    Background Case control studies that randomly assign patients with diagnosis of acute appendicitis to either surgical or non-surgical treatment yield a relapse rate of approximately 14% at one year. It would be useful to know the relapse rate of patients who have, instead, been selected for a given treatment based on a thorough clinical evaluation, including physical examination and laboratory results (Alvarado Score) as well as radiological exams if needed or deemed helpful. If this clinical evaluation is useful, the investigators would expect patient selection to be better than chance, and relapse rate to be lower than 14%. Once the investigators have established the utility of this evaluation, the investigators can begin to identify those components that have predictive value (such as blood analysis, or US/CT findings). This is the first step toward developing an accurate diagnostic-therapeutic algorithm which will avoid risks and costs of needless surgery. Methods/design This will be a single-cohort prospective observational study. It will not interfere with the usual pathway, consisting of clinical examination in the Emergency Department (ED) and execution of the following exams at the physician's discretion: full blood count with differential, C reactive protein, abdominal ultrasound, abdominal CT. Patients admitted to an ED with lower abdominal pain and suspicion of acute appendicitis and not needing immediate surgery, are requested by informed consent to undergo observation and non operative treatment with antibiotic therapy (Amoxicillin and Clavulanic Acid). The patients by protocol should not have received any previous antibiotic treatment during the same clinical episode. Patients not undergoing surgery will be physically examined 5 days later. Further follow-up will be conducted at 7, 15 days, 6 months and 12 months. The study will conform to clinical practice guidelines and will follow the recommendations of the Declaration of Helsinki. The protocol

  9. Estado atual do diagnóstico e tratamento da apendicite aguda na criança: avaliação de 300 casos Present status for diagnosis and treatment of acute appendicitis in children: evaluation of 300 cases

    Directory of Open Access Journals (Sweden)

    Pedro Félix Vital Jr

    2005-12-01

    advances in diagnostic methods acute appendicitis still represents a problem in children, resulting in late diagnosis and treatment, and case of greater severity. Our objective is to assess the current state of diagnosis and treatment of acute appendicitis in children treated in two important referral hospitals of São Paulo (Brazil, over a 30 month's period. METHODS: The variables studied were: age, sex, clinical manifestations, time for the diagnosis to be established, the findings from physical examination and laboratory tests, surgical findings and antibiotic protocols, postoperative complications and hospital lenght of stay. RESULTS: In the present sample, of 300 children, 65% were boys and 35% girls, with an initial diagnosis of appendicitis being made in 63% of the cases. The signs and symptoms most frequently encountered were: abdominal pain in the right iliac fossa (85.3% and peritoneal irritation in this region (82%. We identified leukocytosis in 83% of the patients and the urine analysis showed leukocyturia in 39.7% of the patients. Around 92.4% of the simple radiological studies of the abdomen produced images that were not specific to acute appendicitis. Ultrasonography studies diagnosed the disease in 80.1% of the cases. Various antibiotic schemes were used, although there was special attention towards Gram-negative and anaerobic bacteria. The main complication was infection of the surgical wound, and there was no mortality. The average hospital length of stay was 5 days. CONCLUSION: In spite of greater knowledge of acute appendicitis and greater refinement of laboratory and radiological techniques, the diagnosis is still delayed and disease constitutes a cause of great morbidity among pediatric age groups.

  10. Acute Appendicitis During Pregnancy:an Analysis Report of 32 Misdiagnosed Cases%妊娠期急性阑尾炎32例报告并误诊原因分析

    Institute of Scientific and Technical Information of China (English)

    宋彬; 宋德锋; 冯野

    2015-01-01

    目的:探讨妊娠期急性阑尾炎的诊断要点与治疗原则,以保障母婴安全。方法回顾分析32例妊娠期急性阑尾炎的临床资料。结果本组早期妊娠6例、中晚期妊娠26例,表现为转移性右下腹痛26例、单纯右下腹痛6例,部分伴恶心、呕吐、发热。7例病程早期误诊为早孕反应4例、急性胃肠炎3例,误诊率21.9%。均经查体、B超或手术病理诊断确诊。本组手术治疗30例术后痊愈,其中2例行人工流产,1例自然流产,27例至孕足月顺利分娩,胎儿无异常;2例予保守治疗症状缓解,1例复发。结论仔细查体、甄别症状并及时行B超检查是提高妊娠期急性阑尾炎确诊率的关键;一旦确诊应积极行手术治疗,以保障母婴安全。%Objective To explore the key points of the diagnosis of acute appendicitis during pregnancy and treatment principle, to ensure the safety of the mother and the infant. Methods Retrospective analysis of the clinical data of 32 cases of pregnancy with acute appendicitis was conducted. Results In the group, there were 6 cases of early pregnancy and 26 cases of middle-late pregnancy, characterized by metastatic right lower quadrant abdominal pain in 26 cases, by right quadrant lower abdominal pain in 6 cases, some of them with nausea, vomiting and fever. 3 cases were misdiagnosed as early pregnancy reac-tion, 34 cases were misdiagnosed as acute gastroenteritis. The 7 initially misdiagnosed cases were 4 cases of early pregnant re-action and 3 cases of AGE and the misdiagnosis rate was 21. 9%. All of them were confirmed with diagnosis by physical exam-ination, ultrasound or surgical pathology. 30 cases of this group had postoperative recovery. 2 cases had abortion, 1 case had spontaneous abortion, 27 cases delivered the birth of full-term pregnancy, and the fetus were normal. 2 cases improved after conservative treatment, 1 case had relapse. Conclusion Careful physical examination, timely identification

  11. Transverse abdominal incision sutured by single layer extraperitoneal suture for purulent appendicitis during gestational period%横切口腹膜外单层缝合用于妊娠期化脓性阑尾炎治疗

    Institute of Scientific and Technical Information of China (English)

    薛玉珍; 吕会增; 陈图锋; 郑宗珩; 周如建

    2011-01-01

    目的 探讨横切口腹膜外单层缝合法应用于妊娠期化脓性阑尾炎的临床效果.方法 2006年1月至2010年11月3所大学附属医院收治129例妊娠期化脓阑尾炎患者,分为2组,观察组68例采用横切口腹膜外单层缝合法行阑尾切除术,对照组61例常规麦氏切口(或横切口)分层缝合法行阑尾切除术,对2组患者的手术时间、术后疼痛程度、术后流产或早产率、术后切口感染率、术后住院时间等指标进行观察比较.结果 观察组与对照组术后流产或早产率比较差别无统计学意义(P>0.05).观察组可明显减少手术时间(P<0.01),降低患者术后切口疼痛、切口感染率及术后住院时间(P<0.01).2组患者在住院治疗期间均未发生切口出血、切口疝、肠粘连、肠梗阻等并发症.结论 横切口腹膜外单层缝合法在妊娠期化脓性阑尾炎切除术中具有操作简单、安全、并发症少等优点,值得推广.%Objective To investigate the clinical effect of transverse abdominal incision sutured by single layer extrap eritoneal suture for purulent appendicitis during gestational period. Methods During January 2006 to November 2010 , 129 pa tients with suppurative appendicitis from three universities ' affiliated hospital were divided into observation group and control group. Sixty-eight patients in observation group were taken transverse incision sutured by single layer extraperitoneal suture af ter appendectomy. Sixty-one patients in control group were taken McBumeys' incision ( or transverse incision) sutured by multi-layer extraperitoneal suture for the appendectomy. The operating time, the degree of postoperative pain, the abortion or premature birth rate, the incision infection rate and the length of hospitalization of patients between observation group and con trol group were compared. Results There were no statisitic significance of the abortion or premature birth rate between obser vatioin group and control

  12. Conservative approach versus urgent appendectomy in surgical management of acute appendicitis with abscess or phlegmon Resultados del tratamiento conservador inicial y de la cirugía urgente en la apendicitis aguda evolucionada

    Directory of Open Access Journals (Sweden)

    J. M. Aranda-Narváez

    2010-11-01

    Full Text Available Background: Surgical management of acute appendicitis with appendiceal abscess or phlegmon remains controversial. We studied the results of initial conservative treatment (antibiotics and percutaneous drainage if necessary, with or without interval appendectomy compared with immediate surgery. Methods: We undertook an observational, retrospective cohort study of patients with a clinical and radiological diagnosis of acute appendicitis with an abscess or phlegmon, treated in our hospital between January 1997 and March 2009. Patients younger than 14, with severe sepsis or with diffuse peritonitis were excluded. A study group of 15 patients with acute appendicitis complicated with an abscess or phlegmon underwent conservative treatment. A control group was composed of the other patients, who all underwent urgent appendectomy, matched for age and later randomized 1:1. The infectious risk stratification was established with the National Nosocomial Infections Surveillance System (NNIS index. Dependent variables were hospital stay and surgical site infection. Analysis was with SPSS, with p Introducción: Existe controversia acerca del tratamiento idóneo de la apendicitis aguda evolucionada en forma de absceso o flemón. Realizamos un estudio para la evaluación de resultados del tratamiento conservador inicial (antibiótico y drenaje percutáneo si se precisa, con/sin apendicectomía diferida y del tratamiento quirúrgico urgente. Método: Estudio observacional analítico de cohortes retrospectivas. Criterios de inclusión: pacientes con diagnóstico clínico y radiológico de apendicitis aguda evolucionada en forma de absceso o flemón, tratados en nuestro hospital entre enero 1997 y marzo 2009, excluyendo pacientes pediátricos, con sepsis grave o peritonitis difusa. En 15 pacientes con apendicitis complicada con absceso o flemón (cohorte de estudio se indicó tratamiento conservador inicial. El grupo control se obtuvo del resto de pacientes (en

  13. Clinical analysis of 19 cases of ectopic appendicitis with laparoscopic exploration and appendectomy%腹腔镜探查并阑尾切除术治疗异位阑尾炎19例临床分析

    Institute of Scientific and Technical Information of China (English)

    阿合提别克·塔布斯; 周军; 李剑辉; 努尔保拉提·阿曼; 艾龙龙; 张玉江; 张童鑫

    2015-01-01

    目的 探讨异位阑尾炎的临床表现、诊断要点及腹腔镜治疗的策略.方法 对新疆医科大学第二附属医院2011年4月-2015年4月间收治的19例异位阑尾炎的临床资料进行回顾性分析,总结其临床表现、诊治、腹腔镜探查指征及腹腔镜阑尾切除术的技巧.所有患者均在气管插管全麻下行腹腔镜探查+腹腔镜阑尾切除术.结果 19例患者中,术前有16例经B超检查得到确诊,B超确诊率为92.63%;3例急性局限性腹膜炎患者术前误诊,分别为右侧肾结石、急性胆囊炎、右侧附件炎各1例;中转开腹手术2例,手术中转率为10.53%.术中出血5~ 20 mL,术后9h下床活动,12 h进全流质饮食;平均住院时间4d.戳孔处感染1例,全腹腔镜手术的并发症发病率为5.27%,术后随访12 ~18个月未发现其他远期并发症.结论 异位阑尾炎无特异性的临床表现,易误诊.辅助检查中,超声检查是诊断异位阑尾炎的首选检查手段.腹腔镜探查术+腹腔镜阑尾切除术是急诊治疗异位阑尾炎的理想术式,值得临床推广.%Objective To explore the clinical manifestations,diagnosed main points,laparoscopic trestment strategy of ectopic appendicitis.Methods The 19 clinical data of ectopic appendicitis,from April 2011 to April 2015 in our hosipital,were retrospective analysised,and we sum up the clinical manifestation,diagnosis and treatment,laparoscopic exploration indications and the technique of laparoscopic appendectomy.Laparoscopy exploration and laparoscopic appendectomy were made on all patients under general anesthesia by tracheal cannula.Results Of 19 patients,16 cases by ultrasonic examination get correct diagnosis before operation,of which the ultrasound diagnosis rate is 92.63%,3 limitations of acute peritonitis patients were preoperative misdiagno~s,they were the right kidney stones,acute cholecystitis and the right side of the annex inflammation;there were 2 patients converted to open

  14. 不缝合腹膜预防阑尾切口感染355例分析%Aralysis of 355 patients with non-suturing peritoneum in preventing purulent infection of incisional wound of appendicitis

    Institute of Scientific and Technical Information of China (English)

    赵沨

    2010-01-01

    Objective To explore the effect of mon-suturing peritoneum in perforating purulent infection of incisional wound of appendicitis. Methods 907 patients suffered purulent perforating and gangrenous appendicitis were divided randomly into two groups:the non-suturing group of 355 patients and the control group of 552 patients.Of the non-suturing group,peritoneum was not sutured when his/her abdominal cavity was closed.It was just on the contrary to the control group.Then examined whether eoncotic rythrogenic or tender incision occurred,or whether purulent secretion flowed outside from the operative incision.These items below were also been recorded carefully:the average number of days when the temperature was abnormal,the grades of healing of incision and the average hospital stay. Results In the non-suturing group,21(5.9%)patients suffered postoperative infection,the number of days of abnormal temperature was(3.8 ± 1)d on average,and the average hospital stay was(7.5 ± 1)d;in the control group,119(21.6%)patients suffered postoperative infection,the number of days of abnormal temperature was(4.3 ± 1)d on average,and the average hospital stay was(12.9 ± 1)d.First rate healing of incision in the non-suturing group was far higher than that in the control group(P<0.05). Conclusion Non-suturing peritoneum could help internal drainage peritoneum,which was an efficient way to guard against the postoperative infection.And non-suturing was also of great significance to reduce the average number of days of abnormal temperature and hospital stay.Meanwhile,the probability of ankylenteron and incisional hernia was not increased.%目的 探讨降低化脓性、穿孔性、坏疽性阑尾炎手术切口感染的方法. 方法 将907例化脓性、穿孔性、坏疽性阑尾炎907例患者随机分成不缝合腹膜组(不缝组)355例和对照组552例,不缝合腹膜组关闭腹腔时开放腹膜不缝合,对照组关闭腹腔时关腹时常规缝

  15. Hospital expenses of acute simple appendicitis in different medical insurance systems%急性单纯性阑尾炎不同医疗保险形式患者住院费用分析

    Institute of Scientific and Technical Information of China (English)

    路光贤; 江增强; 刘伟; 郑文贵

    2012-01-01

    Objective To compare the hospital expenses of patients with acute simple appendicitis under different medical insurance systems and to explore the influential factors for controlling the increase of the expense. Methods The case information of acute simple appendicitis hospitalized in our hospital from January 2006 to December 2011 were collected. The hospital expenses were analyzed by descriptive analysis,one -way ANOVA analysis and linear regression analysis. Results Drug expenditure accounted for the biggest proportion of 36. 16% in hospital costs. The average cost and the average expenses for medicine were the highest in medical insurance for urban workers,4 970. 07 yuan and 2 586. 33 yuan,respectively. The daily cost of 597. 62 yuan for new rural cooperative medical insurance patients was the highest,while the costs for the patients at one' s own expenses were lower. The major factors affecting the hospital expenses were hospital stay, any surgery, age and payment method. Conclusion The hospital expenses of patients under different medical systems vary a lot. To control the unreasonable increase of the hospital costs, much attention should be paid to managing the different medical insurance forms and controlling the hospital stay of patients.%目的 比较分析不同医疗保险形式急性单纯性阑尾炎患者住院费用,探索影响医疗费用的因素,为合理控制医疗费用增长提供参考.方法 收集某院2006-2011年间收治的住院急性单纯性阑尾炎病例信息,对住院费用进行描述性分析、单因素方差分析及多元线性回归分析.结果 费用中以药品费比例最高达36.16%,城镇职工医保病人平均费用4 970.07元和平均药费2 586.33元最高,新农合病人日均费用597.62元最高,自费病人平均费用、日均费用和平均药费均低.住院费用主要影响因素有住院天数、是否手术、年龄、保险方式、转归情况.结论 不同医疗保险患者的住院费用差别很

  16. Pneumoperitoneum due to perforated appendicitis: a rare anatomo-radiologic correlation Pneumoperitônio devido à apendicite perfurada: correlação anátomo-radiológica rara

    Directory of Open Access Journals (Sweden)

    André Luiz Santos Rodrigues

    2008-09-01

    Full Text Available BACKGROUND: Pneumoperitoneum is usually associated with a perforated peptic ulcer. However, perforated appendicits may be evolved on it. In the medical literature, the anatomo-radiologic correlation between them is an uncommon event. CASE REPORT: Man with 56-year-old look for assistance with diffuse abdominal pain and distension associated with fever, vomit and absence of flatus and evacuation for about 14 days. The chest radiography revealed a pneumoperitoneum. Diffuse peritonitis was found during the exploratory laparotomy. Appendectomy, peritoneal cavity cleaning and drainage with tubular drains were carried out. However, severe sepsis occurred and the patient died on the 16th post-operative day with multiple systemic organ failure. CONCLUSION: Although rare as pneumoperitoneum ethiology, acute appendicitis may be thought as it's cause.INTRODUÇÃO: Penumoperitôneo é usualmente associado à perfuração gástrica ou duodenal. Entretanto, apendicite perfurada pode também desenvolvê-lo. Na literatura, correlação clínica-radiológica é rara nesses eventos. RELATO DO CASO: Homem com 56 anos foi atendido com dor abdominal difusa, distensão abdominal e febre, vômitos, parada de eliminação de gazes e fezes por 14 dias. Estudo radiológico de tórax mostrou pneumoperitôneo. No procedimento cirúrgico, peritonite difusa foi encontrada e apendicectomia com lavagem abdominal e drenagem foi efetuada. Entretanto, o paciente morreu por sepse generalizada e falência múltipla de órgãos e sistemas no 16o. dia do pós-operatório. CONCLUSÃO: Embora rara como causa de pneumoperiotôneo, a apendicite aguda deve ser pensada como sua possível causa.

  17. Potential use of fucose-appended dendrimer/α-cyclodextrin conjugates as NF-κB decoy carriers for the treatment of lipopolysaccharide-induced fulminant hepatitis in mice.

    Science.gov (United States)

    Akao, Chiho; Tanaka, Takahiro; Onodera, Risako; Ohyama, Ayumu; Sato, Nana; Motoyama, Keiichi; Higashi, Taishi; Arima, Hidetoshi

    2014-11-10

    The purpose of the present study is to treat lipopolysaccharide (LPS)-induced fulminant hepatitis by NF-κB decoy complex with fucose-appended dendrimer (generation 2; G2) conjugate with α-cyclodextrin (Fuc-S-α-CDE (G2)). Fuc-S-α-CDE (G2, average degree of substitution of fucose (DSF2))/NF-κB decoy complex significantly suppressed nitric oxide and tumor necrosis factor-α (TNF-α) production from LPS-stimulated NR8383 cells, a rat alveolar macrophage cell line, by adequate physicochemical properties and fucose receptor-mediated cellular uptake. Intravenous injection of Fuc-S-α-CDE (G2, DSF2)/NF-κB decoy complex extended the survival of LPS-induced fulminant hepatitis model mice. In addition, Fuc-S-α-CDE (G2, DSF2)/NF-κB decoy complex administered intravenously highly accumulated in the liver, compared to naked NF-κB decoy alone. Furthermore, the liver accumulation of Fuc-S-α-CDE (G2, DSF2)/NF-κB decoy complex was inhibited by the pretreatment with GdCl3, a specific inhibitor of Kupffer cell uptake. Also, the serum aspartate aminotransferase, alanine aminotransferase and TNF-α levels in LPS-induced fulminant hepatitis model mice were significantly attenuated by the treatment with Fuc-S-α-CDE (G2, DSF2)/NF-κB decoy complex, compared with naked NF-κB decoy alone. Taken together, these results suggest that Fuc-S-α-CDE (G2, DSF2) has the potential for a novel Kupffer cell-selective NF-κB decoy carrier for the treatment of LPS-induced fulminant hepatitis in mice.

  18. ApplicationofEpiduralNerveBlockCombinedwithKetamineAnesthesiainPediatricAppendicitisOperation%硬膜外神经阻滞复合氯胺酮麻醉在小儿阑尾手术中的应用

    Institute of Scientific and Technical Information of China (English)

    王爱文

    2013-01-01

      目的观察罗哌卡因硬膜外阻滞复合氯胺酮-丙泊酚静脉麻醉在小儿阑尾手术中的应用,对呼吸循环功能以及术后恢复情况的影响。方法60例行阑尾手术患儿随机分为两组:氯胺酮基础麻醉后,硬膜外神经阻滞复合氯胺酮-丙泊酚静脉麻醉组(A组,n=30),硬膜外穿刺成功后注入0.375%罗哌卡因0.2mL/kg,术中以氯胺酮一丙泊酚持续静注;另一组氯胺酮基础麻醉后,单纯氯胺酮-丙泊酚静脉麻醉组(B组,n=30),术中氯胺酮一丙泊酚持续静注。结果术中A组循环,呼吸功能较B组稳定(P<0.05),肢体不良自主运动,喉痉挛等不良反应较B组少(P<0.05),A组氯胺酮用量明显少于B组(P<0.01),术后A组苏醒较快且平稳,恢复期精神症状少,与B组比较有显著差异(P<0.05)。结论硬膜外神经阻滞复合氯胺酮-丙泊酚静脉麻醉应用于小儿阑尾手术,可减少氯胺酮用量从而减少其不良反应,使患儿在麻醉手术期间呼吸循环更平稳,外科医师更满意,在小儿麻醉中是一种值得推广的麻醉方法。%Objective To observe the effect of ropivacaine epidural anesthesia combined with ketamine and propofol intravenous anesthesia used in pediatric appendicitis operation and the effect on the recovery of respiratory and circulatory function and postoperative. Methods 60 cases of appendix operations were randomly divided into two groups:ketamine basic anesthesia, epidural nerve block combined with ketamine and propofol intravenous anesthesia group (group A, n=30), epidural puncture success after injection of 0.375%ropivacaine 0.2mL/kg, intraoperative ketamine-propofol continuous infusion;another group of ketamine after basal anesthesia, ketamine and propofol intravenous anesthesia group (group B, n=30), intraoperative ketamine-propofol continuous infusion. Results The patients in group A than in group B stable circulatory and

  19. 急性阑尾炎患者阑尾病灶组织分离的病原体及其耐药性分析%Pathogens isolated from lesion in patients of acute appendicitis and drug resistance analysis

    Institute of Scientific and Technical Information of China (English)

    罗标; 梁结玲; 刘琼章; 徐艳红; 欧阳辉妹; 邓润钦

    2015-01-01

    目的:了解急性阑尾炎患者中常见病原体及其对抗菌药物的耐药性,为临床选择抗菌药物治疗提供参考。方法对2011年1月至2013年12月收集的415例阑尾病灶组织标本采用法国生物梅里埃公司ATB半自动微生物鉴定仪进行细菌鉴定和药敏试验,对药敏结果采用WHONET5.6软件进行统计分析,并对大肠埃希菌、奇异变形杆菌、肺炎克雷伯菌进行了超广谱β-内酰胺酶(ESBL)检测。结果从415例阑尾病灶组织中分离出348株病原体,其中G-杆菌322株(92.52%),G+球菌26株(7.47%);检出率居前5位的病原菌依次为大肠埃希菌(76.14%)、铜绿色假单胞菌(6.90%)、奇异变形杆菌(3.45%)、肺炎克雷伯菌(3.16%)和粪肠球菌(1.44%)。药敏结果显示大肠埃希菌耐药率较低者依次为亚胺培南(0)、哌拉西林/他唑巴坦(0)、阿米卡星(5.3%)、头孢西丁(10.2%)和阿莫西林/克拉维酸(24.6%),大肠埃希菌耐药率较高者依次为青霉素类抗生素类(86.8%~90.6%)、复方新诺明(67.9%)及第一、二代头孢菌素类药物(60.3%~67.9%),G+球菌对万古霉素、替考拉宁、左旋氧氟沙星耐药率最低,对其他抗菌药物都有不同程度的耐药。ESBL确证试验结果显示,265株大肠埃希菌检出124株,产酶率为46.8%;奇异变形杆菌、肺炎克雷伯菌均未检出产ESBL菌株。结论急性阑尾炎感染细菌以G-杆菌为主,特别是以大肠埃希菌居首位;此菌对青霉素类、头孢类和喹诺酮类抗菌药物的耐药率逐年上升,特别是产ESBL菌株呈现出多药耐药现象严峻。应加强病原菌的检测和药敏试验,合理选择抗生素,减少耐药菌株的产生和扩散。%Objective To investigate the common pathogens isolated from lesion in patients of acute appen-dicitis and to analyze their drug resistance, in order to provide guidance for clinical selection of reasonable antibiotics. Methods A total of 415

  20. 急性阑尾炎手术切口脂肪层下置管引流降低感染率效果观察%Appendicitis operation incision fat layer drainage under reducing the rate of infection effect observation

    Institute of Scientific and Technical Information of China (English)

    谷伟; 郭国民

    2015-01-01

    目的:探讨急性阑尾炎手术切口脂肪层下置管引流预防术后切口感染的可行性及效果。方法选取2012年6月至2014年6月期间收治的行阑尾切除术的急性阑尾炎患者,采用随机抽签法将其分为两组。对照组行常规腹腔冲洗,研究组采用脂肪层下置管引流联合腹腔冲洗,对比分析两组患者切口感染及愈合情况。结果研究组切口感染明显低于对照组(10.76%比33.54%,χ2=23.7826,P <0.05);研究组单纯性阑尾炎、化脓性阑尾炎、坏疽性阑尾炎术后切口感染率均明显低于对照组( P <0.05);研究组患者术后切口愈合时间为5.68±2.54 d 明显高于对照组的9.75±3.14 d( t =12.6672,P <0.05);研究组切口愈合情况明显优于对照组(χ2=10.4548,P <0.05)。结论急性阑尾炎手术切口脂肪层下置管引流能有效预防术后切口感染,促进切口愈合,缩短愈合时间,提高愈合质量。%Objective To analyze the feasibility and effect in the prevention of postoperative incision infection in acute appendicitis opera-tion incision of fat layer drainage,to promote early healing of incision,to provide reference for future application. Methods According to the ran-dom number table,patients with acute appendicitis form June 2012 to June 2014 were included into the control group and the study group. The study group received catheter drainage combined with peritoneal lavage in the fat layer. To compare and analyze incision infection and healing be-tween the two groups. Results Wound infection in the study group was significantly lower than the control group(10. 76% vs. 33. 54% ;χ2 =23. 7826,P < 0. 05). Postoperative wound infection rate of simple appendicitis,acute appendicitis,gangrenous appendicitis in study group was obviously lower than that of control group( P < 0. 05). The postoperative wound healing time in the study group was significantly shorter than that in the control group(9

  1. 腹针促进阑尾炎术后不全肠梗阻肠功能恢复临床观察%Promotional Effect of Abdominal Acupuncture on Intestinal Function Recovery in Postoperative Appendicitis Patients with Incomplete Intestinal Obstruction

    Institute of Scientific and Technical Information of China (English)

    王玉凯

    2013-01-01

    目的 观察腹针对阑尾炎患者术后肠功能恢复的促进作用.方法 将128例阑尾炎术后患者随机分为治疗组64例和对照组64例,治疗组在常规治疗基础上予以腹针治疗,对照组仅给予补液、抗感染等常规治疗,比较两组患者的临床疗效以及肠鸣音恢复时间、肛门排气时间、排便时间.结果 治疗组肠鸣音恢复时间、排气时间、排便时间均显著少于对照组(P0.05).结论 腹针对阑尾炎患者术后肠功能恢复有较好的促进作用.%Objective To observe the promotional effect of abdominal acupuncture on the intestinal function recovery in postoperative appendicitis patients. Methods A total of 128 postoperative appendicitis patients were randomly divided into abdominal acupuncture group (n = 64) and control group in = 64). The abdominal acupuncture group received abdominal acupuncture in addition to conventional treatment, while the control group received conventional treatment including fluid infusion and anti-infective therapy. The two groups were compared in terms of treatment outcome, time to first bowel sound, time to first flatus,and time to first defecation. Results The time to first bowel sound, time to first flatus, and time to first defecation were significantly shorter in the abdominal acupuncture group than in the control group (P0. 05). Conclusion Abdominal acupuncture has a good promotional effect on the intestinal function recovery in postoperative appendicitis patients.

  2. RANS simulation of viscous flow over full appended submarine and field variables validation and vorticity analysis%全附体潜艇粘性流场的RANS模拟及场量和涡量的校验分析

    Institute of Scientific and Technical Information of China (English)

    杨琼方; 王永生; 张志宏

    2012-01-01

    After RANS simulation of full appended SUBOFF submarine's viscous flow with four groups of grids of the same mesh block topology and close mesh quality and five turbulent models, effects of mesh density and nodes distribution and turbulent models on calculation precision were analyzed, and detailed validation of force integral variables and velocity field variables and vorticity of viscous flow were completed at last. Results show that G4 (1.4 million) with the most mesh density can get the high- est precision,which calculated total drag just differ by 0. 723% to the experiment. As for the G4 mesh, choosing the SST model in the calculation is the best. Using G4, the predicted pressure coefficient and wall shear stress coefficient distribution both fit very well with the experiment; The numerical precision of the velocity profiles on propeller disk plane is near to the reference,and the calculated radial position for dimensional axial velocity over 0.9 is a little bigger than the experiment,while the rest is good agree- ment with the data; The precision of the three velocity components at r/R=0. 25 is higher than refer- ence too as a whole, and its axial component fits well with the experiment, the radial components' peak is a little lower while its circumferential position is coincident with the measure. What's more important, RANS simulation of the G4 successfully captures the complexity vorticity structures,including counter- rotating vortex induced by flow over fairwater cap and stern fin's tip surface, necklace-shaped vortex pair downstream of the appendages' root section,shoe-shaped vortex attached upwards of stern fin's tip sur- face trailing edge, horse-shoe vortex system induced by the flow around the appendages, vortex induced by flow extrusion within the passages of stern appendages, and the vortex concentration phenomenon on propeller disk plane,even the phenomenon of counter-rotating vortex induced by flow over fairwater cap being stable

  3. Acute appendicitis: position paper, WSES, 2013

    OpenAIRE

    Agresta, Ferdinando; Ansaloni, Luca; Catena, Fausto; Verza, Luca Andrea; Prando, Daniela

    2014-01-01

    Appendectomy is one of the most frequently performed operative procedures in general surgery departments of every size and category. Laparoscopic Appendectomy – LA - as compared to Open Appendectomy – OA - was very controversial at first but has found increasing acceptance all over the World, although the percentage of its acceptance is different in the various single National setting. Various meta-analyses and Cochrane reviews have compared LA with OA and different technical details. Further...

  4. ACUTE APPENDICITIS A CLINICO - RADIOLOGICAL STUDY

    Directory of Open Access Journals (Sweden)

    Govind

    2015-08-01

    Full Text Available Appendix Latin word means an addition or appendage was first identified as early as 3000 B.C. during the mummification process in Egypt. The prefix vermiform derived its name from its worm like appearance. Appendix was probably discovered by Celsus during dissecting criminal s executed by Caeser and was first depicted in anatomic drawings in 1492 by Leonardo da Vinci.

  5. 循证护理在预防小儿急性化脓性阑尾炎术后切口感染中的应用分析%Application of Evidence-based Nursing in the Prevention of Incision Infection in Children With Acute Suppurative Appendicitis

    Institute of Scientific and Technical Information of China (English)

    陈雅卓

    2016-01-01

    目的:探讨循证护理对小儿急性化脓性阑尾炎术后切口感染的预防效果。方法选择我院2014年3月~2015年3月收治的急性化脓性阑尾炎术后切口感染患儿62例,将其按照护理方法分为对照组和观察组,对照组行常规护理,观察组行常规护理联合循证护理,对比两组患儿的护理效果。结果对照组伤口愈合率、满意率分别为70.97%、83.87%,观察组分别为93.54%、100%,比较差异有统计学意义(P<0.05)。结论给予急性化脓性阑尾炎患儿应用循证护理,可有效预防切口感染的发生,减轻患儿痛苦。%Objective To explore the effect of evidence-based nursing on prevention of incision infection in children with acute suppurative appendicitis after operation.Methods From March 2014 and March 2015 in our hospital, 62 cases of children with acute suppurative appendicitis surgery incision infection, according to the nursing methods were divided into control group and observation group, control group received routine nursing care, observation group received routine nursing combined cycle syndrome nursing, compared with two groups of children nursing effect. Results The wound healing rate and the satisfaction rate of the control group were 70.97% and 83.87%, respectively, 93.54% and 100% in the observation group, and the difference was significant (P<0.05). Conclusion Acute suppurative appendicitis in children revceiving evidence-based nursing can prevent the occurrence of wound infection, reduce the pain of patients.

  6. Leucograma, proteína C reativa, alfa-1 glicoproteína ácida e velocidade de hemossedimentação na apendicite aguda Leucocyte count, C reactive protein, alpha-1 acid glycoprotein and erithrocyte sedimmentation rate in acute appendicitis

    Directory of Open Access Journals (Sweden)

    Bruno Ramalho de Carvalho

    2003-03-01

    ína ácida e velocidade de hemossedimentação mostraram-se pouco sensíveis e específicos. CONCLUSÕES: O leucograma e a proteína C reativa apresentam-se alterados de forma significativa nos casos de apendicite aguda, independentemente do sexo ou da faixa etária. O leucograma e, principalmente, a proteína C reativa devem ser exames considerados em indivíduos com tempo de evolução sintomática superior a 24 horas. Valores aumentados, entretanto, devem ser somados e não substituir a avaliação clínica do médico examinador. Dosagens de velocidade de hemossedimentação e da alfa-1 glicoproteína ácida não trazem auxílio ao diagnóstico da apendicite aguda.BACKGROUND: The diagnosis of acute appendicitis is clinic, but in some cases, it can present unusual symptoms. The diagnostic difficulties still lead surgeons to unnecessary laparotomies, which reach rates from 15% to 40%. Laboratory exams, then, may become important to complement appendicitis diagnosis. The leucocyte count seems to be the most important value, but measurement of acute phase proteins, specially, the C-reactive protein, is object of several studies. PATIENTS AND METHODS: This was a prospective study, involving 63 patients submitted to appendecectomies for acute appendicitis suspicion, in "Hospital das Clínicas", Federal University of Uberlândia, MG, Brazil, in whose blood were made dosages of acute phase proteins and the leucocyte count. RESULTS: The sample was composed by 44 male and 19 female patients, and the majority of them was between 11 and 30 years of age. The flegmonous type was the most freqüent (52.4%. The leucocyte count was altered in 74.6% of the cases and C-reactive protein elevation was observed in 88.9%. The alfa-1 acid glycoprotein and the erithrocyte sedimmentation rate were predominantly normal. The C-reactive protein was augmented in more than 80% of the cases in all ages. Leucocyte count and C-reactive protein were altered in 80% of the patients with the limit of 24

  7. Utilidad de la tomografía computada en pacientes con dolor en fosa iliaca derecha: Apendicitis aguda y su diagnóstico diferencial Usefulness of computed tomography in patients with right inferior abdominal quadrant pain: acute appendicitis and its alternative diagnosis

    Directory of Open Access Journals (Sweden)

    Sebastián Atilio Rossini

    2009-03-01

    fosa iliaca derecha. Conclusión: La TCH posee una elevada sensibilidad y especificidad para el diagnóstico de apendicitis aguda y para la evaluación y manejo de los pacientes con un cuadro de abdomen agudo de fosa iliaca derecha.Purpose: To review the tomography findings of the acute appendicitis, their complications and alternative diagnosis. To value the use of helicoidal computed tomography (HCT in the diagnosis of acute appendicitis and in the study of patients with right inferior abdominal quadrant (RIQ pain and acute abdomen, for diagnosis and eventual complications, in order to decide treatment. Materials and method: For five months, the populations included in this retrospectively study were all patients delivered for presenting with RIQ pain for a HCT exam. These exams were made with oral and intravenous contrasts, when there were not contraindications. The HCT results were correlated with clinical follow up, surgery and histopathologic exams. Results: Over a total of 100 patients studied, 53 presented tomographic diagnosis of appendicitis, 22 of which presented perforation signs; 27 showed an alternative diagnosis (ovaries follicles, uretheral litiasis, tiphlitis, diverticulitis, colitis, salpingitis, 18 patients did not present tomographic findings to support the clinical symptoms and 2 presented indetermined results. These data represented a sensibility of 100%, specifity of 95,7%, positive predictiv value (PPV of 96,2% and negative predictiv value (NPV of 100% for the tomography diagnosis of acute appendicitis and a sensibility of 100%, specificity of 81,8%, PPV of 95,1% and NPV of 100% for the tomography diagnosis of the different etiology in patient with right inferior acute abdomen. Conclusion: HCT is extremely useful in the study of patients with acute abdomen with origin in the RIQ, not only to make a diagnosis, but also to evaluate the complications, so as to decide proper treatment.

  8. Effects of ethidine and hydrocortisone on post-anesthesia shivering in surgery for acute purulent appendicitis%氢化可的松和哌替啶治疗急性化脓性阑尾炎麻醉后寒战疗效评价

    Institute of Scientific and Technical Information of China (English)

    谢文静; 李北平

    2013-01-01

    目的 评价氢化可的松和哌替啶对急性化脓性阑尾炎蛛网膜下隙阻滞麻醉后寒战的治疗作用.方法 急性化脓性阑尾炎蛛网膜下隙阻滞麻醉后寒战Wrench分级2级及以上的患者73 例,随机分为氢化可的松(2.0 mg/ kg)组、哌替啶( 0.05 mg/ kg)组和生理盐水 (10 ml)组.术中监测肛温(T)及常规麻醉监测指标.记录各组基础体温(T0),寒战发生时(T1),寒战后10 min(T2)、30 min(T3)、60 min(T4)体温,对T1~T4时间点的寒战进行评分,并观察不良反应的发生情况.结果 与对照组相比,哌替啶组和氢化可的松组患者麻醉后寒战缓解迅速,持续时间短,症状较轻(P<0.05);哌替啶组患者恶心、呕吐发生率较氢化可的松组高(P<0.05).结论 哌替啶和氢化可的松均可用于麻醉后寒战治疗;氢化可的松较少引起恶心、呕吐等不良反应,更适用于急性化脓性阑尾炎麻醉后寒战的治疗.%Objective To investigate the effects of treatment with pethidine and hydrocortisone on post-anesthesia shivering following subarachnoid block anesthesia in surgery for acute purulent appendicitis . Methods 73 patients with purulent appendectomy (Wrench Ⅱ-Ⅳ) were randomly divided into three groups,pethidine (0.05 mg/kg) group,hy- drocortisone (2.0 mg/ kg) group and normal saline group. Signs and parameters such as body temprature were monitored during the operation. Manifestations of shivering,were evaluated at 0,10,30 and 60 min after shivering,and the side effects such as nausea and vomiting were observed . Results The time of recovery from shivering was significantly shorter in pethidine and hydrocortisone group ( P < 0.05 ) . The incidence of nausea and vomiting was much lower in hydrocorti-sone group than in pethidine and saline group ( P < 0.05 ). Conclusions Pethidine and hydrocortisone are effective for the treatment of post -anesthesia shivering. Compared with pethidine,hydrocortisone had fewer side effects such as nausia and

  9. Pyridine appended L-methionine: A novel chelating resin for pH dependent Cr speciation with scanning electron microscopic evidence and monitoring of yeast mediated green bio-reduction of Cr(VI) to Cr(III) in environmental samples

    International Nuclear Information System (INIS)

    Chemical speciation and pH dependent separation of Cr(III) and Cr(VI) species in environmental samples have been achieved by solid phase extraction using a new chelating resin containing pyridine appended L-methionine. Cr(III) is completely sorbed on the resin at pH 8.0 and Cr(VI) at pH 2.0. Hence a pH dependent separation of Cr(III) and Cr(VI) is possible with a limit of detection of 1.6 μg mL-1 and 0.6 μg mL-1 respectively. The sorption capacity of the resin for Cr(III) and Cr(VI) is 2.8 mmol g-1 and 1.3 mmol g-1 respectively. The sorption of chromium on the resin is supported by scanning electron microscopy (SEM). Complete desorption of Cr(III) and Cr(VI) from 1 g of Cr loaded resin was achieved using 10 mL of 2 mol L-1 HNO3 and 6 mL of 3 mol L-1 HNO3 respectively. Quantitative recoveries of Cr(III) (pH 8.0) and Cr(VI) (pH 2.0) were found to be 96.0% and 98.0% respectively. Reduction efficiency of Rhodotornula mucilaginosa yeast from Cr(VI) to Cr(III) was monitored with this new resin. Concentrations of metal ions were measured by flame atomic absorption spectroscopy (FAAS).

  10. [Hyperbilirrubinemia as a predictive factor of perforated appendicitis].

    Science.gov (United States)

    Alanis-Rivera, Bianca; Zúñiga-Vázquez, Luis Abraham; Silva-Escamilla, María Carmen

    2016-01-01

    Introducción: en estudios recientes se considera la hiperbilirrubinemia como un marcador para identificar la presencia de apendicitis perforada. El objetivo del estudio es comprobar que la presencia de hiperbilirrubinemia es un marcador útil para identificar preoperatoriamente a los pacientes con presencia de perforación apendicular, y de esta manera proporcionar un tratamiento oportuno evitando la progresión de la patología y sus complicaciones. Métodos: estudio retrospectivo, con 225 pacientes, los cuales contaban con los criterios de inclusión y exclusión, del periodo de enero de 2012 a octubre del 2014 en el HGZ 29 del IMSS, tomando en cuenta resultados de laboratorio y posquirúrgico, realizando análisis univariado, bivariado y multivariado. Resultados: el 56.9% presentó bilirrubina 1, el 62.88% presentó apendicitis perforada. La hiperbilirrubinemia incrementa 17 veces más el riesgo de presentar apendicitis perforada (RMP: 17.63; IC 95%: 6.882-45.207; p protocolo de apendicitis, lo cual, a su vez, puede determinar una mejor planeación para el abordaje quirúrgico.

  11. Diabetes insipidus uncovered during conservative management of complicated acute appendicitis

    OpenAIRE

    Mamtani, Anita; Odom, Stephen R.; Butler, Kathryn L.

    2016-01-01

    Key Clinical Message Diabetes insipidus (DI) arises from impaired function of antidiuretic hormone, characterized by hypovolemia, hypernatremia, polyuria, and polydipsia. This case is a reminder of the rare but challenging obstacle that undiagnosed DI poses in fasting surgical patients, requiring prompt recognition and vigilant management of marked homeostatic imbalances.

  12. Diabetes insipidus uncovered during conservative management of complicated acute appendicitis.

    Science.gov (United States)

    Mamtani, Anita; Odom, Stephen R; Butler, Kathryn L

    2016-05-01

    Diabetes insipidus (DI) arises from impaired function of antidiuretic hormone, characterized by hypovolemia, hypernatremia, polyuria, and polydipsia. This case is a reminder of the rare but challenging obstacle that undiagnosed DI poses in fasting surgical patients, requiring prompt recognition and vigilant management of marked homeostatic imbalances. PMID:27190614

  13. Demographic characteristics and seasonal variations of acute appendicitis.

    Science.gov (United States)

    Bal, Ahmet; Ozkececi, Ziya Taner; Turkoglu, Ozgur; Ozsoy, Mustafa; Celep, Ruchan Bahadir; Yilmaz, Sezgin; Arikan, Yüksel

    2015-01-01

    L’appendicite è la patologia che più comunemente richiede un intervento chirurgico in emergenza, e l’appendicectomia è il procedimento chirurgico più commune in tutto il mondo, importante in quanto rappresenta un trattamento efficace. Il nostro scopo è stato quello di determinare le variazioni stagionali dell’appendicite nella nostra regione e di indentificare le differenze demografiche e regionali, e per questo abbiamo analizzato retrospettivamente I dati dei pazienti ricoverati nell’ospedale universitario Afyon Kocatepe e nell’ospedale statale Sivrihisar State tra il 2003 ed il 2012, cioè 839 pazienti. L’età media di tutti i pazienti era di 33 ± 14.7 anni, e la maggior frequenza dell’appendicite acuta è risultata in autunno e nella primavera (P > 0.05). Non si sono osservate differenze sigfnificative stagionali nell’ospedale universitario Afyon Kocatepe, mentre l’appendicite si è manifestata più frequentemente in autunno che non in inverno nell’ospedale statale Sivrihisar (P temperatura media mensile, l’umidità, l’entità delle precipitazioni e la frequenza dell’appendicite (P > 0.05). In conclusion, sebbene l’appendicite presenta una variazione stagionale, altri fattori embientali e l’impatto delle abitudini alimentari non vanno ignorate. L’etiologia dell’appendicite è comunque.multifattoriale, e nei futuri studi multiparametrici nell’intero territorio nazionale potrebbero evidenziarsi delle etiologie territorio-specifiche di questa patologia.

  14. Xanthogranulomatous appendicitis in interval appendectomy specimens of children

    OpenAIRE

    Yusuf Hakan Çavuşoğlu; Burak Ardıçlı; Sema Apaydın; Çağatay Evrim Afşarlar; Engin Yılmaz

    2016-01-01

    Xanthogranulomatous inflammation is common in interval appendectomy specimens in adults, but it is unusual in children. Histopathologic specimens of interval appendectomy, within an 8-year period, were reevaluated to assess the true incidence. A computer search of the hospital database of all appendectomies was performed between January 2008 and June 2015 to identify all interval appendectomy cases. A total of 2694 patients underwent appendectomies. Of these, 13 were interval appendectomies. ...

  15. A Unique Case of Congenital Band Mimicking Perforated Appendicitis

    Directory of Open Access Journals (Sweden)

    Mohsen Kalhor

    Full Text Available Intestinal obstruction caused by an anomalous congenital band is a very rare condition in adult and children. We report rare cause of acute non-post operative small bowel obstruction.A case of 21-year-old female with abdominal pain, while clinical and radiographic examinations were not diagnostic. After an open laparotomy a congenital band extending from antimesenteric wall of the jejunum to the root of mesentery was found that cause direct compression and entrapment of a segment of bowel loop.

  16. Are antibiotics a safe and effective treatment for acute uncomplicated appendicitis?

    Directory of Open Access Journals (Sweden)

    Felipe Moraga

    2016-03-01

    Full Text Available La apendicitis aguda es una causa típica de dolor abdominal agudo y la causa más frecuente de cirugía abdominal de urgencia. En las últimas dos décadas se ha publicado creciente evidencia sobre el uso de antibióticos como tratamiento exclusivo de la apendicitis aguda. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos nueve revisiones sistemáticas que en conjunto incluyen cinco estudios aleatorizados. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que el uso de antibióticos para el tratamiento la apendicitis aguda no complicada podría tener menor efectividad que la apendicectomía y probablemente aumente las complicaciones mayores en comparación con la apendicectomía.

  17. Surgical audit: A prospective study of the morbidity and mortality of acute appendicitis.

    Science.gov (United States)

    Malatani, T S; Latif, A A; Al-Saigh, A; Cheema, M A; Abu-Eshy, S

    1991-03-01

    Between March and September 1989, acute apendicitis was clinically diagnosed in 317 patients who were studied as part of a prospective surgical audit. The study was designed to determine the accuracy of diagnosis, comparison of the macroscopic appearance of the appendix at operation, and subsequent histopathology and complications associated with the morbidity and mortality of emergency appendectomy. The clinical diagnosis was correct in 278 patients (88%). Thirty-nine (12%) of the patients had a negative laparotomy. There was no mortality, and wound infection was the source of increased morbidity in 37 (12%) patients. The highest incidence of wound infection was among those who had pus in the peritoneum (20%) or had a perforated or gangrenous appendix (25%). When the macroscopic appearance of the appendix was compared with the subsequent histopathological findings, a false positive error of 7% and a false negative error of 42% was found. During appendectomy the gross appearance of the appendix must be carefully noted so that a meticulous surgical technique can be complemented by appropriate antibiotic prophylaxis against wound infection, started at the time of surgery.

  18. Nickel(ii) radical complexes of thiosemicarbazone ligands appended by salicylidene, aminophenol and aminothiophenol moieties.

    Science.gov (United States)

    Kochem, Amélie; Gellon, Gisèle; Jarjayes, Olivier; Philouze, Christian; du Moulinet d'Hardemare, Amaury; van Gastel, Maurice; Thomas, Fabrice

    2015-07-28

    The nickel(ii) complexes of three unsymmetrical thiosemicarbazone-based ligands featuring a sterically hindered salicylidene (1), aminophenol (2) or thiophenol (3) moiety were synthesized and structurally characterized. The metal ion lies in an almost square planar geometry in all the complexes. The cyclic voltammetry (CV) curve of 1 shows an irreversible oxidation wave at E = 0.49 V, which is assigned to the phenoxyl/phenolate redox couple. The CV curves of 2 and 3 display a reversible one-electron oxidation wave (E1/2 = 0.26 and 0.22 V vs. Fc(+)/Fc, respectively) and an one-electron reduction wave (E1/2 = -1.55 and -1.46 V, respectively). The cations 2(+) and 3(+) as well as the anions 2(-) and 3(-) were generated. The EPR spectra of the cations in THF show a rhombic signal at g1 = 2.034, g2 = 2.010 and g3 = 1.992 (2(+)) and g1 = 2.069, g2 = 2.018, g3 = 1.986 (3(+)) that is consistent with a main radical character of the complexes. The difference in anisotropy is assigned to the different nature of the radical, iminosemiquinonate vs. iminothiosemiquinonate. The anions display an isotropic EPR signal at giso = 2.003 (2(+)) and 2.006 (3(+)), which is indicative of a main α-diimine radical character of the compounds. Both the anions and cations exhibit charge transfer transitions of low to moderate intensity in their visible spectrum. Quantum chemical calculations (B3LYP) reproduce both the g-values and Vis-NIR spectra of the complexes. The radical anions readily react with dioxygen to give the radical cations. 2(+) catalyzes the aerobic oxidation of benzyl alcohol into benzaldehyde. PMID:26086684

  19. Experimental and Quantum Chemical Calculations of Imidazolium Appended Naphthalene Hybrid in Different Biomimicking Aqueous Interfaces.

    Science.gov (United States)

    Yenupuri, Tej Varma; Mydlova, Lucia; Agarwal, Devesh S; Sharma, Ritika; Sakhuja, Rajeev; Makowska-Janusik, Malgorzata; Pant, Debi D

    2016-08-25

    The effect of solvent polarity and micellar headgroup on a newly designed imidazolium based ionic liquid (IL) conjugated with naphthalene, 1,2-dimethyl-3-((6-(octyloxy)naphthalen-2-yl)methyl)-1H-imidazol-3-ium chloride (IN-O8-Cl), was studied using steady state and time-resolved fluorescence techniques. We observed that the dipole moment in the excited state is remarkably higher than the ground state. The effect of micellar surface charge on the photophysics of IN-O8-Cl in aqueous phase at room temperature was investigated. Formation of premicellar aggregates in sodium dodecylsulfate (SDS) was perceived; further the microenvironment of IN-O8-Cl was examined using steady-state fluorescence spectroscopy. Micropolarity of the micellar environment of SDS was found to be lower than that of cetyltrimethylammonium bromide (CTAB) and triton X-100 (TX100) following the order SDS < TX-100 < CTAB. The binding constant (Kb) and edge excitation red shift (EERS) from the emission maximum suggest that the probe binds strongly to the micelles. Multiexponential behavior was observed in time-resolved fluorescence lifetime studies in all micellar environments. We have observed an increase in rotational correlation time as we move from pure aqueous phase to solution containing surfactants of different head charge. Varieties of spectral parameters were used to justify the region in which the probe is present. The experimentally obtained dipole moment data were justified and explained by the DFT calculations of the electronic properties of IN-O8-Cl molecules in gas phase and in selected solvents. PMID:27486828

  20. Transvaginal Ultrasound in Fertile Patients with Suspected Appendicitis: An Experience Report of Current Practice

    Directory of Open Access Journals (Sweden)

    Malek Tabbara

    2012-01-01

    Full Text Available Background. Transvaginal ultrasound (TVU in female patients with acute right lower quadrant (RLQ abdominal pain is time and infrastructure intensive and not always available. This study aims to evaluate the role of TVU in these patients. Methods. Retrospective analysis identified 224 female patients with RLQ pain and TVU. Results. TVU revealed an underlying pathology in 34 (15% patients, necessitating a diagnostic laparoscopy in 12 patients. Six patients (2% had a true gynaecological emergency. The remaining 23 patients did not require surgery. The other 190 patients with RLQ pain had a bland TVU; 127 (67% were discharged, while 63 patients (33% received a diagnostic laparoscopy. Conclusion. The incidence of true gynaecological emergencies requiring urgent surgical intervention is very low in our patient cohort. TVU is a helpful tool if performed by a physician who is well trained in TVU.

  1. Donor-Appended N,C-Chelate Organoboron Compounds: Influence of Donor Strength on Photochromic Behaviour.

    Science.gov (United States)

    Mellerup, Soren K; Yuan, Kang; Nguyen, Carmen; Lu, Zheng-Hong; Wang, Suning

    2016-08-22

    Recently, four-coordinated N,C-chelate organoboron compounds have been found to show many interesting photochemical transformations depending on the nature of their chelating framework. As such, the effect of substitution on the chelate ligand has been well-established and understood, but the impact of the aryl groups attached to the boron atom remains less clear. To investigate the effect of enhanced charge-transfer character, a series of new N,C-chelate organoboron compounds with donor-functionalized aryl groups have been synthesized and characterized using NMR, UV/Vis, and electrochemical methods. These compounds were found to possess bright and tunable charge-transfer luminescence which is dependent on the donor strength of the amino substituent. In addition, some of these compounds undergo photochromic switching, producing dark isomers of various colors. This work establishes that donor-functionalization of the aryl groups in N,C-chelate boron compounds is an effective strategy for tuning both the photophysical and photochemical properties of such systems. The new findings also help elucidate the influence of electronic structure on the photoreactivity of N,C-chelate organoboron compounds which appears to be as important as steric crowding around the boron atom.

  2. Primary tuberculous appendicitis presented with caecal perforation:A case report

    Institute of Scientific and Technical Information of China (English)

    Elamurugan TP; Sivashanker M; Suresh Kumar S; Muthukumarassamy R; Vikram Kate

    2012-01-01

    Gastrointestinal tuberculosis accounts for 3%of the extrapulmonary tuberculosis with ileocaecal region being the common site of involvement up to 75%. Primary involvement of appendix is very rare and accounts for only 0.6% to 2.9% of gastrointestinal tuberculosis in the absence tubercular focus elsewhere. The pre-operative investigations usually give non-specific results. The diagnosis in most instances made only after histopathology. Here we report a case of primary appendicular tuberculosis in a patient presented with caecal perforation.

  3. The Nuclear Waste Policy Act, as amended, with appropriations acts appended. Revision 1

    International Nuclear Information System (INIS)

    This act provides for the development of repositories for the disposal of high-level radioactive wastes, low-level radioactive wastes, and spent nuclear fuels. In addition, it establishes research and development programs, as well as demonstration programs regarding the disposal of these wastes. This Act consists of the Act of Jan. 7, 1983 (Public Law 97-425; 96 Stat. 2201), as amended by Public Law 100-203 and Public Law 102-486

  4. [Costs of appendicitis treatment by diagnosis-related groups in a third-level pediatric hospital].

    Science.gov (United States)

    Tlacuilo-Parra, Alberto; Hernández-Hernández, Araceli; Venegas-Dávalos, Martha; Gutiérrez-Hermosillo, Violeta; Guevara-Gutiérrez, Elizabeth; Ambriz-González, Gabriela

    2014-01-01

    Antecedentes: los grupos relacionados con el diagnóstico se utilizan ampliamente en Europa; permiten comparar el desempeño de los hospitales y facilitan el sistema de pago hospitalario. Objetivo: clasificar mediante grupos relacionados con el diagnóstico a los niños operados por apendicitis en un hospital de tercer nivel de atención. Material y métodos: estudio transversal. Se analizaron: comorbilidad, tiempo de hospitalización, histología de la apendicitis y clasificación mediante grupos relacionados con el diagnóstico. Resultados: se incluyeron 313 pacientes, 62% hombres, con edad promedio de 8 ± 3 años, 91% llegaron referidos de otra unidad. Recibieron atención en el turno nocturno 67%, y permanecieron hospitalizados durante 4 ± 3 días. Hubo comorbilidad en 8% y complicaciones quirúrgicas en 11%. La apendicitis fue: edematosa en 11%, supurada en 36%, gangrenada en 22%, perforada en 29% y abscedada en 2%. La condición de egreso fue: con mejoría en 97%. El gasto total del grupo relacionado con el diagnóstico 343 fue 10,470,173 pesos, del grupo relacionado con el diagnóstico 342 de 1,227,592 pesos, y del grupo relacionado con el diagnóstico 340 de 511,521 pesos, lo que sumó 12,209,286 pesos mexicanos. Conclusión: el costo unitario del tratamiento de la apendicitis correspondiente al grupo relacionado con el diagnóstico 343 fue de 37,935 pesos, del grupo relacionado con el diagnóstico 342 de 49,103 pesos y del grupo relacionado con el diagnóstico 340 de 42,626 pesos. Puesto que 88% de los casos de apendicitis ocurrieron sin diagnóstico principal complicado, esos pacientes se podrían haber intervenido en un segundo nivel de atención, utilizando el reembolso obtenido del monto 343, sin necesidad de generar gastos adicionales.

  5. Perforated appendicitis masquerading as acute pancreatitis in a morbidly obese patient

    OpenAIRE

    Forster, Michael J.; Akoh, Jacob A.

    2008-01-01

    Diagnosis and treatment of common conditions in morbidly obese patients still pose a challenge to physicians and surgeons. Sometimes too much reliance is put on investigations that can lead to a misdiagnosis. This case demonstrates an obese woman admitted under the medical team with a presumed diagnosis of pneumonia, who was later found to have an acute abdomen and raised amylase, which led to an assumed diagnosis of pancreatitis. She died within 24 h of admission and post mortem confirmed th...

  6. Fluoride Binding and Crystal-Field Analysis of Lanthanide Complexes of Tetrapicolyl-Appended Cyclen.

    Science.gov (United States)

    Blackburn, Octavia A; Kenwright, Alan M; Jupp, Andrew R; Goicoechea, Jose M; Beer, Paul D; Faulkner, Stephen

    2016-06-20

    Lanthanide complexes of tetrapicolyl cyclen displayed remarkably high affinities for fluoride (log K≈5) in water, and were shown to form 1:1 complexes. The behaviour of these systems can be rationalised by changes to the magnitude of the crystal-field parameter, B20 . However, such changes are not invariably accompanied by a change in sign of this parameter: for early lanthanides, the N8 donor set with a coordinated axial water molecule ensures that the magnetic anisotropy has the opposite sense to that observed in the analogous dehydrated lanthanide complexes. PMID:27167830

  7. Acute appendicitis with a neuroendocrine tumor G1 (carcinoid): pitfalls of conservative treatment.

    Science.gov (United States)

    Watanabe, Hiroyuki A; Fujimoto, Taketoshi; Kato, Yo; Sasaki, Mayumi; Ikusue, Toshikazu

    2016-08-01

    A man in his early thirties presented to our clinic with right lower abdominal pain. Computed tomography (CT) and ultrasonography (US) revealed a swollen appendix and an appendicolith. Abscess formation was not observed but ongoing appendiceal rupture was not ruled out. Three months after successful conservative therapy, the lumen of the apical portion was kept dilated and laparoscopic interval appendectomy was performed. No tumorous findings were observed macroscopically. However, histology revealed many tiny nests infiltrating the submucosa, muscular layer, and subserosa at the root of the appendix. An appendiceal neuroendocrine tumor G1 (NET G1; carcinoid) was diagnosed immunohistologically. Neither CT nor US visualized the tumor because of its non-tumor-forming but infiltrative growth. In conclusion, after successful conservative treatment, interval appendectomy should be considered to uncover a possible appendiceal NET G1 (carcinoid), particularly when dilatation of the distal lumen is kept under observation. PMID:27311320

  8. The Nuclear Waste Policy Act, as amended, with appropriations acts appended. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-02-01

    This act provides for the development of repositories for the disposal of high-level radioactive wastes, low-level radioactive wastes, and spent nuclear fuels. In addition, it establishes research and development programs, as well as demonstration programs regarding the disposal of these wastes. This Act consists of the Act of Jan. 7, 1983 (Public Law 97-425; 96 Stat. 2201), as amended by Public Law 100-203 and Public Law 102-486.

  9. The Nuclear Waste Policy Act, as amended with appropriations acts appended

    Energy Technology Data Exchange (ETDEWEB)

    1994-03-01

    The Nuclear Waste Policy Act of 1982 provides for the development of repositories for the disposal of high-level radioactive waste and spent nuclear fuel, to establish a program of research, development and demonstration regarding the disposal of high-level radioactive waste and spent nuclear fuel. Titles 1 and 2 cover these subjects. Also included in this Act are: Title 3: Other provisions relating to radioactive waste; Title 4: Nuclear waste negotiation; Title 5: Nuclear waste technical review board; and Title 6: High-level radioactive waste. An appendix contains excerpts from appropriations acts from fiscal year 1984--1994.

  10. Can outer-to-outer diameter be used alone in diagnosing appendicitis on 128-slice MDCT?

    Institute of Scientific and Technical Information of China (English)

    Jamal; Yaqoob; Muhammad; Idris; Muhammad; Shahbaz; Alam; Nazia; Kashif

    2014-01-01

    AIM: To assess the frequency of visualization, position and diameter of normal appendix on 128-slice multidetector computed tomography(MDCT) in adult population.METHODS: Retrospective cross sectional study conducted at Radiology Department, Dallah Hospital, Riyadh, Saudi Arabia from March 2013 to October 2013. Non-enhanced computed tomography scans of abdomen and pelvis of 98 patients presenting with hematuria(not associated with abdominal pain, fever or colonic disease) were reviewed by two radiologists, blinded to patient history. The study group included 55 females and 43 males with overall mean age of 54.7 years(range 21 to 94 years). The coronal reformatted images were reviewed in addition to the axial images. The frequency of visualization of appendix was recorded with assessment of position, diameter and luminal contents.RESULTS: The appendix was recorded as definitely visualized in 99% of patients and mean outer-to-outer diameter of the appendix was 5.6 ± 1.3 mm(range 3.0-11.0 mm).CONCLUSION: MDCT with its multiplanar reformation display is extremely useful for visualization of normal appendix. The normal appendix is very variable in its position and diameter. In the absence of other signs, the diagnosis of acute appendix should not be made solely on outer-to-outer appendiceal diameter.

  11. Perforated peptic ulcer in an adolescent boy with acute appendicitis: a case report

    Directory of Open Access Journals (Sweden)

    Aazam Khorassani

    2013-06-01

    Full Text Available Background: Peptic ulcer disease is one of the most common GI disorders. Perforation has the highest mortality rate of any complication of ulcer disease, while early diagno-sis and emergency treatment save patient life.Case presentation: This paper reports an adolescent boy admitted to the Ziaeian University Hospital. He suffered from severe abdominal pain with dyspnea had been started since past three hours. Periumbilical pain started from past 2-3 days, gradually localized to the right lower quadrant. He had anorexia without nausea and vomiting. He was tachycardic and tachypneic, but he did not have fever. On physical examination, bowel sound was hypoactive, there was generalize tenderness, guarding and rebound tender-ness focused in the right lower quadrant and suprapubic region. Laboratory finding indicated leukocytosis. Chest X-ray showed free air under diaphragm. Once the diagno-sis has been made, the patient was given analgesia and antibiotics, resuscitated with isotonic fluid, and taken to the operating room. Laparotomy was implemented through a midline incision. There was bile secretion in the peritoneal cavity. Appendix was inflamated. Cecum and ileum were normal. A small perforation, 4mm in size was detected in first portion of duodenum. Appendectomy and omental patch repair were done. Ten days later, the patient was discharged in a good state. Serologic test for helicobacter pylori was negative.Conclusion: Stomach and duodenal perforation should be considered in patients with-out peptic ulcer disease, especially in children and adolescents with sudden and severe abdominal pain who are admitted to the hospital for other diseases. Because some patients present with peptic ulcer complications that are seemingly exacerbated by stressful life events.

  12. Pyrene appended bile acid conjugates: Synthesis and a structure-gelation property study

    Indian Academy of Sciences (India)

    Shreedhar Bhat; Arto Valkonen; Juha Koivukorpi; Anupama Ambika; Erkki Kolehmainen; Uday Maitra; Kari Rissanen

    2011-07-01

    A wide variety of novel compounds obtained by combining two types of known organogelators, viz., bile acid alkyl amides and pyrene alkanoic acids, were synthesized and screened for their gelation ability. The 3 esters of 1-pyrene butyric acid (PBA) of alkylamides of deoxycholic acid (DCA) turned out to be effective in the gel formation with many organic solvents although the gelation has to be triggered by the addition of a charge transfer (CT) agent 2,4,7-trinitrofluorenone (TNF). The special feature of these molecules is that the organogelation is achieved only after derivatizing the acid moiety of the 1-pyrenealkanoic acids. Additionally, the gelation properties can be fine-tuned by inserting different functional groups at the bile acid side chain. The gels obtained are deep red in colour and optically transparent up to 2% w/v. The SEM studies of the obtained xerogels revealed bundled rod-like morphology without specialized branching.

  13. Lactoferrin-appended solid lipid nanoparticles of paclitaxel for effective management of bronchogenic carcinoma.

    Science.gov (United States)

    Pandey, Vikas; Gajbhiye, Kavita Rai; Soni, Vandana

    2015-02-01

    Lung cancer is a dreadful disease which claims to be more life threatening as compared to total sum up of colon, prostate and breast cancers. Thus, there is an urgent need to develop an effective delivery approach for its management. Paclitaxel (PTX) is one of the well-known choice as antineoplasitic agent used for the treatment of different types of human cancers such as non-small-cell lung, head and neck cancers, leukemia, breast, ovarian and melanoma. Lactoferrin (Lf), a "multifunctional protein" is crucial for natural immunity which is secreted by exocrine glands. Lf receptors are expressed on the apical surface on bronchial epithelial cells. These over-expressed LF receptors can be utilized for the transportation of Lf-conjugated drug or nanocarrier devices. The present study was aimed to develop PTX-loaded Lf-coupled solid lipid nanoparticles (SLNs) for the treatment of lung cancer. PTX-loaded SLNs were prepared, characterized and then coupled with Lf using carbodiimide chemistry. The formulations were characterized by transmission electron microscopy, particle size, polydispersity index and zeta potential, whereas Lf conjugation was confirmed by FT-IR and ¹H NMR and efficiency of prepared system was evaluated by in vitro, ex vivo and in vivo evaluations. The ex vivo cytotoxicity studies on human bronchial epithelial cell lines, BEAS-2B, revealed superior anticancer activity of Lf-coupled SLNs than plain SLNs and free PTX. In vivo biodistribution studies showed higher concentrations of PTX accumulated in lungs via Lf-coupled SLNs than plain SLNs and free PTX. These studies suggested that Lf-coupled PTX-loaded SLNs could be used as potential targeting carrier for delivering anticancer drug to the lungs with the minimal side effects.

  14. Synthesis of novel coumarin appended bis(formylpyrazole) derivatives: Studies on their antimicrobial and antioxidant activities.

    Science.gov (United States)

    Nagamallu, Renuka; Srinivasan, Bharath; Ningappa, Mylarappa B; Kariyappa, Ajay Kumar

    2016-01-15

    A series of novel coumarin pyrazole hybrids of biological interest were synthesized from the hydrazones, carbazones and thiocarbazones via Vilsmeier Haack formylation reaction. These intermediates and formyl pyrazoles were evaluated for antimicrobial and antioxidant activities. Among the series, compounds 6g and 6h showed excellent antimicrobial activity against different bacterial and fungal strains and compounds 7g, 7h were found to be potent antioxidant agents in both DPPH and hydroxyl radical scavenging assays. Further, detailed quantitative structure-activity relationship (QSAR) analysis indicated the molecular parameters that contribute to increased potency of inhibition. The above findings would further encourage our understanding in employing coumarin pyrazole hybrids as potential antibiotic agents for treating infections caused by pathogenic microbes and fungi. Further, it also paves the way for exploration of these compounds as potential therapeutic agents to treat conditions arising because of excessive oxidative damage.

  15. Apendicitis del muñón apendicular Appendicitis of the appendicular stump

    OpenAIRE

    María Carolina Berrogain; Noelia González; Silvana Rocha; Cristian Daher; Sergio Moguillansky

    2012-01-01

    La apendicitis del muñón es una entidad rara, caracterizada por un proceso inflamatorio del remanente apendicular luego de una apendicectomía incompleta. Los signos y síntomas no difieren de una apendicitis aguda. Al no ser una patología usualmente pensada como posible diagnóstico diferencial del abdomen agudo inflamatorio, tiene mayor riesgo de complicaciones y morbi-mortalidad. Los métodos seccionales de diagnósticos por imágenes resultan muy beneficiosos para definir el diagnóstico. La ult...

  16. What is the optimal treatment for appendiceal mass formed after acute perforated appendicitis?

    Institute of Scientific and Technical Information of China (English)

    Enver Zerem; Goran Imamovi(c); Farid Ljuca; Jasmina Alid(z)anovi(c)

    2012-01-01

    We read with great interest the editorial article by Meshikhes AWN published in issue 25 of World J Gastroenterol 2011.The article described the advantages of emergency laparoscopic appendectomy compared with interval appendectomy as a new safe treatment modality for the appendiceal mass.The author concluded that the emergency laparoscopic appendectomy was a safe treatment modality for the appendiceal mass,and might prove to be more cost-effective than conservative treatment,with no need for interval appendectomy.However,we would like to highlight certain issues regarding the possibility of percutaneous catheter drainage to successfully treat the appendiceal mass,with no need for appendectomy,too.

  17. Diamine-appended metal-organic frameworks: enhanced formaldehyde-vapor adsorption capacity, superior recyclability and water resistibility.

    Science.gov (United States)

    Wang, Zhong; Wang, WenZhong; Jiang, Dong; Zhang, Ling; Zheng, Yali

    2016-07-28

    Capturing formaldehyde (HCHO) from indoor air with porous adsorbents still faces challenges due to their low uptake capacity, difficult regeneration, and especially, the sorption capacity reduction that is caused by the competitive adsorption of H2O when exposed to a humid atmosphere. In this work, MIL-101 is modified with ethylenediamine (ED) on its open-metal sites to substantially improve the HCHO adsorption properties. The HCHO uptake capacity of modified MIL-101 can be up to 5.49 mmol g(-1) in this study, which is among the highest-levels of various adsorbents reported thus far. Moreover, this modification both improved the material's recyclability and water resistibility, allowing for cyclic and selective tests with stable adsorption capacities, revealing the potential utility of amine-modified MOFs for indoor air purification. PMID:27338802

  18. Synthesis and properties of arsenic(III)-reactive coumarin-appended benzothiazolines: a new approach for inorganic arsenic detection.

    Science.gov (United States)

    Ezeh, Vivian C; Harrop, Todd C

    2013-03-01

    The EPA has established a maximum contaminant level (MCL) of 10 ppb for arsenic (As) in drinking water requiring sensitive and selective detection methodologies. To tackle this challenge, we have been active in constructing small molecules that react specifically with As(3+) to furnish a new fluorescent species (termed a chemodosimeter). We report in this contribution, the synthesis and spectroscopy of two small-molecule fluorescent probes that we term ArsenoFluors (or AFs) as As-specific chemodosimeters. The AFs (AF1 and AF2) incorporate a coumarin fluorescent reporter coupled with an As-reactive benzothiazoline functional group. AFs react with As(3+) to yield the highly fluorescent coumarin-6 dye (C6) resulting in a 20-25-fold fluorescence enhancement at λem ∼ 500 nm with detection limits of 0.14-0.23 ppb in tetrahydrofuran (THF) at 298 K. The AFs also react with common environmental As(3+) sources such as sodium arsenite in a THF/CHES (N-cyclohexyl-2-aminoethanesulfonic acid) (1:1, pH 9, 298 K) mixture resulting in a modest fluorescence turn-ON (1.5- to 3-fold) due to the quenched nature of coumarin-6 derivatives in high polarity solvents. Bulk analysis of the reaction of the AFs with As(3+) revealed that the C6 derivatives and the Schiff-base disulfide of the AFs (SB1 and SB2) are the ultimate end-products of this chemistry with the formation of C6 being the principle photoproduct responsible for the As(3+)-specific turn-ON. It appears that a likely species that is traversed in the reaction path is an As-hydride-ligand complex that is a putative intermediate in the proposed reaction path. PMID:23421428

  19. Biocatalytic self-assembly of supramolecular charge-transfer nanostructures based on n-type semiconductor-appended peptides.

    Science.gov (United States)

    Nalluri, Siva Krishna Mohan; Berdugo, Cristina; Javid, Nadeem; Frederix, Pim W J M; Ulijn, Rein V

    2014-06-01

    The reversible in situ formation of a self-assembly building block (naphthalenediimide (NDI)-dipeptide conjugate) by enzymatic condensation of NDI-functionalized tyrosine (NDI-Y) and phenylalanine-amide (F-NH2) to form NDI-YF-NH2 is described. This coupled biocatalytic condensation/assembly approach is thermodynamically driven and gives rise to nanostructures with optimized supramolecular interactions as evidenced by substantial aggregation induced emission upon assembly. Furthermore, in the presence of di-hydroxy/alkoxy naphthalene donors, efficient charge-transfer complexes are produced. The dynamic formation of NDI-YF-NH2 and electronic and H-bonding interactions are analyzed and characterized by different methods. Microscopy (TEM and AFM) and rheology are used to characterize the formed nanostructures. Dynamic nanostructures, whose formation and function are driven by free-energy minimization, are inherently self-healing and provide opportunities for the development of aqueous adaptive nanotechnology. PMID:24788665

  20. BODIPY-Appended 2-(2-Pyridyl)benzimidazole Platinum(II) Catecholates for Mitochondria-Targeted Photocytotoxicity.

    Science.gov (United States)

    Mitra, Koushambi; Gautam, Srishti; Kondaiah, Paturu; Chakravarty, Akhil R

    2016-09-01

    Platinum(II) complexes of the type [Pt(L)(cat)] (1 and 2), in which H2 cat is catechol and L represents two 2-(2-pyridyl)benzimidazole ligands with 4,4-difluoro-4-bora-3a,4a-diaza-s-indacene (BODIPY) pendants, were synthesized to achieve mitochondria-targeted photocytotoxicity. The complexes showed strong absorptions in the range λ=510-540 nm. Complex 1 exhibited intense emission at λ=525 nm in 1 % DMSO/water solution (fluorescence quantum yield of 0.06). Nanosecond transient absorption spectral features indicated an enhanced population of the triplet excited state in di-iodinated complex 2. The generation of singlet oxygen by complex 2 upon exposure to visible light, as evidenced from experiments with 1,3-diphenylisobenzofuran, is suitable for photodynamic therapy because of the remarkable photosensitizing ability. The complexes resulted in excellent photocytotoxicity in HaCaT cells (half maximal inhibitory concentration IC50 ≈3 μm, λ=400-700 nm, light dose=10 J cm(-2) ), but they remained non-toxic in the dark (IC50 >100 μm). Confocal microscopy images of 1 and Pt estimation from isolated mitochondria showed colocalization of the complexes in the mitochondria. Complex 2 displayed generation of reactive oxygen species induced by visible light, disruption of the mitochondrial membrane potential, and apoptosis. PMID:27465792

  1. Laparoskopi ved formodet appendicitis acuta. Erfaringer med de 233 første laparoskopier på en universitetsafdeling

    DEFF Research Database (Denmark)

    Pedersen, A G; Petersen, O B; Wara, P;

    1996-01-01

    patients (0.9% and 1.7%), respectively. There was only one complication (0.4%) directly related to the laparoscopic procedure, namely a coecal leak. In conclusion, in a teaching hospital, laparoscopic appendicectomy can be safely offered to patients where surgery is indicated due to suspicion...

  2. Anthracene appended pyridinium amide–urea conjugate in selective fluorometric sensing of L-N-acetylvaline salt

    OpenAIRE

    Kumaresh Ghosh; Tanmay Sarkar; Chattopadhyay, Asoke P

    2010-01-01

    A new anthracene labeled pyridinium amide–urea conjugate 1 has been designed and synthesized. The receptor shows a different fluorometric response with L-N-acetylvaline and L-N-acetylalanine salts in CH3CN in contrast to the other salts of L-N-acetyl α-amino acids and (S)-α-hydroxy acids studied. Upon complexation of the tetrabutylammonium salt of L-N-acetylvaline, the emission of 1 increases accompanied by the formation of a new band at higher wavelength and this characterist...

  3. Anthracene appended pyridinium amide–urea conjugate in selective fluorometric sensing of L-N-acetylvaline salt

    OpenAIRE

    Ghosh, Kumaresh; Sarkar, Tanmay; Chattopadhyay, Asoke P

    2010-01-01

    A new anthracene labeled pyridinium amide–urea conjugate 1 has been designed and synthesized. The receptor shows a different fluorometric response with L-N-acetylvaline and L-N-acetylalanine salts in CH3CN in contrast to the other salts of L-N-acetyl α-amino acids and (S)-α-hydroxy acids studied. Upon complexation of the tetrabutylammonium salt of L-N-acetylvaline, the emission of 1 increases accompanied by the formation of a new band at higher wavelength and this characteristic change distin...

  4. The validity and reliability of iridology in the diagnosis of previous acute appendicitis as evi-denced by appendectomy

    OpenAIRE

    Frank, L.; J. T. Ferreira; J. Pellow

    2013-01-01

    Iridology is defined as a photographic science that identifies pathological and functional changes within organs via biomicroscopic iris assessment for aberrant lines, spots, and discolourations. According to iridology, the iris does not reflect changes  during  anaesthesia,  due  to  the  drugs inhibitory  effects  on  nerves  impulses,  and  in cases of organ removal, it reflects the pre-surgical condition.The profession of Homoeopathy is frequently associated with iridology and in a recent...

  5. Chemistry of porphyrin-appended cellulose strands with a helical structure: spectroscopy, electrochemistry, and in situ circular dichroism spectroelectrochemistry.

    Science.gov (United States)

    Redl, F X; Lutz, M; Daub, J

    2001-12-17

    Around 100 porphyrin units have been selectively linked at C(6)-O to a cellulose (Avicel). The properties of the metal-free and zincated porphyrin-celluloses 2 and Zn-2 have been determined by optical and electrochemical methods. Circular dichroism indicates a helical arrangement of the porphyrin units and reveals intra-chain coupling reminiscent, in the broadest sense, of strands of nucleic acids. Cyclic voltammetry and spectroelectrochemistry have been used to characterize the radical ions and dianions. The electrochromism of the oxidation of cellulose 2 to porphyrin radical cations of 2 has been employed for both molecular switching and the transduction of an electrochemical input into chiroptical signal expression. PMID:11822435

  6. An iron-iron hydrogenase mimic with appended electron reservoir for efficient proton reduction in aqueous media.

    Science.gov (United States)

    Becker, René; Amirjalayer, Saeed; Li, Ping; Woutersen, Sander; Reek, Joost N H

    2016-01-01

    The transition from a fossil-based economy to a hydrogen-based economy requires cheap and abundant, yet stable and efficient, hydrogen production catalysts. Nature shows the potential of iron-based catalysts such as the iron-iron hydrogenase (H2ase) enzyme, which catalyzes hydrogen evolution at rates similar to platinum with low overpotential. However, existing synthetic H2ase mimics generally suffer from low efficiency and oxygen sensitivity and generally operate in organic solvents. We report on a synthetic H2ase mimic that contains a redox-active phosphole ligand as an electron reservoir, a feature that is also crucial for the working of the natural enzyme. Using a combination of (spectro)electrochemistry and time-resolved infrared spectroscopy, we elucidate the unique redox behavior of the catalyst. We find that the electron reservoir actively partakes in the reduction of protons and that its electron-rich redox states are stabilized through ligand protonation. In dilute sulfuric acid, the catalyst has a turnover frequency of 7.0 × 10(4) s(-1) at an overpotential of 0.66 V. This catalyst is tolerant to the presence of oxygen, thereby paving the way for a new generation of synthetic H2ase mimics that combine the benefits of the enzyme with synthetic versatility and improved stability. PMID:26844297

  7. An iron-iron hydrogenase mimic with appended electron reservoir for efficient proton reduction in aqueous media

    OpenAIRE

    Becker, René; Amirjalayer, Saeed; Li, Ping; Woutersen, Sander; Reek, Joost N. H.

    2016-01-01

    The transition from a fossil-based economy to a hydrogen-based economy requires cheap and abundant, yet stable and efficient, hydrogen production catalysts. Nature shows the potential of iron-based catalysts such as the iron-iron hydrogenase (H2ase) enzyme, which catalyzes hydrogen evolution at rates similar to platinum with low overpotential. However, existing synthetic H2ase mimics generally suffer from low efficiency and oxygen sensitivity and generally operate in organic solvents. We repo...

  8. Cyclotriphosphazene appended porphyrins and fulleropyrrolidine complexes as supramolecular multiple photosynthetic reaction centers: steady and excited states photophysical investigation.

    Science.gov (United States)

    Nair, Vishnu Sukumaran; Pareek, Yogita; Karunakaran, Venugopal; Ravikanth, Mangalampalli; Ajayaghosh, Ayyappanpillai

    2014-06-01

    New multiple photosynthetic reaction centers were constructed from cyclophosphazene decorated multiporphyrin chromophores and a fulleropyrrolidine having a pyridine ligand (FPY). The excited state electron transfer in the self-assembled donor-acceptor assembly was investigated by using steady state absorption and emission, time-resolved emission spectroscopy and nanosecond laser flash photolysis. The effect of metal (Zn(2+)) coordination to porphyrin units in the multiporphyrin arrays on cyclophosphazine scaffold (P3N3Zn) was studied by comparing with metal free porphyrin assembly on a cyclophosphazene scaffold (P3N3). In P3N3Zn, the decrease of absorption and fluorescence intensity and the lowering of the amplitude of longer fluorescence lifetime with increase of FPY concentration reflect the formation of a ground state complex with an association constant of ∼14,910 M(-1). When compared to the metal-free complex P3N3, the metal-coordinated derivative P3N3Zn exhibited shortening of the singlet and triplet state lifetimes and lowering of the singlet and triplet quantum yields. The cause of the decrease of the triplet quantum yields by insertion of zinc metal is discussed along with the possible non-planarity of the porphyrin ring. From the fluorescence lifetime measurements for the P3N3Zn-FPY mixture, it is proposed that self-assembly of the donor-acceptor complex leads to charge separated species with a rate constant of 7.1 × 10(9) s(-1). The decrease of triplet state intensity and lifetime of the P3N3Zn in the P3N3Zn-FPY complex from the nanosecond transient absorption studies support the occurrence of intermolecular electron transfer in the triplet state.

  9. Is single port incisionless-intracorporeal conventional equipment-endoscopic surgery feasible in patients with retrocecal acute appendicitis?

    OpenAIRE

    Karakus, Suleyman Cuneyt; Kilincaslan, Huseyin; Koku, Naim; Ertaskin, Idris

    2013-01-01

    Purpose Since laparoscopic appendectomy was first described, various modifications, such as single port incisionless-intracorporeal conventional equipment-endoscopic surgery (SPICES), have been described for reducing pain and improving cosmetic results. In the retrocecal and retrocolic positions, attachments to the lateral peritoneum and cecum may lead to difficulties during SPICES, which is performed with only one port. Here, we present the effects of variations in the position of the vermif...

  10. Host-guest complexation. 18. Effects on cation binding of convergent ligand sites appended to macrocyclic polyethers

    International Nuclear Information System (INIS)

    Syntheses are reported for 16 new macrocyclic polyether ligand systems which contain potentially convergent side chains containing additional binding sites. The free energies of association of these systems in CDCl3 at 250C with Li+, Na+, K+, Rb+, Cs+, NH4+, CH3NH3+, and t-BuNH3+ picrates were determined

  11. A STUDY OF RECENCY OF CITED ITEMS APPENDED IN THE ARTICLES PUBLISHED IN JOURNAL OF ALGEBRA AND DISCRETE MATHEMATICS

    Directory of Open Access Journals (Sweden)

    Nikhil Kumar Sardar

    2014-01-01

    Full Text Available The aim of this paper is to study recency, weighted recency and average weighted recency of the cited items in the articles published in the Journal of Algebra and Discrete Mathematics during the period from 2010 to 2012 by using statistical methods based on sampling. This study reveals that the average weighted recency of the citations of the articles published in 2011 are more than those of the other two years. (cf. the bar diagram is in the page 15. This indicates that the articles published in 2011 are of more recent origin than those of other two years.

  12. Diamine-appended metal-organic frameworks: enhanced formaldehyde-vapor adsorption capacity, superior recyclability and water resistibility.

    Science.gov (United States)

    Wang, Zhong; Wang, WenZhong; Jiang, Dong; Zhang, Ling; Zheng, Yali

    2016-07-28

    Capturing formaldehyde (HCHO) from indoor air with porous adsorbents still faces challenges due to their low uptake capacity, difficult regeneration, and especially, the sorption capacity reduction that is caused by the competitive adsorption of H2O when exposed to a humid atmosphere. In this work, MIL-101 is modified with ethylenediamine (ED) on its open-metal sites to substantially improve the HCHO adsorption properties. The HCHO uptake capacity of modified MIL-101 can be up to 5.49 mmol g(-1) in this study, which is among the highest-levels of various adsorbents reported thus far. Moreover, this modification both improved the material's recyclability and water resistibility, allowing for cyclic and selective tests with stable adsorption capacities, revealing the potential utility of amine-modified MOFs for indoor air purification.

  13. A Bifunctional Thioether Linked Coumarin Appended Calix[4]arene Acquires Selectivity Toward Cu(2+) Sensing on Going from Solution to SAM on Gold.

    Science.gov (United States)

    Samanta, Kushal; Rao, Chebrolu Pulla

    2016-02-10

    A bifunctional calix[4]arene molecule bearing coumarin moiety on the lower rim and thioether moiety on the upper rim (L1), has been synthesized and well characterized by (1)H, (13)C NMR and mass spectrometry. Suitably functionalized coumarin moieties are well suited for selective recognition of various cations and anions. Among the 10 different metal ions studied, only Cu(2+) and Fe(3+) exhibit appreciable changes in the absorption spectra owing to the availability of functional moieties present at both the lower as well as the upper rim of free L1 in acetonitrile solution. To bring better selectivity, we blocked one of these functional moieties by coating on to a surface so that only the other one is exposed to the environment for sensing. Such a study carried out in the present case using the self-assembled monolayer (SAM) of L1 on Au(111) resulted in selective sensing of Cu(2+) over several other metal ions as studied by surface plasmon resonance (SPR). The SAM of L1 on Au(111) was confirmed by different techniques, such as grazing incidence FT-IR, contact angle measurement, cyclic voltammetry and scanning tunneling microscopy. Thus, L1 is proven to be a suitable sensor for Cu(2+) when attached to gold surface.

  14. Amidofluorene-appended lower rim 1,3-diconjugate of calix[4]arene: synthesis, characterization and highly selective sensor for Cu2+

    Science.gov (United States)

    Nemati, Mohammad; Zadmard, Reza; Mohadjerani, Maryam

    2016-01-01

    Summary Functionalization of calix[4]arene with amidofluorene moieties at the lower rim led to formation of the 1,3-diconjugate of calix[4]arene L as a novel fluorescent chemosensor for Cu2+. The receptor molecule L exhibited a pronounced selectivity towards Cu2+ over other mono and divalent ions. The formation of the complex between L and Cu2+ was evaluated by absorption, fluorescence and 1H NMR spectroscopy. The sensor L showed a remarkable color change from colorless to purple and a fluorescence quenching only upon interaction with Cu2+. The 1:1 stoichiometry of the obtained complex has been determined by Job’s plot. The association constant determined by fluorescence titration was found to be 1.8 × 106 M−1. The sensor showed a linear response toward Cu2+ in the concentration range from 1 to 10 µM with a detection limit of 9.6 × 10−8 M.

  15. Amidofluorene-appended lower rim 1,3-diconjugate of calix[4]arene: synthesis, characterization and highly selective sensor for Cu(2.).

    Science.gov (United States)

    Hosseinzadeh, Rahman; Nemati, Mohammad; Zadmard, Reza; Mohadjerani, Maryam

    2016-01-01

    Functionalization of calix[4]arene with amidofluorene moieties at the lower rim led to formation of the 1,3-diconjugate of calix[4]arene L as a novel fluorescent chemosensor for Cu(2+). The receptor molecule L exhibited a pronounced selectivity towards Cu(2+) over other mono and divalent ions. The formation of the complex between L and Cu(2+) was evaluated by absorption, fluorescence and (1)H NMR spectroscopy. The sensor L showed a remarkable color change from colorless to purple and a fluorescence quenching only upon interaction with Cu(2+). The 1:1 stoichiometry of the obtained complex has been determined by Job's plot. The association constant determined by fluorescence titration was found to be 1.8 × 10(6) M(-1). The sensor showed a linear response toward Cu(2+) in the concentration range from 1 to 10 µM with a detection limit of 9.6 × 10(-8) M. PMID:27559419

  16. Amidofluorene-appended lower rim 1,3-diconjugate of calix[4]arene: synthesis, characterization and highly selective sensor for Cu2+

    Science.gov (United States)

    Nemati, Mohammad; Zadmard, Reza; Mohadjerani, Maryam

    2016-01-01

    Summary Functionalization of calix[4]arene with amidofluorene moieties at the lower rim led to formation of the 1,3-diconjugate of calix[4]arene L as a novel fluorescent chemosensor for Cu2+. The receptor molecule L exhibited a pronounced selectivity towards Cu2+ over other mono and divalent ions. The formation of the complex between L and Cu2+ was evaluated by absorption, fluorescence and 1H NMR spectroscopy. The sensor L showed a remarkable color change from colorless to purple and a fluorescence quenching only upon interaction with Cu2+. The 1:1 stoichiometry of the obtained complex has been determined by Job’s plot. The association constant determined by fluorescence titration was found to be 1.8 × 106 M−1. The sensor showed a linear response toward Cu2+ in the concentration range from 1 to 10 µM with a detection limit of 9.6 × 10−8 M. PMID:27559419

  17. Tromboflebite séptica da veia porta secundária à apendicite Septic thrombophlebitis of the portal vein as a complication of appendicitis

    Directory of Open Access Journals (Sweden)

    Olival Cirilo Lucena da Fonseca-Neto

    2007-06-01

    Full Text Available INTRODUÇÃO: A tromboflebite séptica da veia porta ou pileflebite é evento raro e associado com alta mortalidade e seu diagnóstico requer a demonstração de trombo portal. RELATO DO CASO: Mulher de 19 anos com história de dor abdominal há 40 dias com piora há 10 foi admitida no hospital. Referia dor de forte intensidade em hipocôndrio direito, vômitos, febre, e calafrios. No exame físico de entrada tinha sinais e sintomas de sepse abdominal. Submetida à laparotomia exploradora foi encontrado abscesso hepático e apêndice ileiocecal rôto e bloqueado. Realizada apendicectomia e drenagem de abscesso, que evoluiu com necessidade de re-laparotomia no 6º dia e drenagem de novos abscessos hepáticos. Após longa internação, recebeu alta e no seguimento de 6 meses estava bem. CONCLUSÃO: A pileflebite é complicação rara, porém grave, devendo ser rapidamente diagnosticada e o seu manejo multidisciplinar instituído prontamente.BACKGROUND:Portal vein septic thrombophlebitis or pylephlebitis is a rare event associated with high mortality rates and its' diagnosis requires portal thrombosis demonstration. CASE REPORT: Nineteen year-old female was admitted to the hospital with a history of abdominal pain for the last 40 days, worsening for the last 10. The patient complained of intense and strong pain in the right hypochondrium, vomit, fever and cold chills. During physical examination the patient showed signs and symptoms of abdominal sepsis. She was then submitted to exploratory laparotomy, during which a hepatic abscess and blocked and ruptured ileocecal appendix was found. Appendicectomy and drainage of the abcess was performed, having the necessity of a second laparotomy in the sixth day and further drainage of new formatted hepatic abscesses. After a long period of admission, the patient was discharged and was well following the next six months. CONCLUSION: Pylephlebitis is a rare and severe complication, which has the urgency of being quickly and appropriately diagnosed as well as in a multidisciplinary manner.

  18. Torsion of the fallopian the mimicking appendicitis in a pregnant woman; Torsion de la trompa de Falopio en una mujer gestante simulando apendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Tapia-Vine, M.; Pedrosa, I.; Escribano, N. [Hospital Clinico San Carlos (Spain)

    2000-07-01

    Isolated torsion of the fallopian tube is an uncommon entity. Given the difficulties involved in the preoperative diagnosis, the ultrasound findings characteristic of this anomaly are not widely known. We present a case of tubal torsion associated with a cyst, describing the ultrasound images in our case and those reported in the literature. (Author) 18 refs.

  19. Application of Ultrasounic Diagnosis in 60 Patients of Acute Appendicitis%超声诊断急性阑尾炎60例

    Institute of Scientific and Technical Information of China (English)

    韩芳

    2004-01-01

    急性阑尾炎是外科最常见的急腹症之一,但其临床诊断则常有失误,临床拟诊急性阑尾炎的手术中发现结果为阴性者可高达20%~40%。超声诊断阑尾炎的准确率虽因仪器性能、探头频率及扫查技术优劣等有很大差别,但有报道其准确率为85.1%,因此已成为临床诊断急性阑尾炎的重要诊断手段。两年来,我们用超声诊断为急性阑尾炎并经手术及病理证实的患者有60例,现报告如下。

  20. Thermodynamic and structural studies on the complexation of guanidino-appended α-cyclodextrin derivatives with p-nitrophenolate ion

    Science.gov (United States)

    Takezawa, Keita; Hirai, Tomoki; Yamamoto, Tatsuyuki; Yoshikiyo, Keisuke

    2016-03-01

    Thermodynamic parameters (ΔG, ΔH, and TΔS) for the complexation of mono(3-deoxy-3-guanidino-altro)-α-cyclodextrin (1) or mono(3-deoxy-3-guanidino)-α-CD (2) with p-nitrophenolate ion were determined by 1H NMR titration experiments in D2O solution containing 0.10 mol dm-3 Na2CO3-NaHCO3 at 298, 308, 318, and 328 K, to investigate the effect of the macro ring flexibility of 1 on the complexation with the planar guest. Both ΔH and TΔS values for the inclusion complexation of 1 with the guest (-39.6 kJ mol-1 and -23.3 kJ mol-1, respectively) decreased more than those for 2 with the guest (-27.6 kJ mol-1 and -10.0 kJ mol-1, respectively). This fact suggested that the degree of freedom of the guest and the flexibility of the macro ring of 1 were decreased by the tight binding of the guest in the manner of induced fit. The existence of anisotropic ring current effect by the guest on the 1H NMR signals for C(3)- and C(5)-H's of 1 confirmed that the molecular rotation of the guest is retarded in the complex of 1 with p-nitrophenolate ion. The molecular orientation of the guest in the inclusion complex with 1 was determined by means of ROESY (rotating-frame overhauser effect spectroscopy) experiment.

  1. Acceptable outcome after laparoscopic appendectomy in children

    DEFF Research Database (Denmark)

    Stilling, Nicolaj M; Fristrup, Claus; Gabers, Torben;

    2013-01-01

    An increasing proportion of childhood -appendicitis is being treated with laparoscopic appendectomy (LA). We wanted to elucidate the outcome of childhood appendicitis treated primarily by residents in a university hospital....

  2. Práticas cirúrgicas baseadas em evidências: tomografia computadorizada helicoidal no diagnóstico da apendicite aguda Evidence-based surgical practices: helical computed tomography in acute appendicitis diagnosis

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Guimarães

    2008-08-01

    Full Text Available Os cirurgiões são instados a não somente ler os artigos dos periódicos, mas também a compreendê-los e analisá-los criticamente quanto à validade. Eles cuidam melhor dos seus pacientes se são capazes de analisar criticamente a literatura e aplicar os resultados a sua prática. Este é o segundo artigo de uma série - Práticas Cirúrgicas Baseadas em Evidência - que tem por objetivo apresentar a avaliação crítica de um teste diagnóstico.Surgeons are told that they need not only read journal articles, but also understand them and make a critical appraisal of their validity. They offer better care if they are able to appraise critically the original literature and apply the results to their practice. This is the second article of a series - Evidence-Based Surgical Practices - which focus on critical appraisal of a diagnostic test.

  3. Numerical simulation of a fully appended submarine model in steady turn%全附体潜艇模型回转运动流场数值模拟

    Institute of Scientific and Technical Information of China (English)

    曹留帅; 朱军; 黄昆仑; 葛义军; 王智宇

    2015-01-01

    为研究潜艇的回转运动,在RANS方程中引入旋转坐标系科氏力和艇体惯性离心力,并采用分块结构化网格技术,对全附体潜艇模型回转运动的流场进行了CFD数值模拟.首先,推导了旋转坐标系下流场计算的控制方程,给出了科氏力和艇体惯性离心力的表达式,并将其引入到动量方程中;然后,采用RNG k-ε湍流模型以及用户自定义函数方法设置了计算边界条件,数值模拟了全附体潜艇模型(DRAPA SUBOFF)的操舵定常回转运动流场;最后,分析了所计算流场的速度、压力和涡的分布及形态,分析表明计算结果符合其规律性.

  4. An elusive vinyl radical isolated as an appended unit in a five-coordinate Co(iii)-bis(iminobenzosemiquinone) complex formed via ligand-centered C-S bond cleavage.

    Science.gov (United States)

    Sarkar, Prasenjit; Tiwari, Archana; Sarmah, Amrit; Bhandary, Subhrajyoti; Roy, Ram Kinkar; Mukherjee, Chandan

    2016-08-23

    Redox-active ligand H4Pra(edt(AP/AP)) experienced C-S bond cleavage during complexation reaction with Co(OAc)2·2H2O in the presence of Et3N in CH3OH in air. Thus, formed complex 1 was composed of two iminobenzosemiquinone radicals in its coordination sphere and an unprecedented stable tethered-vinyl radical. The complex has been characterized by mass, X-ray single crystal, X-band EPR, variable-temperature magnetic moment measurements and DFT based computational study.

  5. 'PET' vs. 'push-pull' induced ICT: a remarkable coumarinyl-appended pyrimidine based naked eye colorimetric and fluorimetric sensor for the detection of Hg2+ ions in aqueous media with test trips.

    Science.gov (United States)

    Goswami, Shyamaprosad; Das, Avijit Kumar; Maity, Sibaprasad

    2013-12-14

    A novel colorimetric and fluorescent chemosensor based on 7-(diethylamino)-3-(pyrimidin-4-yl)-2H-chromen-2-one (PYC) has been designed and synthesized for the detection of Hg(2+) in the presence of other competing metals in mixed aqueous media. The PYC exhibits naked eye color change from green to red, and the fluorescence color changes from yellowish green to light orange with Hg(2+). It also shows a red shift in wavelength of about 80 nm in absorption spectra. Test strips based on PYC were fabricated, which could act as convenient and efficient Hg(2+) test kits. PMID:24096453

  6. 右半结肠癌误诊为阑尾周围脓肿48例分析%Right colon caner complicated with appendicitis misdiagnosed as appendicular abscess:An analysis of 48 cases

    Institute of Scientific and Technical Information of China (English)

    查保国; 王美华; 王智勇

    2005-01-01

    目的探讨右半结肠癌误诊的原因.方法收集我院近25年间误诊为阑尾周围脓肿的右半结肠癌48例进行回顾性分析.结果本组病例的临床表现与阑尾周围脓肿相似,主要依靠病史和综合检查加以确诊.结论依靠临床表现,重视综合检查和治疗效果,以及动态观察发病情况是减少误诊的关键.

  7. To select whether ultrasonography or CT scan for suspected acute appendicitis%拟诊急性阑尾炎选择超声波检查还是CT检查

    Institute of Scientific and Technical Information of China (English)

    王文利; 张瑜; 郑静华; 刘洁; 陈文婧

    2012-01-01

    目的 回顾性分析比较超声波检查及CT检查诊断急性阑尾炎的准确性.方法 选择同时行超声波检查(US组)及CT检查(CT组)的543例拟诊急性阑尾炎患者,比较两组中阑尾的影像显示率以及急性阑尾炎的影像诊断阳性率,分析两组中诊断急性阑尾炎的各个诊断评价指标.结果 US组与CT组阑尾的影像显示率和急性阑尾炎的影像诊断阳性率比较均没有统计学差异(P>0.05).两组中诊断急性阑尾炎的准确性分别为92.6%与96.7%,Youden指数分别为85.1%与93.5%.肥胖(BMI≥28 kg/m2)及肠胀气多导致了US组较高的假阴性病例,而体重过低(BMI 0. 05 ). The diagnosis accuracy was 92. 6% and 96. 7% , the Youden's index was 85. 1% and 93.5% respectively in US group and in CT group. Obesity( BMI≥28 kg/m 2) and obvious flalulence in US group led to more false negalive cases,yet the lower weight( BMI < 18. 5 kg/m 2) in CT group led to more false negalive cases. However, The appendix display rale of US group was significantly lower in obese cases(P = 0. 00) ,bul higher in lower weight cases(P = 0. 00) than that of CT group. The diagnostic posilive rale of US group in appendix perforation cases which were not forming enclosed mass was higer lhan that of CT group(P < 0. 05). Conclusions For suspecled acule appendicilis in obese or obviously flalulent cases ( excepl pregnant women) ,we suggest clinicians to choose CT scan direclly. If in non-obese or not obviously flalulent cases, then suggest lo choose either ullrasonography or CT scan, but now if in the lower weight cases, choose ullrasonography preferably.

  8. The Niśvāsamukha, the Introductory book of the Niśvāsatattvasaṃhitā: critical edition, with an introduction and annotated translation appended by Śivadharmasaṅgraha 5–9

    OpenAIRE

    Kafle, Nirajan

    2015-01-01

    A single 9th-century Nepalese palm-leaf manuscript transmits what appears to be the oldest surviving Śaiva tantra, called the Niśvāsatattvasaṃhitā. The manuscript consists of five separate books: Niśvāsamukha, Mūlasūtra, Nayasūtra, Uttarasūtra and Guhyasūtra. The Niśvāsamukha, which is divided into four chapters to what the text calls Laukika (lay religion), Vaidika (Vedic), Ādhyātmika (spiritual), and Atimārga (transcendental), serves as the introductory book prefacing the Niśvāsatattvasaṃhi...

  9. Right adrenal abscess -- an unusual complication of acute apendicitis.

    Science.gov (United States)

    Dimofte, Gabriel; Dubei, Liviu; Lozneanu, Lili-Gabriela; Ursulescu, Corina; Grigora Scedil, Mihai

    2004-09-01

    Acute appendicitis represents one of the most frequent abdominal emergencies encountered in everyday surgical practice. Local infectious complications are not unusual and retroperitoneal abscesses after acute retrocaecal appendicitis have been previously described. The authors present the case of a 22-years-young female patient, admitted for a right iliac fossa abscess, secondary to gangrenous appendicitis. A right adrenal mass 35/40 mm was revealed during preoperative ultrasound evaluation, which evolved in an adrenal abscess that spontaneously drained 10 days after appendectomy and retrocecal drainage. Adrenal abscesses are exceptionally rare, with only a few cases being reported in the literature, but none of these after acute appendicitis.

  10. Poverty Children and Reading Curriculum Reform: A Broad Perspective

    Science.gov (United States)

    Rosen, Carl L.

    1970-01-01

    Discusses the inability of the educational system to deal effectively with minority children from poverty backgrounds. Includes suggestions for reading curriculum reform. Appended are 37 references. (AA)

  11. [COMPLICATED AMOEBIC APENDICITIS.REPORT OF A CASE

    Science.gov (United States)

    Casavilca Zambrano, Sandro; Gomez Anchante, Victor; Cisneros Gallegos, Eduardo

    2000-01-01

    We report a case of acute abdomen that is operated with the presumptive diagnosis of complicated acute appendicitis. In the histologic examination we make the diagnosis of complicated amoebic appendicitis. We discuss clinical manifestations and histopathologic findings of this unusual presentation of amoebic infection.

  12. Cesarean Section: The Operation

    Medline Plus

    Full Text Available ... It's been added to your dashboard . '; $("#video-display").html(data); $("title").append(_vidTitle + " | March of Dimes"); $("#main.container > em").append(_vidTitle); $("#vidTitle").html(_vidTitle); $("#vidDesc").html(_vidDesc); $("#vidDuration").html(convert_time(_ ...

  13. Gestational Hypertension and Preeclampsia

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    Full Text Available ... It's been added to your dashboard . '; $("#video-display").html(data); $("title").append(_vidTitle + " | March of Dimes"); $("#main.container > em").append(_vidTitle); $("#vidTitle").html(_vidTitle); $("#vidDesc").html(_vidDesc); $("#vidDuration").html(convert_time(_ ...

  14. At Least 39 Weeks

    Medline Plus

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  15. Exercise during Pregnancy

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  16. Labor and Delivery: At the Hospital

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  17. Folic Acid

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  18. Healthy Choices: What to Eat during Pregnancy

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  19. Alcohol and Pregnancy

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  20. Gestational Diabetes

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  1. Cesarean Section: Recovering After Surgery

    Medline Plus

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  2. A Dynamic Supramolecular System Exhibiting Substrate Selectivity in the Catalytic Epoxidation of Olefins

    DEFF Research Database (Denmark)

    Jonsson, Stefan; Odille, Fabrice G. J.; Norrby, Per-Ola;

    2005-01-01

    A dynamic supramolecular system involving hydrogen bonding between a Mn(III) salen catalyst and a Zn(II) porphyrin receptor exhibits selectivity for pyridine appended cis-beta-substituted styrene derivatives over phenyl appended derivatives in a catalytic epoxidation reaction....

  3. The management of right iliac fossa pain - is timing everything?

    LENUS (Irish Health Repository)

    McCartan, D P

    2012-01-31

    BACKGROUND: Right iliac fossa (RIF) pain remains the commonest clinical dilemma encountered by general surgeons. We prospectively audited the management of acute RIF pain, examining the relationship between symptom duration, use of pre-operative radiological imaging and patient outcome. METHODS: Over a six-month period, 302 patients, median age 18 years, 59% female, were admitted with RIF pain. Symptoms, clinical findings and laboratory results were documented. Patient management, timing of radiological investigations and operations, and outcome were recorded prospectively. RESULTS: Non-specific abdominal pain (26%), gynaecological (22%) and miscellaneous causes (14%) accounted for most admissions. Ultimately, 119 patients (39%) had appendicitis. Anorexia, tachycardia or rebound tenderness in the RIF significantly predicted a final diagnosis of appendicitis. Patients with perforated appendicitis (n = 29) had a longer duration of pre-hospital symptoms (median 50h) compared to those with simple appendicitis (median 17 h) (p<0.001). The use of pre-operative imaging resulted in an increased time to surgery but was not associated with increased post-operative morbidity or perforated appendicitis. CONCLUSION: The majority of patients presenting to hospital with RIF pain did not have appendicitis. Increased duration of pre-hospital symptoms was the main factor associated with perforated appendicitis. However, increased in-hospital time to theatre was not associated with perforated appendicitis or post-operative morbidity.

  4. Exercises in Computational Chemistry

    DEFF Research Database (Denmark)

    Spanget-Larsen, Jens

    2016-01-01

    A selection of HyperChem© PC-exercises in computational chemistry. Answers to most questions are appended (Roskilde University 2014-16).......A selection of HyperChem© PC-exercises in computational chemistry. Answers to most questions are appended (Roskilde University 2014-16)....

  5. An exceptional cause of left lower quadrant abdominal pain

    Institute of Scientific and Technical Information of China (English)

    Bassam Abboud; Ronald Daher

    2009-01-01

    Acute appendicitis is an exceptional cause of left lower quadrant abdominal pain. Computed tomography scan is the key to its diagnosis and helps to establish its early treatment. We present a case of a 35-year-old male patient who presented acute appendicitis with redundant and loosely attached cecum which was diagnosed based on his left lower quadrant abdominal pain.

  6. 语文词典义项设立的专门与顺带∗--外来义项增列模式探讨%Establishment of Specific and Incidental Senses in Philological Dictionaries:A Study of the Patterns of Appending Borrowed Senses

    Institute of Scientific and Technical Information of China (English)

    周荐

    2016-01-01

    现代汉语语文工具书中条目的义项之设立,做法并不完全一致,而存在着专门设立、顺带设立两种情形。义项专门设立的情况在语文工具书里较为普遍,毋庸多论;义项顺带设立的情况在语文工具书里显得较为复杂,需要仔细研究。义项顺带设立的问题,在汉语语文工具书收立非汉语义项———外来义项时,表现得尤其突出。弄清这一问题,对于认清汉语词目中一些义项的增收模式,认清词典条目一些词项、义项设立的规律,都具有重要的价值和意义。%The methods of the establishment of meaning entries vary in modern Chinese language reference books,which is shown in two scenarios:special and incidental set-ups.Doubtless,special set-up of meaning entries in language reference books is more common,but incidental set-up of mean-ing entries is a more complex issue which requires more careful study.The problem in the latter case becomes particularly conspicuous when it comes to set-up of entries of non-Chinese meanings,collect-ed in Chinese language reference books.It is of great value and significance to clarify this issue,un-derstand the patterns of increasing the meaning entries of Chinese headwords and find out the rules of establishing oflexical entries and sense entries.

  7. Abdome agudo por apendicite com apresentação atípica levando a choque em paciente obeso e hepatopata crônico = Acute abdomen due appendicitis with atypical presentation leading to shock in an obese patient and with chronic liver disease

    Directory of Open Access Journals (Sweden)

    Todescatto, Alexandra Damasio

    2014-01-01

    Conclusões: O quadro de abdome agudo tem grande incidência nas unidades de pronto atendimento e, uma vez que compreende inúmeras situações clínicas, faz-se imprescindível conhecer e suspeitar de suas principais causas e de suas apresentações atípicas, de difícil diagnóstico.

  8. Abdome agudo por apendicite com apresentação atípica levando a choque em paciente obeso e hepatopata crônico =Acute abdomen due appendicitis with atypical presentation leading to shock in an obese patient and with chronic liver disease

    OpenAIRE

    Todescatto, Alexandra Damasio

    2014-01-01

    Objetivos: Expor um caso de abdome agudo por apendicite cujo diagnóstico apresentou-se difícil e complicado devido ao perfil do paciente e suas comorbidades. Descrição do Caso: Paciente masculino, 52 anos, superobeso, tabagista e hepatopata crônico, com queixa de dor abdominal aguda em hipocôndrio direito, vômitos e baixa diurese. Inicialmente sem sinais de irritação peritoneal, foi manejado clinicamente, mas apresentou piora do quadro, evoluindo para choque e parada cardiorrespiratória. E...

  9. Utilidad de la tomografía computada en pacientes con dolor en fosa iliaca derecha: Apendicitis aguda y su diagnóstico diferencial Usefulness of computed tomography in patients with right inferior abdominal quadrant pain: acute appendicitis and its alternative diagnosis

    OpenAIRE

    Sebastián Atilio Rossini; Diego Haberman; Rubén F. González Villaveirán

    2009-01-01

    Propósito: Repasar los hallazgos de tomografía computada (TC) de la apendicitis aguda, sus complicaciones y diagnósticos diferenciales. Evaluar la utilidad de la tomografía computada helicoidal (TCH) en el diagnóstico de la apendicitis aguda y en el manejo de los pacientes con abdomen agudo de fosa iliaca derecha, tanto en la determinación de un diagnóstico, como de sus complicaciones, que permitan tomar una medida terapéutica. Materiales y métodos: Estudio de cohorte retrospectivo realizado ...

  10. An appending study of the stele with images the Gods of Zoroastrianism and inscriptions erected by Ru Xiaoce leading a hundred members of a country society in Northern Wei Dynasty%北魏茹小策合邑一百人造像碑补考

    Institute of Scientific and Technical Information of China (English)

    施安昌

    2003-01-01

    本文记述了作者到西安碑林目睹此碑之后的进一步研究.认为碑上刻有老子、阿胡拉·马兹达和佛三圣像,突出了祭拜圣火、礼赞胡摩(haoma)等图像,与题记讲的设盦敬袄相互吻合.

  11. A Re -inquiry on "Private Land" in Wilderness Rules Which Appended to" Land Decrees in Tang Dynasty" of "Tiansheng Rule · Land Decrees"--A Discussion with Mr. Yang Jiping%《天圣令·田令》所附唐田令荒废条"私田"的再探讨--与杨际平先生商榷

    Institute of Scientific and Technical Information of China (English)

    何东

    2006-01-01

    唐律令里的"公-私"是一对与"官-民"比较接近的概念.两者间很难找出实质性的差异.唐代的律令里见不到公-民、官-民的用法,也见不到"民田"的用语,而将民田一律称为私田.因此,认为"私"即私有权,"私田"就是土地私有的看法有问题.根据"此谓永业、口分之外,别能垦起公私荒田者"不能得出这只能是均田制体系外的农民私有田地的结论.比如,田令规定的赐田、勋田都是口分、永业之外的私田.如果荒了,就是永业、口分田之外的私荒田,这和均田制体系内外没有关系.

  12. 输尿管软镜下钬激光碎石术治疗上尿路结石——附126例报告%Treatment of Upper Urinary Calculi with Holmium Laser Lithotriptor under Flexible Ureteroscope (Appended with Report of 126 Cases)

    Institute of Scientific and Technical Information of China (English)

    周振宇; 何朝晖; 杨江根; 曾国华

    2013-01-01

    Objective To evaluate the clinical effect of holmium laser with flexible ureteroscope on upper urinary calculi.Methods All 126 patients of upper urinary calculi were treated with Holmium laser lithotriptor under flexible ureteroscope in our hospital.Of them,75 patients had calculi in the right side and 51 patients in the left side.The calculi were in the kidney for 64 patients,in the upper ureteral for 33 patients,and both in the upper ureteral and kidney for 29 patients.The diameter of the calculi ranged 0.6-2.0 cm,mean 1.33 cm.After ureter dilation and placement of ureteral access sheath,the stone were fragmented and removed with 200μm Ho ∶ YAG laser fiber,energy 0.8-1.0 J,frequency 5-10 Hz.Results The successful rate of stone fragmentation after single session was 92.86% (117/126).Mean operation time was 48 min(23-71 min).Six patients had low fever after the operation.Neither ureteral perforation nor pyonephrosis was observed.Conclusions The therapy of Holmium laser lithotriptor under flexible ureteroscope is safe and effective for upper urinary calculi,especially for upper ureteral,pelvis,middle calyx and upper calyx stones.%目的 探讨输尿管软镜下钬激光碎石术治疗上尿路结石的疗效.方法 上尿路结石患者126例,其中右侧结石75例,左侧结石51例.输尿管上段结石33例,输尿管上段合并肾结石29例,肾结石64例.结石大小0.6 ~2.0 cm,平均1.33 cm.经输尿管硬镜扩张后留置输尿管扩张鞘寻找结石,采用输尿管软镜下钬激光碎石术治疗,光纤直径200μm,能量0.8~1.0J,频率5~10Hz.结果 单次碎石成功117例(占92.86%),手术时间25~ 75 min,平均48 min.术后6例出现低热,无脓肾、输尿管穿孔等并发症.结论 输尿管软镜下钬激光碎石术治疗上尿路结石安全有效,尤其适用于输尿管上段、肾盂、肾中盏及肾上盏结石.

  13. Appendagitis following Diagnostic Laparoscopy and Laparoscopic Appendicectomy

    Directory of Open Access Journals (Sweden)

    R. Kumar

    2016-01-01

    Full Text Available Appendagitis is an uncommon clinical entity, often not recognised, and mistaken for more serious infective conditions. We describe a proven case of appendagitis which occurred after confirmed appendicitis. We postulate that this condition can coexist with appendicitis and indeed may be the result of coinflammation. This has several implications. Firstly, clinicians must retain an index of suspicion for this condition in a patient with localised abdominal pain which occurs after appendicitis. Secondly, it would be reasonable to suggest careful examination of colocated appendages in a patient with an otherwise normal-appearing appendix. Treatment might require laparoscopic resection, as performed in this case.

  14. A Preterm Birth Caused By Postoperative Peritonitis and Peritoneal Abscess

    Directory of Open Access Journals (Sweden)

    Sukru Yildiz

    2013-08-01

    Full Text Available Appendicitis is the most common condition leading to an intraabdominal operation for a non obstetric problem in pregnancy and diagnosis of appendicitis is complicated by the physiologic and anatomic changes that occur during pregnancy. Although a surgical procedure carries the risk of fetal loss or preterm delivery, delay in diagnosis also increases the risk of complications in both mother and fetus. The following case illustrates our experience and to analyze clinical characteristic and the pregnancy outcome of appendicitis during the third trimester of pregnancy. [Cukurova Med J 2013; 38(4.000: 751-753

  15. Technical Problems in Implementing University-Level Computer-Assisted Instruction in Mathematics and Science: First Annual Report. Technical Report No. 293.

    Science.gov (United States)

    Blaine, Lee; And Others

    Difficulties in implementing the EXCHECK/VOCAL System, a general program for mathematics instruction written in the VOCAL language, are presented in terms of informal mathematics procedures, audio and prosodic features, and proposed research. References are appended. (CMV)

  16. Abdominal exploration

    Science.gov (United States)

    ... you when to arrive at the hospital. Outlook (Prognosis) You should be able to start eating and ... Read More Acute Adhesion Appendicitis Biopsy Cancer Chronic pancreatitis CT scan Diverticulitis Ectopic pregnancy Endometriosis Hodgkin lymphoma ...

  17. Randomized clinical trial of laparoscopic versus open appendicectomy

    DEFF Research Database (Denmark)

    Pedersen, Allan Gorm; Petersen, O B; Wara, P;

    2001-01-01

    BACKGROUND: Laparoscopy in patients with a clinical suspicion of acute appendicitis has not gained wide acceptance, and its use remains controversial. METHODS: In a randomized controlled trial of laparoscopic versus open appendicectomy, 583 of 828 consecutive patients consented to participate...

  18. Can the Librarian Become a Computer Data Base Manager?

    Science.gov (United States)

    Landau, Herbert B.

    1971-01-01

    Librarians must become skilled in the language and techniques of computer systems and data management in order to administer large machine readable files of information. An annotated bibliography for a self-education program is appended. (Author/AB)

  19. TTVP Audit Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The data set contains information on retail market spot check audit purchases. Data are available from May 2001 to present with new data appended annually....

  20. EPA Region 1 - New England Towns, with Population

    Data.gov (United States)

    U.S. Environmental Protection Agency — The New England Town Boundary coverage is a compilation of coverages received from the six New England State GIS Offices. The EPA New England GIS Center appended...

  1. Human trafficking in Europe : an economic perspective

    OpenAIRE

    Liemt, Gijsbert van

    2004-01-01

    Focuses on irregular migration for sexual and labour exploitation in context with activities that can be relocated and those that cannot. Considers the growth of organised crime involvement, and appends a list of smuggling fees into and in Europe.

  2. Computer Program NIKE

    DEFF Research Database (Denmark)

    Spanget-Larsen, Jens

    2014-01-01

    FORTRAN source code for program NIKE (PC version of QCPE 343). Sample input and output for two model chemical reactions are appended: I. Three consecutive monomolecular reactions, II. A simple chain mechanism...

  3. 2010 Census Blocks with Geographic Codes Southwestern PA

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This file can be used as a tool to append geographic codes to geocoded point data. The file was developed by Pitt's Center for Social and Urban Research and...

  4. Mathematics and Meteorology: Perfect Partners.

    Science.gov (United States)

    Bomeli, Cynthia L.

    1991-01-01

    The integration of science and mathematics in the middle school using the topic of meteorology is discussed. Seven selected activities for this approach are suggested. Lists of materials and resources for use in this teaching approach are appended. (CW)

  5. Simulation of a Novel Bipolar-FET Type-S, Negative Resistance Circuit

    Directory of Open Access Journals (Sweden)

    Umesh Kumar

    2003-01-01

    Full Text Available A new circuit which uses FET and bipolar transistor is given. It exhibits Type-S differential negative resistance and a theoretical explanation is appended along with PSPICE simulation.

  6. New Mexico geothermal commercialization planning. Semi-annual progress report, January 1, 1979-June 30, 1979

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez, P.; Scudella, G.; Fedor, D.

    1979-06-01

    The market potential for geothermal energy development in New Mexico is estimated. Barriers to market penetration and geothermal development initiatives were identified. Statutes and regulations affecting geothermal development are appended.

  7. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    Full Text Available ... to someone having appendicitis is really a basic service that one needs, really, to consider one’s self- ... of the care in Haiti is fee-for-service. And so whenever -- you know, he spent many, ...

  8. A Comparison of Community and Hospital Pharmacy Preceptors.

    Science.gov (United States)

    Brown, Charles H.

    1978-01-01

    A preliminary study that seeks to determine, quantitatively and qualitatively, the effectiveness of externship preceptors in training Purdue University students to practice pharmacy in community and hospital environments is described. Variables that can effect externships are appended. (JMD)

  9. Electrostatics and confinement in Einstein's unified field theory

    OpenAIRE

    Antoci, S.; Liebscher, D. -E.; Mihich, L.

    2007-01-01

    A way for appending sources at the right-hand sides of the field equations of Einstein's unified field theory is recalled. Two exact solutions endowed with point sources in equilibrium are shown, and their physical meaning is discussed.

  10. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    Full Text Available ... of looks a little bit like a spider web. 5 I think what we’ll see right ... to someone having appendicitis is really a basic service that one needs, really, to consider one’s self- ...

  11. Giant appendicolith: Rare finding in a common ailment

    Directory of Open Access Journals (Sweden)

    Sanjeev Singhal

    2016-01-01

    Full Text Available Acute appendicitis is one of the commonest surgical emergencies worldwide. There is considerable variation in prevalence of appendicoliths with appendicitis. Most of the patients with appendicoliths are asymptomatic and they are not pathognomic for acute appendicitis. However, appendicoliths show increased association with perforation and abscess formation. Appendicolith are quite common, being present in 3% of general population and in nearly 10% cases of appendicitis. However, giant appendicoliths measuring over 2 centimeters (cms are extremely rare. Computed Tomography (CT has increased their pre-operative diagnosis considerably. Use of spectral analysis can give us the details of composition of the stone pre-operatively. We present a young male diagnosed pre-operatively on Non-Contrast Computed Tomography (NCCT to have a giant calcium struvite appendicolith. On laparoscopy he had a 3 cm stone and an incidental Meckel's diverticulum and underwent appendectomy. The case is presented for the unique size of the appendicolith alongwith review of literature.

  12. Random Thoughts--In Search for Answers

    Science.gov (United States)

    Sobelman, C. P.

    1976-01-01

    This paper discusses the problem of textbook selection for Chinese instruction, and considers the role of Chinese language teachers and content of Chinese courses. Lists of supplementary materials for PRC and DeFrancis texts are appended. (CHK)

  13. Pyogenic liver abscess

    Science.gov (United States)

    Liver abscess; Bacterial liver abscess ... There are many potential causes of liver abscesses, including: Abdominal infection, such as appendicitis , diverticulitis , or a perforated bowel Infection in the blood Infection of the bile draining tubes ...

  14. Belly Pain

    Science.gov (United States)

    ... appendicitis, you will need an operation called an appendectomy. If stress seems to be causing your stomach ... Terms of Use Visit the Nemours Web site. Note: All information on KidsHealth® is for educational purposes ...

  15. Computational Astrophysics Consortium 3 - Supernovae, Gamma-Ray Bursts and Nucleosynthesis

    Energy Technology Data Exchange (ETDEWEB)

    Woosley, Stan [Univ. of California, Santa Cruz, CA (United States)

    2014-08-29

    Final project report for UCSC's participation in the Computational Astrophysics Consortium - Supernovae, Gamma-Ray Bursts and Nucleosynthesis. As an appendix, the report of the entire Consortium is also appended.

  16. Incorporating Cobalt Carbonyl Moieties onto Ethynylthiophene-Based Dithienylcyclopentene Switches. 1. Photochemistry

    NARCIS (Netherlands)

    Harvey, Emma C.; Areephong, Jetsuda; Cafolla, Attilio A.; Long, Conor; Browne, Wesley R.; Pryce, Mary T.; Feringa, Bernard

    2014-01-01

    The synthesis and characterization of a series of dithienyl perhydro- and perfluorocyclopentene photochromic molecular switches appended with cobalt carbonyl binding 3-ethynylthiophene and phenyl-3-ethynylthiophene substituents are reported. Their photochromic properties, fatigue resistance, and the

  17. Lev D. Landau: his life and work

    International Nuclear Information System (INIS)

    A biographical portrait of the Soviet theoretical physicist as presented at a CERN Colloquium in June 1978. A selected list of 39 scientific papers, and 18 references to his work in books and articles, are appended. (Auth.)

  18. Caecal-caecal intussusception caused by Trichuris trichiura in a young healthy adult.

    Science.gov (United States)

    To, Kelvin K W; Cheng, Vincent C C; Hung, Ivan F N; Tang, Bone S F; Wong, Samson S Y; Yuen, Kwok-Yung

    2006-01-01

    Trichuris trichiura is a worldwide problem affecting millions of people. We report an unusual case of intussusception caused by T. trichiura that mimics acute appendicitis. The literature on T. trichiura associated intussusception is reviewed.

  19. Autonomic Dysreflexia

    Science.gov (United States)

    ... blockage in the urinary drainage device, inadequate bladder emptying, bladder spasms, or possibly stones in the bladder. ... overstimulation can trigger AD. Severe abdominal conditions like gastric ulcers and appendicitis are possible triggers. Broken bones ...

  20. A Short History of the Computer.

    Science.gov (United States)

    Reid-Green, Keith

    1981-01-01

    Beginning with Blaise Pascal's adding machine (1642), a brief look is taken at mechanical computers, electronic developments, transistors, and first, second, and third generation computers. A glossary is appended. (KC)

  1. Setting Up a Library Accessible Area for the Blind or Visually Impaired: Considerations.

    Science.gov (United States)

    Henson, Dawn

    1997-01-01

    Discusses library planning for services for blind and visually impaired users, including access needs of patrons, available library space, appropriate adaptive technology, equipment costs and budget resources, Internet access, and staff training. A list of pertinent resources is appended. (LRW)

  2. Giant appendicolith: Rare finding in a common ailment

    Science.gov (United States)

    Singhal, Sanjeev; Singhal, Anu; Mahajan, Harsh; Prakash, Brahm; Kapur, Sunil; Arora, Pankaj K.; Tiwari, Bishwanath; Sethi, Punit

    2016-01-01

    Acute appendicitis is one of the commonest surgical emergencies worldwide. There is considerable variation in prevalence of appendicoliths with appendicitis. Most of the patients with appendicoliths are asymptomatic and they are not pathognomic for acute appendicitis. However, appendicoliths show increased association with perforation and abscess formation. Appendicolith are quite common, being present in 3% of general population and in nearly 10% cases of appendicitis. However, giant appendicoliths measuring over 2 centimeters (cms) are extremely rare. Computed Tomography (CT) has increased their pre-operative diagnosis considerably. Use of spectral analysis can give us the details of composition of the stone pre-operatively. We present a young male diagnosed pre-operatively on Non-Contrast Computed Tomography (NCCT) to have a giant calcium struvite appendicolith. On laparoscopy he had a 3 cm stone and an incidental Meckel's diverticulum and underwent appendectomy. The case is presented for the unique size of the appendicolith alongwith review of literature. PMID:27073312

  3. When and why use unenhanced computed tomography in patients with acute abdomen; Tomografia computadorizada sem contraste intravenoso no abdome agudo: quando e por que usar

    Energy Technology Data Exchange (ETDEWEB)

    Freire Filho, Edison de Oliveira; D' Ippolito, Giuseppe; Szejnfeld, Jacob [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Diagnostico por Imagem]. E-mail: eofilho@ig.com.br; Jesus, Paulo Eduardo Marinho de [Clinica Radiologica de Anapolis, GO (Brazil)

    2006-01-15

    The use of unenhanced computed tomography has been frequently recommended for the initial assessment of patients with clinical suspicion of acute abdomen instead of other diagnostic methods. The authors present a review of the literature on the main aspects, advantages, limitations and efficacy of unenhanced computed tomography for the diagnosis of acute appendicitis, renal colic, diverticulitis, acute pancreatitis, primary epiploic appendicitis, pneumoperitoneum and small bowel obstruction. The advantages and limitations of this technique are also discussed. (auth0008.

  4. When and why use unenhanced computed tomography in patients with acute abdomen

    International Nuclear Information System (INIS)

    The use of unenhanced computed tomography has been frequently recommended for the initial assessment of patients with clinical suspicion of acute abdomen instead of other diagnostic methods. The authors present a review of the literature on the main aspects, advantages, limitations and efficacy of unenhanced computed tomography for the diagnosis of acute appendicitis, renal colic, diverticulitis, acute pancreatitis, primary epiploic appendicitis, pneumoperitoneum and small bowel obstruction. The advantages and limitations of this technique are also discussed. (author)

  5. Appendiceal diameter: CT versus sonographic measurements

    Energy Technology Data Exchange (ETDEWEB)

    Orscheln, Emily S. [University of Cincinnati Medical Center, Department of Radiology, Cincinnati, OH (United States); Trout, Andrew T. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States)

    2016-03-15

    Ultrasound and CT are the dominant imaging modalities for assessment of suspected pediatric appendicitis, and the most commonly applied diagnostic criterion for both modalities is appendiceal diameter. The classically described cut-off diameter for the diagnosis of appendicitis is 6 mm when using either imaging modality. To demonstrate the fallacy of using the same cut-off diameter for both CT and US in the diagnosis of appendicitis. We conducted a retrospective review of patients younger than 18 years who underwent both US and CT of the appendix within 24 h. The shortest transverse dimension of the appendix was measured at the level of the proximal, mid and distal appendix on US and CT images. We compared mean absolute difference in appendiceal diameter between US and CT, using the paired t-test. We reviewed exams of 155 children (58.7% female) with a mean age of 11.3 ± 4.2 years; 38 of the children (24.5%) were diagnosed with appendicitis. The average time interval between US and CT was 7.0 ± 5.4 h. Mean appendiceal diameter measured by CT was significantly larger than that measured by US in cases without appendicitis (5.3 ± 1.0 mm vs. 4.7 ± 1.1 mm, P < 0.0001) and in cases with appendicitis (8.3 ± 2.2 mm vs. 7.0 ± 2.0 mm, P < 0.0001). Mean absolute diameter difference at any location along the appendix was 1.3-1.4 mm in normal appendices and 2 mm in cases of appendicitis. Measured appendiceal diameter differs between US and CT by 1-2 mm, calling into question use of the same diameter cut-off (6 mm) for both modalities for the diagnosis of appendicitis. (orig.)

  6. Synthesis of 3,3-Spiroindolines via FeCl3-Mediated Cyclization of Aryl- or Alkene-Containing 3-Substituted N-Ac Indoles.

    Science.gov (United States)

    Nandi, Raj Kumar; Guillot, Régis; Kouklovsky, Cyrille; Vincent, Guillaume

    2016-04-15

    We report the cyclization of 3-substituted N-acetylindoles for the straightforward synthesis of 3,3-spiroindolines via the Friedel-Crafts reaction of an appended aryl group or the formal [2 + 2] cycloaddition of an appended alkene. Our strategy involves an Umpolung of the C2═C3 bond of the indole nucleus during FeCl3-mediated hydroarylation or annulation reactions. PMID:27015315

  7. Biomimetic supramolecular metallohosts for binding and activation of dioxygen

    OpenAIRE

    Sprakel, Vera Stefanie Irene

    2004-01-01

    Host-guest chemistry involves the binding of a specific substrate in a receptor via molecular recognition based on supramolecular interactions. Metal-containing derivatives of receptors for the selective supramolecular binding of dihydroxybenzene substrates, which receptors model oxygen binding enzymes both in structure and in function are described in this thesis with the ultimate goal to realize biomimetic catalysis. A PY2-appended receptor 1 and a TPA-appended receptor 2 and the bis-copper...

  8. Evaluation of Right Iliac Fossa Pain with Reference to Alvarado Score – Can We Prevent Unnecessary Appendicectomies?

    Directory of Open Access Journals (Sweden)

    P. D. Gurav

    2013-07-01

    Full Text Available Background: Appendicectomy for acute appen-dicitis is the most common surgical cause ofemergency laparotomy throughout the world.Acute appendicitis is a clinical diagnosis; theaccuracy of clinical examination has been re-ported from 71 to 97% and varies greatly de-pending upon the experience of the examiner.The treatment being surgical, negative appen-dicectomy rates are high. Aim and Objective:Present study was conducted to evaluateAlvarado Scoring system for diagnosis of acuteappendicitis and its co-relation by histopathol-ogy. Material and Methods: Prospective studyof consecutive patients admitted with suspectedacute appendicitis during the period of July2011 to December 2012 was undertaken.Alvarado Score of each patient was calculated.Out of 130, 95 patients had histologicallyproven acute appendicitis. Reliability of scor-ing system was assessed by calculating posi-tive predictive value and negative appendicec-tomy rate. Results and Conclusion: The posi-tive predictive value was 88.37% and negativeappendicectomy rate was 11.63% (with respectto Alvarado score > 7. Alvarado Scoring sys-tem is easy, simple, cheap, useful tool in pre-operative diagnosis of acute appendicitis.

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

    International Nuclear Information System (INIS)

    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. 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. 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. 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. 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. (orig.)

  10. NOD2/CARD15 genotype and common gastrointestinal diseases in 43 600 individuals

    DEFF Research Database (Denmark)

    Yazdanyar, S.; Nordestgaard, B.G.

    2010-01-01

    appendicitis, 646 irritable bowel syndrome, 1301 infectious diseases of the gastrointestinal tract, 681 anal fissure, fistula and abscess, 826 gastrointestinal cancer and 161 developed cancer in liver and pancreas. Results. Some 89% were non-carriers, 11% heterozygotes, 0.15% homozygotes and 0.23% compound...... heterozygotes. Cumulative incidences differed by genotype for appendicitis (log-rank P = 0.02), anal fissure, fistula and abscess (P = 0.003) and gastrointestinal cancer (P = 0.004), but not for any of the other endpoints. Compared with non-carriers, age and sex adjusted hazard ratios were 2.7 (95% CI 1.......4-5.5) for appendicitis amongst compound heterozygotes, 3.2 (1.3-7.8) for anal fissure, fistula and abscess amongst compound heterozygotes, and 3.8 (1.6-9.2) for gastrointestinal cancer amongst homozygotes, whilst other genotypes did not have increased risk. The increased risk of gastrointestinal cancer amongst...

  11. Streptococcus milleri in the appendix.

    Science.gov (United States)

    Poole, P M; Wilson, G

    1977-10-01

    The appendix was investigated as a possible habitat of Streptococcus milleri. Both normal and inflamed appendices were examined and the isolation rates compared. S. milleri was present in a quarter of the normal appendices and more than half of those associated with apendicitis--a difference that was statistically highly significant. The isolation rates throughout were indepencent of age. There was a pronounced connection between the presence of S. milleri in the appendix and the purulent manifestations of appendicitis. S. milleri was isolated from other abdominal sites associated with appendicitis. The frequency of isolation was increased by culture in an enrichment broth containing nalidixic acid and sulphadimidine.

  12. Solar-parabolic dish-Stirling-engine-system module. Task 1: Topical report, market assessment/conceptual design

    Energy Technology Data Exchange (ETDEWEB)

    1982-11-30

    The major activities reported are: a market study to identify an early market for a dish-Stirling module and assess its commercial potential; preparation of a conceptual system and subsystem design to address this market; and preparation of an early sales implementation plan. A study of the reliability of protection from the effects of walk-off, wherein the sun's image leaves the receiver if the dish is not tracking, is appended, along with an optical analysis and structural analysis. Also appended are the relationship between PURPA and solar thermal energy development and electric utility pricing rationale. (LEW)

  13. Primary bacterial peritonitis in otherwise healthy children: imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Dann, Phoebe H.; Amodio, John B.; Rivera, Rafael; Fefferman, Nancy R. [New York University School of Medicine, Department of Radiology, New York (United States)

    2005-02-01

    We report the imaging findings of two recent cases of primary bacterial peritonitis in otherwise healthy children with a clinical presentation mimicking acute appendicitis. Primary bacterial peritonitis is rare in the absence of underlying systemic disease. Although it has been described in the pediatric literature, the imaging findings have not been described in the radiological literature to the best of our knowledge. With imaging playing an increasing role in the evaluation of appendicitis in children, it is important for the radiologist to be familiar with this inflammatory process. (orig.)

  14. Detectability of the appendix with multidetector-row CT scanning and multiplanar reconstruction

    International Nuclear Information System (INIS)

    Twenty-six consecutive patients with the clinical diagnosis of appendicitis underwent multidetector-row CT (MD-CT) in order to detect entire longitudinal configuration of the appendix. While axial CT failed to detect the appendix in 7 patients, multiplanar reconstruction (MPR) demonstrated a longitudinal tubular structure continuous from the cecal caput in 25 patients (96.2%), including 7 patients whose post-surgical pathology were available. It is summarized that scanning and MPR images are advantageous to finding inflammatory processes in the appendix when the diagnosis of appendicitis remains ambiguous even with US. (author)

  15. Primary bacterial peritonitis in otherwise healthy children: imaging findings

    International Nuclear Information System (INIS)

    We report the imaging findings of two recent cases of primary bacterial peritonitis in otherwise healthy children with a clinical presentation mimicking acute appendicitis. Primary bacterial peritonitis is rare in the absence of underlying systemic disease. Although it has been described in the pediatric literature, the imaging findings have not been described in the radiological literature to the best of our knowledge. With imaging playing an increasing role in the evaluation of appendicitis in children, it is important for the radiologist to be familiar with this inflammatory process. (orig.)

  16. Unusual Presentation of Dengue Fever Leading to Unnecessary Appendectomy.

    Science.gov (United States)

    Kumar, Lovekesh; Singh, Mahendra; Saxena, Ashish; Kolhe, Yuvraj; Karande, Snehal K; Singh, Narendra; Venkatesh, P; Meena, Rambabu

    2015-01-01

    Dengue fever is the most important arbovirus illness with an estimated incidence of 50-100 million cases per year. The common symptoms of dengue include fever, rash, malaise, nausea, vomiting, and musculoskeletal pain. Dengue fever may present as acute abdomen leading to diagnostic dilemma. The acute surgical complications of dengue fever include acute pancreatitis, acute acalculous cholecystitis, nonspecific peritonitis, and acute appendicitis. We report a case of dengue fever that mimicked acute appendicitis leading to unnecessary appendectomy. A careful history examination for dengue-related signs, and serial hemogram over the first 3-4 days of disease may prevent unnecessary appendectomy. PMID:26167314

  17. Unusual Presentation of Dengue Fever Leading to Unnecessary Appendectomy

    Directory of Open Access Journals (Sweden)

    Lovekesh Kumar

    2015-01-01

    Full Text Available Dengue fever is the most important arbovirus illness with an estimated incidence of 50–100 million cases per year. The common symptoms of dengue include fever, rash, malaise, nausea, vomiting, and musculoskeletal pain. Dengue fever may present as acute abdomen leading to diagnostic dilemma. The acute surgical complications of dengue fever include acute pancreatitis, acute acalculous cholecystitis, nonspecific peritonitis, and acute appendicitis. We report a case of dengue fever that mimicked acute appendicitis leading to unnecessary appendectomy. A careful history examination for dengue-related signs, and serial hemogram over the first 3-4 days of disease may prevent unnecessary appendectomy.

  18. 16 CFR 260.5 - Interpretation and substantiation of environmental marketing claims.

    Science.gov (United States)

    2010-01-01

    ... deceptive or unsubstantiated environmental advertising claims. A current list of environmental marketing... substantiation of environmental marketing claims. Section 5 of the FTC Act makes unlawful deceptive acts and... Statement on the Advertising Substantiation Doctrine. 49 FR 30999 (1984); appended to Thompson Medical...

  19. Gender Differences in Workplace Communication: A Seminar Outline.

    Science.gov (United States)

    Kenton, Sherron B.

    1990-01-01

    Presents an outline for a half-day seminar on gender differences in workplace communication, which can be modified for a class lecture/workshop in a graduate management communication or an undergraduate business communication course. Appends a role-play activity for use in the seminar. (SR)

  20. Healthy Choices: What to Eat during Pregnancy

    Medline Plus

    Full Text Available ... positions State advocacy Federal advocacy Victories & achievements Research & data Tools & Resources Frequently asked questions Peristats Nursing programs ... been added to your dashboard . '; $("#video-display").html(data); $("title").append(_vidTitle + " | March of Dimes"); $("#main.container > ...