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At least 217 records · Page 12Linked to original sources
PubMed1998

[Ileocolonic pouch with appendix in situ through umbilicus as a continent conduit].

OBJECTIVE: To try to use appendix in situ without any special treatment as a conduit of the continent cutaneous ileocolonic reservoir. METHODS: An isolated ileocolonic segment, about 20 cm of terminal ileum and 20 cm of ascending colon, was detubularized by antimensenteric splitting and a pouch was completed by side-to-side anastomosis of the colon and the ileum loop. Both ureters were implanted into two separate submucosal tunnels of 3 cm long into the colon wall of the pouch. The appendix after tail was amputated was passed through the umbilicus hole with which the base of the cecum was sutured. RESULTS: As a conduit of the pouch, the appendix had a good continent ability when 8 patients were followed up for 10 to 30 months after operation. It was easy and convenient for the patients to make self-catheterization. The mean capacities of the pouch were 500-700 ml and then the pressures were 20-45 cm H2O while it was filled. There were no definite complications such as urine leakage, stoma stenosis, ureter reflux, and hydroureteronephrosis. CONCLUSION: The operation of the ileocolonic pouch with the appendix as a continent umbilical stoma is simple and easy to perform and has such advantages as good continent, convenient self-catheterization and provides a quality life for the patients undergoing total cystectomy.

Adult↗
PubMed1975

Mucoceles of the appendix. Their relationship to hyperplastic polyps, mucinous cystadenomas, and cystadenocarcinomas.

Sixty-four cases of hyperplastic polyp, mucinous cystadenoma, and cystadenocarcinoma of the appendix were studied in relation to the development of mucocele and "pseudomyxoma peritonei." Thirty-three cases were examples of hyperplastic polyps. In 11, the appendix was transformed into a mucocele; eight were associated with mucinous cystadenoma and one with mucinous cystadenocarcinoma. The hyperplastic polyp alone was the cause of mucocele formation in two. Thirty-five cases represented examples of mucinous cystadenoma; 32 resulted in mucocele formation. Rupture with localized pseudomyxoma peritonei was found in six; generalized pseudomyxoma peritonei was encountered only once. In four of the five cases of mucinous cystadenocarcinoma, the appendix was grossly transformed into mucoceles. The histological features of mucinous cystadenoma are identical to villous adenoma of the large bowel and probably represent its counterpart within the appendix.

Aged↗
PubMed2005

Evaluation of the normal appendix at low-dose non-enhanced spiral CT.

PURPOSE: To evaluate the frequency of visualization, thickness and location of the normal appendix at non-enhanced spiral computed tomography (CT). MATERIALS AND METHODS: Low-dose spiral CT scans obtained for renal colic assessment in 243 patients were retrospectively reviewed. The frequency of visualization, thickness and location of normal appendices were recorded without knowledge of the patients' history for the appendectomy. RESULTS: Forty of 234 patients had a past history of appendectomy (17%). Sensitivity, specificity, positive and negative predictive values, and accuracy of visualization of the normal appendix were 71%, 85%, 96%, 37% and 73%, respectively. When no intraluminal content was visualized, this area was excluded from the measurement and the mean thickness was 3.4 mm+/-0.66. CONCLUSION: The normal appendix is frequently seen at nonenhanced spiral CT. Knowing the normal thickness of the appendix can help reduce false positive and false negative diagnoses of acute appendicitis when reviewing non-enhanced spiral CT.

Adolescent↗
PubMedDate not supplied

A study on 'Vermiform Appendix'--a caecal appendage in common laboratory mammals.

The vermiform appendix, a small structure without any known function in human being has been regarded as a vestigial remnant of a more developed distal caecum in man's herbivorous ancestors. A detailed study of the morphological and histological changes in the appendix and the caecum of different mammals with varying dietary habits revealed a distinctly well-defined vermiform appendix in rabbit only. However, the apical part of caecum among the carnivorous animals like cat and dog showed a clear histological picture with heavy infiltration of lymphoid tissue in the mucous & sub-mucous coats as seen in rabbit or human being. Thus, the vermiform appendix is in no way a vestigial organ but a specialized structure without any definitely known function, probably concerned with the establishment and maintenance of the body defence and immunity of the body.

Animals↗
PubMed1991

Analysis of cefepime tissue penetration into human appendix.

Cefepime is a new extended-spectrum cephalosporin with gram-positive and gram-negative coverage including Staphylococcus aureus and Pseudomonas aeruginosa. We evaluated the drug's plasma, peritoneal fluid, and appendix tissue concentrations in patients with a postoperative diagnosis of perforated or gangrenous appendicitis. Patients 18 years of age or older were randomly assigned to receive either cefepime 2 g every 12 hours plus metronidazole 500 mg every 6 hours intravenously, or gentamicin 1.5 mg/kg plus clindamycin 900 mg every 8 hours intravenously. During surgery, appendix tissue, plasma, and peritoneal fluid samples were obtained, and frozen at -70 degrees C for high-pressure liquid chromatographic analysis. Thirty-five patients with perforated (26) or gangrenous (9) appendicitis had concentrations acceptable for analysis. The mean time between the administration of cefepime and the time of sampling (referred to as delta time) was 5.99 +/- 3.75 hours (mean +/- SD). The values for plasma (n = 34), tissue (n = 33), and peritoneal fluid (n = 25) concentrations were 16.27 +/- 21.87 micrograms/ml, 4.84 +/- 6.15 micrograms/g, and 14.4 +/- 22.84 micrograms/ml, respectively. The appendix tissue:plasma ratio was 0.66 +/- 0.52 and the peritoneal fluid:plasma ratio was 0.66 +/- 0.51. Spearman rank correlations indicated statistically significant correlations between plasma concentration (r = -0.889; p less than 0.0001), peritoneal fluid concentration (r = -0.783; p = 0.0002), and appendix tissue concentration (r = -0.704; p = 0.0016) versus delta time.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

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

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

Aged↗
PubMed1991

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

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

Adolescent↗
PubMedDate not supplied

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

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

Appendix↗
PubMed1989

[Mucocele of appendix-report of three cases].

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

Adult↗
PubMed1988

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

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

Adolescent↗
PubMed1986

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

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

Adult↗
PubMed1978

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

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

Appendix↗
PubMed1993

Intussusception of appendix with carcinoid tumour. A case report.

During an operation for suspected appendicitis, no appendix was found at the confluence of the caecal taeniae. A mobile mass in the caecum was explored and intussusception of the appendix was identified. Histological examination of the specimen revealed carcinoid of the appendix. The diagnosis and management of intussusception of the appendix are discussed.

Adult↗
PubMed1995

[Invagination of vermiform appendix in an asymptomatic adult: a case report].

Invagination of the vermiform appendix (appendiceal intussusception) is a very rare disease. Most cases occur in patients under 10 years of age. The clinical presentation of invagination of the vermiform appendix is extremely variable and most cases are symptomatic. The pathogenesis of invagination of appendix is still not clear, but some precipitating factors have been identified. Herein, we report one case of primary invagination of the vermiform appendix in a adult without any symptom. Etiology, precipitating factor, clinical presentation, classification, and diagnosis method are discussed.

Appendix↗
PubMed1996

Mainz pouch with appendix-umbilical stoma using catheterizable conduit elongated with continuous cecal segment: a case report.

The Mainz pouch with appendix-umbilical stoma is a very stable method for continent, self-catheterizable urinary reservoir in the presence of a healthy appendix. If the appendix is too short or an unexpected stenosis is seen at its distal portion, the elongation of the conduit using a part of the cecum and the implantation of the conduit to the pouch by the Mitrofanoff method can be a good alternative procedure. We herein report our experience in a 53-year-old male with high grade, invasive bladder tumor, who underwent cystourethrectomy and appendix Mainz pouch operation using the above technique.

Appendix↗
PubMed1997

Management of ingested foreign bodies within the appendix: a case report with review of the literature.

A case is reported of an elective appendectomy in a patient with known ingestion of a sharp foreign body. The metal drill bit was ingested unintentionally 3 months before presentation at our institution. Plain abdominal films demonstrated the foreign body in the right lower abdominal quadrant. Because the gold dental drill bit was sharp and thought to be lodged in the terminal ileum or cecum, an attempt was made to remove the object during colonoscopy. This attempt was unsuccessful because no drill bit could be detected in the colon or terminal ileum. A laparoscopic exploration was performed, and the foreign body was found to lie in the appendix, after bowel manipulation under fluoroscopic guidance and with direct laparoscopic visualization. A laparoscopic assisted appendectomy was performed. On pathologic examination the drill bit was embedded in the tip of the appendix with signs of intramucosal acute inflammation. Management and indication for surgery of foreign bodies in the appendix are discussed, and we review the related literature. This is the second reported case of a dental drill bit in the appendix causing appendicitis.

Aged↗
PubMed1998

The use of the appendix as a continent catheterizable stoma.

PURPOSE: We review the results of 5 years of using the unmodified appendix for reconstruction of neobladders and native bladders, and describe the mechanism of continence. MATERIALS AND METHODS: Between 1993 and 1997, 24 patients have undergone continent urinary diversion using the unaltered appendix. Median patient age at the time of surgery was 62 years. Patients were followed at the urological outpatient clinic for a mean of 18 months (range 7 to 47). Video urodynamic studies were performed once in the first 6 months postoperatively and repeated if there was any history of incontinence or bladder problems. RESULTS: Of the patients with an appendicovesicostomy onto the native bladder 80% were dry during the day and night. This figure was improved to 94% when 2 patients with incontinence catheterized more frequently. Patients with a neobladder were more likely to be continent and had a longer interval between catheterizations, which reflects the larger reservoir volume rather than better continence mechanism in these patients. The level of continence is at the appendiceal bladder junction in the native bladder and the appendicocecal junction in the neobladder, which is able to withstand reservoir pressures of 30 to 40 cm. water. Stress incontinence driven by abdominal pressure did not occur. Instead incontinence occurred when the bladder became over full and the pressure increased, or during an unstable contraction. CONCLUSIONS: The appendix does not need to be tunneled through the bladder wall to achieve satisfactory continence. In a low pressure reservoir continence may be achieved simply by anastomosing the appendix directly onto the bladder or leaving it in situ when creating a neobladder.

Adult↗
PubMed1976

Intussusception of the appendix caused by an adenovillous papilloma.

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

Acute Disease↗