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At least 271 records · Page 15Linked to original sources
PubMed1994

[Pseudomyxoma peritonei secondary to cystadenocarcinoma on the cecal appendix. Clinical case].

We report a 40 years old female that presented with an ovarian tumor and ascites. The exploratory laparotomy revealed a mucocele of the appendix that was informed as a cystadenoma of the appendix in the fast biopsy. The definitive pathological diagnosis, a cystadenocarcinoma of the appendix, motivated a second intervention, performing a right hemicolectomy, left adnexectomy and omentumectomy. Three years later she presented with an abdominal mass and was subjected to a total hysterectomy and right adnexectomy. The pathological diagnosis was a mucinous cystadenocarcinoma with peritoneal involvement. The patient completed five years of follow up since the first intervention and is free of tumor. Pseudomyxome peritoneai generally is a tumor of ovarian origin, followed by the appendix. Surgical treatment must include the excision of neighboring compromised organs. The follow up must be lengthy considering the possibility of late recurrences.

Adult↗
PubMed1993

Should the 'normal' appendix be removed at operation for appendicitis?

A prospective study was conducted over a 6-month period to assess the ability of the surgeon to determine the presence or absence of acute inflammation of the appendix at operation for acute appendicitis. Over the study period 175 appendices were removed of which 131 (75%) were acutely inflamed histologically. The surgeon's assessment as to the presence of acute inflammation was correct in 120 out of 132 cases, a positive predictive value of 91%. When the surgeon assessed the appendix as being non-inflamed he was wrong in 11 of 43 cases, a false reassurance rate of 26%. The increasing use of laparoscopy in the assessment and treatment of patients with the clinical features of appendicitis should not alter the practice of removing the appendix when it appears macroscopically normal. To do so may result in a number of patients requiring a second operation to remove the appendix in the early postoperative period.

Appendectomy↗
PubMed1993

[Adenocarcinoid (mucinous carcinoid) of the vermiform appendix].

Adenocarcinoid (mucinous carcinoid or goblet cell carcinoid) is an unusual tumour of the appendix with histologic and prognostic features between those of carcinoid and adenocarcinoma. Most patients with adenocarcinoid tumours of the appendix present with symptoms consistent with those of acute appendicitis. We describe a 31 year-old male who presented with such symptoms. Ultrasonography demonstrated an acutely inflamed appendix with a hypoechoic area in the midportion of the appendix, suspicious of a tumour. This rare type of tumour is briefly presented.

Adenocarcinoma↗
PubMed1977

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

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

Adolescent↗
PubMed1994

Ruptured pelvic appendix diagnosed by transvaginal sonography.

BACKGROUND: Appendicitis in a pelvic appendix can be difficult to diagnose. Transvaginal sonography may help to visualize an inflamed pelvic appendix. CASE: A 31-year-old woman presented to the hospital with symptoms suggestive of pelvic inflammatory disease. Transabdominal ultrasound, useful in the diagnosis of appendicitis, showed a mass between the uterus and the right ovary. Transvaginal ultrasound clarified the finding as a bulbous fluid-filled structure extending into the cul-de-sac. The structure was diagnosed as an inflamed appendix. Laparoscopic appendectomy was performed, and the patient had an uneventful recovery. CONCLUSION: To our knowledge, this is the first case of appendicitis diagnosed with transvaginal sonography. Transvaginal sonography can delineate the features of an inflamed pelvic appendix and help to narrow the diagnostic possibilities in symptomatic women of childbearing age.

Adult↗
PubMed1998

[Carcinoid of the appendix. Observations on 4 cases].

Four cases of carcinoid tumors of the vermiform appendix are reported. Clinical presentation in 3 cases was suggestive of acute appendicitis and they were submitted to appendicectomy. The carcinoid tumor was discovered by the pathologist on specimen of appendix. The tumors's size, less than 2 cm, the absence of serosal involvement and lymphatics invasion suggested that simple appendicectomy was a satisfactory treatment for such patients. Occasionally clinical presentation of appendiceal carcinoid is characterized by symptoms of intestinal obstruction or intussusception, palpable mass, bleeding. In the fourth patient, that had symptoms consistent with ileal occlusion, we found at laparotomy a bulky tumor of the base of appendix infiltrating and obstructing the cecum and right colon, without liver metastases. A right hemicolectomy with end-to-end anastomosis was performed. Aggressive behaviour of this tumor was also revealed by the single pulmonary metastasis, finding very uncommon in carcinoid of appendix. This patient died postoperatively, at 25th day, of septic abdominal complications, secondary to anastomotic leak. The former patients at clinical and radiological (CT scan) follow-up performed at 3, 12, 36 months respectively, are still alive and disease free.

Adolescent↗
PubMed1975

Trauma to the appendix. A report of two cases.

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

Abdominal Injuries↗
PubMed1988

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

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

Adult↗
PubMedDate not supplied

Sonographic diagnosis of intussusception of the appendix vermiformis.

We present 2 cases of intussusception of the appendix vermiformis (IAV) in children. Sonographic examination demonstrated a lead point within a characteristic multiconcentric ring sign, and longitudinal sonograms showed the inverted appendix protruding into the cecal lumen. A contrast-enema study, using a water-soluble contrast medium, was performed in each case, and a "coiled-spring" sign or "spiral shell" appearance confirmed the diagnosis. A surgical reduction of the appendix and an appendectomy were performed in each case.

Appendectomy↗
PubMed1988

Adenocarcinoid tumor of appendix presenting as unilateral Krukenberg tumor.

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

Adenocarcinoma↗
PubMed1986

Subepithelial neuroendocrine cells and carcinoid tumours of the human small intestine and appendix. A comparative immunohistochemical study with regard to serotonin, neuron-specific enolase and S-100 protein reactivity.

A comparative immunocytochemical study was performed of subepithelial neuroendocrine cells of the human small intestine and appendix and carcinoid tumours of these sites, using a monoclonal antibody to serotonin and polyclonal antisera against neuron-specific enolase (NSE) and S-100 protein. Subepithelial neuroendocrine cells were easily identified in the lamina propria of the appendix. These cells, which sometimes occurred in aggregates, displayed serotonin and NSE immunoreactivity and were surrounded by S-100 protein immunoreactive cells, presumably of Schwann cell origin. In the appendix scattered cells with corresponding morphological features and immunoreactivity were also observed deep in the submucosa. In addition, subepithelial neuroendocrine cells were sparsely present in the lamina propria of the small intestine, occurring only as single cells in the deeper part of the mucosa below or between the epithelial crypts. Most appendiceal carcinoid tumours (11 of 12 examined cases) were biphasic and consisted of neuroendocrine tumour cells with intermingled S-100 protein immunoreactive cells (Schwann cells) with long cytoplasmic extensions. However, small intestinal (11 cases) and caecal (10 cases) carcinoids lacked S-100 protein immunoreactive cells as an integral component. The results indicate that the appendiceal carcinoids are mostly closely related structurally to the subepithelial neuroendocrine and Schwann cell aggregates of the lamina propria and are thus presumed to be histogenetically related to this cell system, while the histogenesis of small-intestinal and caecal carcinoids remains less clear.

Appendiceal Neoplasms↗
PubMed1993

Localization of plasminogen activator inhibitor-1 production in inflamed appendix by in situ mRNA hybridization.

The peritoneum has been shown to possess fibrinolytic activity which is thought to play a role in the prevention of intra-abdominal adhesion formation. Recently inflamed peritoneal tissue has been shown to have reduced fibrinolytic activity secondary to increased levels of plasminogen activator inhibitor-1 (PAI-1). The aim of this study was to localize the production of PAI-1 in appendix tissue using in situ mRNA hybridization. Sections of normal and inflamed appendix were hybridized with a digoxigenin-labelled cDNA probe. PAI-1 production was localized to both mesothelium and serosal blood vessel endothelium in all inflamed appendix samples. Cell identities were confirmed using immunohistochemistry directed against mesothelial and endothelial cell markers. Staining was not seen on 1 probe following ribonuclease digestion). The identification of the cells expressing the PAI-1 gene in peritoneum increases our understanding of the pathophysiological changes in fibrinolytic activity which occur in inflammation and may lead to adhesion formation.

Appendicitis↗
PubMed1988

Synchronous adenocarcinoma of the transverse colon, the gallbladder and the vermiform appendix.

According to the literature synchronous adenocarcinomas of both, the colon and the gallbladder or the colon and the appendix are extremely unusual. To our knowledge the simultaneous occurrence of all three tumors has never been published before. Preoperative diagnosis of early stage tumors of the gallbladder and the vermiform appendix is also made very seldom. The following case report records an instance of synchronous adenocarcinomas of the gallbladder, the transverse colon, in a colonic polyp and the appendix. Owing to the patient's advanced age simultane cancer occurrence may be mere coincidence. Nevertheless, this extremely rare entity could also be ascribed to a genetic defect or an unknown carcinogenic agent.

Adenocarcinoma↗
PubMed1989

CT demonstration of the appendix in asymptomatic adults.

We prospectively examined 103 consecutive adults (67 women, 36 men; mean age: 58.7 years) referred for abdominal and pelvic computed tomography (CT) in whom there was no history of right lower quadrant symptoms or appendectomy. Contiguous 5-mm CT images through the pericecal region were obtained in each subject, once routine scanning was completed. Three radiologists reviewed all CT images and reached a consensus on appendiceal visualization and the quantity of intraperitoneal fat. Statistical methods were applied to the collected data to seek significant associations between a visualized appendix and the following factors: patient age, sex, intraperitoneal fat grade, and the presence of oral contrast in the cecal lumen. The appendix was definitely visualized in only 45 of the 103 patients (43.7%). Analysis of variance revealed no statistically significant correlation between a CT-demonstrated appendix and the four variables examined. The clinical implications of these findings are discussed.

Adolescent↗
PubMed1999

Intussusception of a mucocele of the appendix secondary to an obstruction by endometriosis: report of a case.

We treated a patient with a complete invagination of the cecum which contained a mucocele of the appendix secondary to an obstruction by endometriosis. Preoperatively, a barium enema showed a crab's claw-like area without filling in the oral side of the transverse colon. An emergency laparotomy was performed and revealed a mucocele of the appendix to have induced appendicecal invagination; however, no colonic invagination was observed. An appendicecal resection was thus done. Pathologically, the resected specimen was a mucosal hyperplasia with mucin-secreting lesions of the appendix. The theories regarding the pathogenesis of appendicecal mucocele are reviewed and discussed.

Adult↗
PubMed1988

Mucosal hyperplasia (mucocele) of the vermiform appendix. Report of a case.

Mucocele of the vermiform appendix was the term formerly used to describe all mucin-secreting lesions of the appendix. In actuality, there are three distinct clinicopathologic entities based on histologic differences. These are mucosal hyperplasia, cystadenoma, and mucinous cystadenocarcinoma of the appendix. Mucosal hyperplasia is usually an incidental finding during laparotomy for an unrelated condition. The case presented herein differed in that the patient had a three-month history of abdominal pain with nothing to suggest the presence of appendicitis, and a 3-cm opacification overlying the right iliac bone on x-ray.

Appendix↗
PubMed1983

Diverticula of the vermiform appendix. Alternatives of clinical presentation and significance.

The vermiform appendix can be the site of development of diverticula which may suffer either inflammatory complications with or without appendicitis or may only be an incidental finding in an uninflamed appendix. This is a retrospective study of 10 of 575 cases of consecutive appendices removed and examined within a year, with single or multiple appendiceal diverticula with diverticulitis and peridiverticulitis. In six of the 10, the lumen of the appendix did not show any inflammatory changes. In conclusion, one could assume that inflammatory complications of the appendiceal diverticula, although they may mimic acute appendicitis, are quite distinct clinical entities. Acute appendicitis in the presence of appendiceal diverticula may carry an earlier and higher rate of perforation and appendiceal diverticula, as an incidental finding, may justify appendectomy on occasion.

Adolescent↗
PubMedDate not supplied

Crohn's disease of the appendix: report of a case and review of the literature.

A case of Crohn's disease of the appendix that simulated a cecal tumor is presented and 27 additional cases are reviewed. Crohn's disease of the appendix most commonly occurs in the younger patient, with 90 per cent in the second and third decades of life. Before operation, appendicitis or an appendiceal abscess is commonly diagnosed. Appendectomy should be performed, if possible; otherwise a limited ileocolectomy should be done. These patients should have a long-term follow-up program because inflammation can develop later in any part of the bowel. Crohn's disease of the appendix should be included in the differential diagnosis of pain or a palpable mass in the right lower quadrant, especially in the young adult patient.

Adult↗