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At least 451 records · Page 25Linked to original sources
PubMed1993

New continent ileocolonic urinary reservoir: Charleston pouch with minimally altered in situ appendix stoma.

A new continent urinary reservoir that utilizes minimally altered in situ appendix stoma is described. The reservoir was constructed from segments of terminal ileum and ascending colon which were detubularized and reorientated to provide maximum reduction in filling pressures. The in situ appendix was utilized to provide a continent catheterizable stoma. Appendicular leak pressures were measured intraoperatively to determine the need, if any, for augmentation. Minimal reinforcement of the appendiculo-colonic junction with two or three sutures was performed in most patients. Preliminary experience with 16 patients who had the Charleston pouch with an appendicular stoma as described herein is reviewed.

Adult↗
PubMed1982

A comparison of regulatory cells from rabbit spleen and appendix.

Both spleen and appendix of the rabbit contain two types of accessory cells that regulate the response of T-cells to concanavalin A. These accessory cells are found among non-T, non-B adherent cells and among B-cells. There is, so far, no evidence for a sequential interaction of these two cell types. In addition, there is an inhibitory adherent cell type in the appendix that interferes with the B-cell-regulated proliferative T-cell response.

Animals↗
PubMed2005

Inverted appendix mistaken for a polyp during colonoscopy and leading to intussusception.

A spectrum of appendiceal diseases, ranging from simple mucous distension to acute perforated appendicitis, are seen in patients with CF. We report a 6 year old boy with CF and recurrent periumbilical pain. During colonoscopy, a fleshy pedunculated mass at the junction of the ascending colon and caecum was mistaken for a polyp and excised. However, histopathological examination suggested it was a segment of inverted appendix. The remnant of the inverted appendix was subsequently found to be associated with an intussusception.

Appendectomy↗
PubMed2004

An "eye" in the gut: the appendix as a sentinel sensory organ of the immune intelligence network.

Neural systems are the traditional model of intelligence. Their complex interconnected network of wired neurons acquires, processes, and responds to environmental cues. We propose that the immune system is a parallel system of intelligence in which the gut, including the appendix, plays a prominent role in data acquisition. The immune system is essentially a virtual unwired network of interacting cells that acquires, processes, and responds to environmental data. The data is typically acquired by antigen-presenting cells (APCs) that gather antigenic information from the environment. The APCs chemically digest large antigens and deconstruct them into smaller data packets for sampling by other cells. The gut performs the same function on a larger scale. Morsels of environmental content that enter the gut are sequentially deconstructed by physical and chemical digestion. In addition to providing nutrients, the componentized contents offer environmental data to APCs in mucosa-associated lymphoid tissues (MALT) that relay the sampled information to the immune intelligence network. In this framework, positioning of the appendix immediately after the ileocecal valve is strategic: it is ideally positioned to sample environmental data in its maximally deconstructed state after small bowel digestion. For single-celled organisms, digestion of the environment has been the primary way to sample the surroundings. Prior to the emergence of complex sensory systems such as the eye, even multi-cellular organisms may have relied heavily on digestion to acquire environmental information. While the relative value of immune intelligence has diminished since the emergence of neural intelligence, organisms still use information from both systems in integrated fashion to respond appropriately to ecologic opportunities and challenges. Appendicitis may represent a momentary maladaptation in the evolutionary transition of sensory leadership from the gut to the eye. Relationships between immune dysfunctions and cognition are explored.

Animals↗
PubMed2001

Crohn's disease limited to the appendix.

BACKGROUND: Crohn's disease confined to the vermiform appendix is rare. In our study, the incidence was 0.2% of all patients diagnosed with Crohn's disease at La Paz University Hospital, Madrid, Spain, in 20 years. METHODS: Here we review the clinical records of 10 patients with isolated appendiceal Crohn's disease. RESULTS: Preoperative diagnosis was acute appendicitis in all 10 cases, and all patients underwent appendectomy. Postoperative complications were limited to an enterocutaneous fistula in 1 patient. There was no evidence of recurrence during a mean follow-up period of 14.5 years (range 2 to 25 year). CONCLUSIONS: We conclude that Crohn's disease when confined to the appendix is less aggressive than in other sections of the intestine, with a low recurrence rate and incidence of postoperative fistula.

Adolescent↗
PubMed2003

Diverticulum of the vermiform appendix is associated with chronic abdominal pain.

BACKGROUND: Diverticulum of the vermiform appendix is rarely encountered. Previous reports in the literature indicate that appendiceal diverticulum without inflammations are asymptomatic. METHODS: During the past 10 years, 217 patients have been evaluated in our office for chronic lower abdominal pain. Six patients in this group were unusual in that no diagnosis could be made after a complete history, physical examination, and multiple imaging and laboratory studies. Each patient had a normal computed tomography scan of the abdomen, upper endoscopy, colonoscopy, barium enema, and small bowel enteroclysis. Each of the 6 patients underwent an exploratory laparoscopy and appendectomy. RESULTS: All 6 patients in this series had acquired diverticulum of the appendix with inspissated intraluminal secretions without histological evidence of inflammation. The age range was 37 to 57 years. Most patients were male, and most had a single diverticulum projecting into the mesoappendix. All 6 patients had complete resolution of their chronic abdominal pain after the laparoscopic appendectomy. CONCLUSIONS: An unusual cause of mild chronic abdominal pain can be the presence of appendiceal diverticulum with inspissated intraluminal secretions. The evaluation of these patients is usually normal. Exploratory laparoscopy with appendectomy should be the final evaluation for patients with mild chronic abdominal pain.

Abdominal Pain↗
PubMed1988

Adenocarcinoma of the appendix.

Thirty-two patients with primary adenocarcinoma of the appendix were studied in this collective review. Immediate operation was performed in 21 patients with a diagnosis of acute appendicitis. At operation, tumor of the appendix was only identified in 50 percent of the 32 patients studied. Survival was unrelated to the histologic tumor type, but significantly correlated with the extent of tumor spread. Right hemicolectomy led to a significant increase in survival compared with appendectomy alone and to a significant decrease in risk of recurrence. In Dukes' B2 and C patients, differences in the survival curves were in favor of right hemicolectomy. Long-term survival was obtained by repeat laparotomy with resection of mucinous material in patients with pseudomyxoma peritonei.

Adenocarcinoma↗
PubMed2000

[Crohn's disease of the appendix].

A giant appendix is an extremely rare and improbable finding during surgery in suspected cases of acute appendicitis. Although this condition is primarily suggestive of neoplasia, it is usually due to an inflammatory or infectious disease. We report a case of Crohn's disease limited to the appendix, which was diagnosed after a short right ileocolectomy. Only 156 similar diagnoses have been reported in the literature to date. This disease appears to have a benign course and therefore differs from classical Crohn's ileocolitis. For this reason, these patients do not require any specific investigation or follow-up.

Adult↗
PubMed2003

[Appendix-ureteroplasty in a child: report of a case].

The use of vermiform appendix as a tube to replace right ureteral segment has been reported, rarely in child. Herein is reported a case of right ischemic ureteral stenosis following a reimplantation of the ureter for high grade reflux secondary to posterior urethral valves with only one functioning kidney. A long ureteral defect was bridged successfully by appendix interposition and then reimplanted in the bladder at four years of age. The interest of ureteroappendiculoplasty provides temporary solution to repair long ureteral defect, in spite of uncertain future, especially in childhood.

Appendix↗
PubMed1980

Herniation of the appendix through the umbilical ring following umbilical artery catheterization.

A case of herniation of the appendix through the umbilical ring following transection of the umbilical cord for arterial catheterization is described. After the appendix was returned into the abdominal cavity and the peritoneal edges closed, the patient had no further difficulty. This rare complication of catheterization can be avoided by careful palpation of the umbilical stump and use of a moist bias tape around the base of the umbilicus prior to transection of the cord.

Appendix↗
PubMed1981

Appendix mass in the very young child.

During the first 3 yr of life 54 (34%) of the 158 patients presenting with appendicitis had an appendix mass at the time the diagnosis was made. In 19 the mass was discovered on clinical examination and in 35 on examination under anesthesia. Complication rate was markedly reduced and hospitals stay shortened if the appendix mass was managed non operatively.

Appendectomy↗
PubMed1986

Segmental aganglionosis of the appendix.

Ignoring the pathologist's dictum that the appendix is not reliable for the identification of ganglion cells in suspected cases of total colonic aganglionosis, the author (K.D.A.) performed an ileostomy in a child whose appendix contained no ganglion cells. The ascending colon was later found to be ganglionic. The appendices from 36 cases of Hirschsprung's disease were examined and the number of ganglion cells in 10 high power fields was compared with 10 appendices from patients who did not have Hirschsprung's disease. There were no ganglion cells in any of the patients with total aganglionosis of the colon. Twenty-two patients with Hirschsprung's disease involving the sigmoid colon had an average of 3.0 ganglion cells per high power field (range 0.5 to 5.1). Five patients with longer segment aganglionosis had 2.2 cells per high power field (range 0 to 4.1). The index case fell into this group and was serially sectioned without finding any ganglion cells. The control group averaged 3.41 cells per high power field (range 1.4 to 5.9). There was no significant difference between the control group and the groups with less than total colonic aganglionosis. It is speculated that this case represents segmental Hirschsprung's disease with the skip area in the ascending colon.

Appendix↗
PubMed1989

Use of the appendix stump in the treatment of meconium ileus.

Three neonates with meconium ileus who failed to respond to non-operative measures were successfully treated by appendicectomy and irrigation with Gastrografin into the small bowel via the appendix stump. The meconium was emptied out and the stump ligated. This method avoids enterotomy, enterostomies or resection of bowel. The post-operative course is simplified and hospital stay decreased. Removal of the appendix precludes future disease of this organ which may be problematic in patients with cystic fibrosis.

Appendectomy↗
PubMed1990

Appendix interposition of the ureter.

Under specific circumstances the appendix vermiformis may be an appropriate organ for plastic repair of a large ureteral defect. We report a situation in which all of the criteria were met and in which a long ureteral defect was bridged successfully with the appendix.

Aged↗
PubMed1990

Continent appendix stoma: a modification of the Mainz pouch technique.

The submucosally embedded in situ appendix guarantees an ideal continence mechanism in patients with ileocecal urinary reservoirs. To date this modification of the Mainz pouch technique has been performed successfully in 13 patients. The appendicocutaneous stoma was placed at the lower right abdominal quadrant in 12 patients and into the umbilical funnel in 1. Urodynamic investigations of the submucosally embedded appendix showed a maximum closure pressure of more than 80 cm. water in pressure profiles. Only 1 case of stomal stenosis required reoperation.

Adult↗
PubMed2000

Appendix and cecum. Embryology, anatomy, and surgical applications.

Surgeons should be familiar with surgery of the cecum and appendix because the diseases of this region, especially appendicitis, are the most common indications for surgical exploration. Usually, diagnosis of appendicitis and appendectomy are not difficult, but atypical location of the appendix or other anatomic anomalies can make the diagnosis of appendicitis and appendectomy difficult. In cases of atypical anatomy or diffuse clinical picture, especially in young adults or elderly patients, the spectrum of embryologic and anatomic anomalies must be kept in mind to make the correct treatment decision for individual patients. If doubt persists, explorative laparotomy must be performed to avoid overlooking rare, acute, intra-abdominal abnormalities.

Adult↗
PubMed2001

Conventional and hydrocolonic US of the appendix with CT correlation performed by on-call radiology residents.

RATIONALE AND OBJECTIVES: The purpose of this study was to assess the feasibility and accuracy of emergent hydrocolonic ultrasonography (US) performed by on-call residents in patients suspected of having appendicitis. MATERIALS AND METHODS: Thirty-one patients with a clinically equivocal diagnosis of appendicitis were prospectively evaluated with conventional US, hydrocolonic US, and appendiceal computed tomography (CT). Midlevel radiology residents performed the US examinations while they were on call. Sensitivity, specificity, and accuracy for diagnosing appendicitis were calculated for conventional and hydrocolonic US by using clinical outcome as the standard. Results of US and CT of the appendix were also correlated. Residents recorded their diagnostic confidence for conventional and hydrocolonic US. All patients were able to hold the rectally administered contrast material until completion of both hydrocolonic US and appendiceal CT. RESULTS: The sensitivity for detecting appendicitis with conventional US, hydrocolonic US, and appendiceal CT was 50%, 75%, and 100%, respectively. Specificity was 96%, 93%, and 93%, respectively. Identification of the normal and abnormal appendix improved from 13% (four of 31 patients) with conventional US to 35% (11 of 31 patients) with hydrocolonic US. The radiology residents' diagnostic confidence increased from 0.74 with conventional US to 0.83 with hydrocolonic US. CONCLUSION: Hydrocolonic US is a feasible addition to conventional US examination for patients suspected of having appendicitis. It improves sensitivity, increases radiology residents' confidence, and is well tolerated by patients.

Adolescent↗
PubMed1997

Melanosis of the appendix: prevalence, distribution and review of the pathogenesis of 47 cases.

The appendix is reported to be a common site for melanosis, especially at autopsy although to date there have been few studies expanding or qualifying this statement. Based on 47 cases identified from a series of 636 consecutive surgical specimens the prevalence, pattern of distribution, nature of the pigment and current knowledge of the aetiology and pathogenesis of melanosis of the appendix is reviewed and compared with melanosis coli.

Adult↗