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At least 685 records · Page 38Linked to original sources
PubMedDate not supplied

Colonic volvulus. Diagnosis and results of treatment in 82 patients.

OBJECTIVE: To test the accuracy of initial diagnosis of colonic volvulus and the results of different treatment regimens. DESIGN: Retrospective population based study. SETTING: Tampere University Hospital (major referral center). SUBJECTS: All patients who presented with colonic volvulus from 1973-1990, 58 patients had sigmoid, 23 caecal and one had transverse colonic volvulus. MAIN OUTCOME MEASURES: Findings of endoscopic or operative treatment compared with the clinical diagnosis and plain abdominal radiographs. Association between treatment and risk factors. RESULTS: Diagnosis was difficult, despite some differences in clinical presentation. Gangrenous bowel was diagnosed only at operation, although caecal volvulus with gangrenous bowel was associated with a high white cell count. In 23 patients with caecal volvulus both right hemicolectomy (n = 11) and tube caecostomy (n = 7) were successful with one death after each procedure and no recurrences. In sigmoid volvulus, resection (n = 19) and detorsion with or without sigmoidopexy (n = 21) resulted in similar numbers of complications and deaths (6 and 4, and 5 and 3, respectively), though recurrences were more common after detorsion (1 (5%) compared with 5 (24%)). Endoscopic decompression was tried in 30 and was successful in 26 cases; it was the only treatment in 17/58 patients, with two deaths (12%) and five recurrences (29%). The overall mortality was 15%, but this was associated more with neuropsychiatric diseases, old age, and residence in mental or nursing homes than with gangrene of the bowel. CONCLUSIONS: Poor diagnostic accuracy is a problem. Caecal volvulus can be safely treated by resection or tube caecostomy. Sigmoid volvulus is best treated by endoscopic detorsion followed by operation in otherwise fit patients. Mortality is associated with neuropsychiatric diseases and old age.

Adolescent↗
PubMedDate not supplied

[Pinworm infestation of the appendix].

The Authors present 2 cases of enterobiasis of appendix observed on a total of 186 appendicectomies. Enterobius infestation is an uncommon cause of acute appendicitis. Preoperative diagnosis of pinworm infestation is almost impossible without clinical suspect. Parasites may produce symptoms which resemble acute appendicitis but parasitic infection rarely causes it. It is also important considered in the differential diagnosis cases that mimic Crohn's disease.

Adult↗
PubMed2002

[Pseudotumoral enterocolic phlebitis of the cecum and rutoside. A case report].

INTRODUCTION: Enterocolic phlebitis is an entity characterized by ischemic injury of the gastrointestinal tract caused by thrombophlebitis of the mesenteric veins without arterial involvement or systemic disease. EXEGESIS: We report a case of enterocolic phlebitis in a 57-year-old female treated by rutoside, revealed by intestinal obstruction related to a pseudotumoral lesion of the caecum. CONCLUSION: This case adds to the four cases of enterocolic phlebitis under rutoside already reported in the literature, suggesting a possible involvement of this drug in this rare disease.

Cecal Diseases↗
PubMed2004

[Laparoscopic therapy of appendicovesical fistula -- two case reports].

Two cases of appendicovesical fistula are reported. One case was caused by Crohn's disease, the second case by a chronical appendicitis. The guiding symptoms in both cases were coprosuria and pneumaturia, with chronical infection of the urinary tract. No diagnostic imaging method was able to detect the fistula. The correct diagnosis was finally made by laparoscopy followed by laparoscopical appendicectomy and fistula closure. The clinical symptoms alone seem to be sufficient for indication to operate. Thus, an early laparoscopic operation significantly can shorten the length of disease.

Adult↗
PubMed1993

Fistulas are not always due to Crohn's disease: an unusual groin abscess.

A 38-yr-old white female with Crohn's disease was admitted for right hemicolectomy to treat an enterocutaneous fistula of 4 yr duration. At laparotomy, it was found that the fistula was related to an appendiceal diverticulum, rather than Crohn's disease, and simple appendicectomy was curative. The literature is reviewed.

Abscess↗
PubMed1979

Pediatric appendicitis. A 20-year study of 1,640 children at Cook County (Illinois) Hospital.

Of 1,640 children with acute appendicitis treated at Cook County (Illinois) Hospital between Jan 1, 1957, and Dec 31, 1976, 35% had appendiceal perforation. Overall morbidity was 12.8% and mortality was 0.24%. Antibiotics, transperitoneal drainage, and delayed wound closure were used routinely in children with appendiceal perforation. Antibiotics and transperitoneal drains did not appreciably alter the incidence of intraabdominal abscess formation. Delayed wound closure in patients with appendiceal perforation reduced the incidence of wound infection by 75%.

Abscess↗
PubMed1988

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

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

Adult↗
PubMed1988

The ultrasonographic diagnosis of typhlitis (neutropenic colitis).

Typhlitis is a necrotizing inflammatory disease of the cecum, usually with secondary infection. It is most often found in acute leukemia patients on chemotherapy but has also been reported in other patients on chemotherapeutic drugs. Diagnostic features of typhlitis have been reported on plain radiographs, barium enema, angiography, CT, and one other reported case with ultrasound. We report three cases of typhlitis with a characteristic echogenic thickening of the mucosa on ultrasound. The sonographic findings in the one previous report were identical to those of our three cases. We believe that the sonographic findings of typhlitis are unique and that ultrasound offers an easy noninvasive method of diagnosing this potentially lethal disease.

Adolescent↗
PubMed1983

Ultrasonographic findings in diseases of the appendix.

Ultrasonographic findings in patients with diseases of the appendix, including acute appendicitis, suspected appendiceal abscess, and palpable right-lower-quadrant abdominal mass, are described. An appendiceal abscess may manifest as a cystic mass, a mixed solid and cystic mass, or a hypoechoic solid mass. An appendiceal calculus within an abscess can be recognized as a hyperechoic structure with acoustic shadowing. On ultrasonography, acute appendicitis in female patients may mimic tubo-ovarian disease. Ultrasonographic features of isolated Crohn's disease of the appendix and mucocele of the appendix are also described.

Abscess↗