exudates and Appendicitis

An acute abdomen in pregnancy can be caused by pregnancy itself, be predisposed to by pregnancy or be the result of a purely incidental cause. These various conditions are discussed. The obstetrician often has a difficult task in diagnosing and managing the acute abdomen in pregnancy. The clinical evaluation is generally confounded by the various anatomical and physiological changes occurring in pregnancy itself. Clinical examination is further hampered by the gravid uterus. The general reluctance to use conventional X-rays because of the pregnancy should be set aside when faced with the seriously ill mother. A reluctance to operate during pregnancy adds unnecessary delay, which increases morbidity for both mother and fetus. Such mistakes should be avoided as prompt diagnosis and appropriate therapy are crucial. A general approach to acute abdominal conditions in pregnancy is to manage these problems regardless of the pregnancy.

Topics: Abdomen, Acute; Abdominal Injuries; Abdominal Pain; Acute Disease; Appendicitis; Cholelithiasis; Diagnosis, Differential; Female; Humans; Malaysia; Ovarian Diseases; Pancreatitis; Pregnancy; Pregnancy Complications

A 1 year review of 529 cases of acute appendicitis, treated at the University Hospital in 1990, was performed. Perforation rate was 23.7% and delay in diagnosis was found to be significant. Patients above 50 years of age were particularly at risk. Diagnostic error was 19.3% and it was a problem not only in young women but also in children. Temperature and rectal examinations were not found to be helpful in the diagnosis in contrast to leukocytosis. Waiting time for operation was long (median 7 hours), be it for a perforated or a nonperforated appendicitis.

Topics: Acute Disease; Adult; Aged; Appendicitis; Body Temperature; Child; Child, Preschool; Diagnostic Errors; Hospitals, University; Humans; Intestinal Perforation; Malaysia; Middle Aged; Physical Examination; Rectum; Risk Factors; Rupture, Spontaneous; Time Factors

In a retrospective study, 455 people were found to have been admitted to the Surgical Unit of the Taiping District Hospital, suspected of acute appendicitis in the study period from 1 July to 31 December 1990. However, only 147 (32.3%) were clinically confirmed to have appendicitis and underwent appendicectomy. Out of these, 120 (81.6%) cases were subjected to detailed analysis. The study showed that the commonest age group affected was the 10 to 20 year old. Males were slightly more often affected but there seemed to be an equal distribution among the major races. The diagnostic accuracy, that is the operated cases that were actually acute appendicitis, was 92.5%. The perforation rate was 31.5%. Fifty-five percent of patients developed some post-operative complications, of which the commonest was fever.

Topics: Acute Disease; Adult; Appendectomy; Appendicitis; Child; Child, Preschool; Female; Hospitals, District; Humans; Malaysia; Male; Middle Aged; Postoperative Complications; Retrospective Studies; Time Factors

Topics: Appendicitis; Diet; Feces; Gastrointestinal Motility; Humans; Intestinal Neoplasms; Malaysia; Rural Population; Social Class; Urban Population

Topics: Abdomen, Acute; Adolescent; Adult; Age Factors; Appendicitis; Child; Child, Preschool; Humans; Malaysia; Middle Aged; Sex Factors