Diagnostic accuracy in appendicitis

The following are common lab tests, scans and scoring systems used in the diagnosis of acute appendicitis. See if you can use some of the information here to help tell if you are having appendicitis. Leave us some comments. The Diagnosis of appendicitis could be very challenging even to the most experienced surgeon sometimes.

Diagnostic accuracy in appendicitis

However, pregnancy may complicate most gastrointestinal diseases, particularly gastroesophageal reflux and inflammatory bowel disease.

Diagnostic accuracy in appendicitis

In addition, gastrointestinal symptoms are extremely common in the pregnant patient. These changes may cause new symptoms, worsen preexisting disease, or mask potentially deadly disease. A lack of experience in dealing with these symptoms can have devastating effects.

The physician must be able to distinguish whether these symptoms are those of normal pregnancy or a potentially life-threatening complication such as preeclampsia. The physician must also know which medications are safe in pregnancy, as well as which tests are safe to perform during pregnancy.

Often a team approach is necessary to optimize the care of the pregnant patient with gastrointestinal symptoms.

Diagnostic accuracy in appendicitis

However, many basic physiologic alterations need to be discussed so that the physician dealing with gastrointestinal symptoms can better understand symptoms and their significance. Esophagus and Stomach Given the common symptoms of nausea, vomiting, and dyspepsia that occur, it is not surprising that the upper gastrointestinal tract is affected by pregnancy.

The enlarging uterus displaces the stomach and may anatomically alter the pressure gradient between the abdomen and thorax. Increased pressure within the stomach allows for reflux of the gastric contents into the esophagus, which lies in the negative pressure of the intrathoracic cavity.

The pressure gradient may even accentuate a hiatal hernia contributing to gastroesophageal reflux. Contributing to the increased incidence of gastroesophageal reflux are the motility changes that also occur with pregnancy. Lower esophageal sphincter tone is decreased secondary to increased progesterone levels and a decrease in the peptide hormone motilin.

Gastric emptying has been partially studied in pregnancy.


Nondyspeptic asymptomatic women have normal solid gastric emptying in early pregnancy, and gastric emptying does not lengthen in the third trimester or postpartum. Studies using gastric ultrasound and acetaminophen clearance in asymptomatic healthy pregnant women at term show normal gastric emptying.

Small Bowel The small intestine exhibits decreased motility during pregnancy.

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This increased transit time is related to elevations in progesterone levels during normal pregnancy and may contribute to the increased symptoms of constipation in late pregnancy. The colon may be subject to the same decreases in motility that affect the other portions of the gastrointestinal tract.

Progesterone has been shown to alter colonic transit time in rats. The functional changes that occur with the enlarging uterus may mechanically limit colonic emptying and probably is the main reason for symptomatic constipation in late term.

There is also a significant increase in water and sodium absorption secondary to the increased aldosterone levels during pregnancy, leading to reduced stool volume and prolonged colonic transit time.Ritz Carlton Kapalua.

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The diagnostic accuracy of contrast-enhanced MR imaging for the detection of acute appendicitis was similar to the accuracy previously reported for CT and was not statistically different from the accuracy of concurrently performed CT .

Jul 23,  · Appendicitis is defined as an inflammation of the inner lining of the vermiform appendix that spreads to its other parts.

This condition is a common and urgent surgical illness with protean manifestations, generous overlap with other clinical syndromes, and significant morbidity, which increases with diagnostic delay (see Clinical Presentation).

Zosyn is a combination product consisting of a penicillin-class antibacterial, piperacillin, and a β-lactamase inhibitor, tazobactam, indicated for the treatment of patients with moderate to severe infections caused by susceptible isolates of the designated bacteria in the conditions listed below.

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INTRODUCTION. Appendicitis is common and is seen in up to 1 in 10 individuals over a lifetime. Most cases present between the ages of 10 and 30 years.

Gastrointestinal Complications in Pregnancy | GLOWM