Acute appendicitis in the preschool child

Article Abstract:

Acute appendicitis (inflammation of the appendix) is not common in preschool children. It accounts for less than 5 percent of all pediatric hospitalizations and is slightly more common in boys than in girls. However, when it does occur it is often associated with serious illness and even death because of difficulty in diagnosing the condition. A major problem is the delay between the onset of symptoms, accurate diagnosis and proper treatment. As might be expected, the earlier it is diagnosed, the better the outcome. When the appendix becomes perforated, the condition becomes much more serious. The perforation rate is very high among preschool children. This may either be because the wall of the appendix is thin in children or because of delayed diagnosis. Children with acute appendicitis may have nonspecific symptoms such as crying, irritability and restlessness. Other illness, such as upper respiratory tract infections, otitis media (middle ear infection) and gastroenteritis (inflammation of the stomach and intestines causing pain, nausea and loss of appetite), are common in children and may confuse the diagnosis. The most common symptom of acute appendicitis in children is vomiting, which occurs in 75 to 81 percent of the cases. Abdominal pain and fever are also common symptoms, but are not present in all cases. Abdominal X-rays are not always helpful in diagnosing appendicitis; ultrasound is much more accurate in this regard. If the appendix can be seen on an ultrasound examination, then the patient has appendicitis. It is concluded that the best way to reduce morbidity from appendicitis is to diagnose the condition early, before the appendix becomes perforated. (Consumer Summary produced by Reliance Medical Information, Inc.)

Pediatric diseases, Children, Diseases

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Pregnancy and cystic fibrosis

Article Abstract:

Cystic fibrosis is an inherited disease that is associated with a high rate of death. It causes the formation of a dense fibrous tissue (similar to scar tissue) and the production of large amounts of thick mucus in the lungs, pancreas and intestines. Although many patients with this disease die during childhood, early diagnosis and new treatments are increasing the number of women who reach childbearing age. Even though this disease reduces fertility, it is possible for women with cystic fibrosis to become pregnant. Several studies have reported that pregnancy in women with this disease is associated with a high incidence of premature birth and other complications. Also, pregnancy can make the mother's condition worse and may require terminating the pregnancy. Based on these findings, it has been suggested that women with cystic fibrosis should not become pregnant. This article describes the outcome of pregnancy in 25 women with a mild form of cystic fibrosis that had not damaged the pancreas. The 25 women had a total of 38 pregnancies. Only two of the pregnancies had to be terminated, the incidence of premature birth and mortality was low, and there were no birth defects. Pregnancy did not affect the function of the mothers' lungs, nor did it reduce the nutritional status of the mothers. The results of this study indicate that women with a mild form of cystic fibrosis, who still have a normal pancreas, can have successful pregnancies. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Pregnancy, Complications of, Pregnancy complications

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Appendicitis in cystic fibrosis

Article Abstract:

Cystic fibrosis is a genetic disorder of the exocrine glands affecting the pancreas, respiratory system, and sweat glands. The disease is complicated by abdominal pain, most often resulting from the distal ileum obstruction syndrome (DIOS), or blockage of the lower portion of the small intestines. Abdominal pain in patients with cystic fibrosis may also result from tissue invaginations; obstruction resulting from twisting of the bowels; inflammation of the pancreas; and stones in the feces. Appendicitis, the inflammation of the appendix, is not prevalent in patients with cystic fibrosis and is not often diagnosed until the appendix ruptures and forms abscesses. Various imaging methods can be used to differentiate appendicitis from DIOS. The clinical features and X-ray findings of nine patients with cystic fibrosis and appendicitis were assessed. The appendicitis had progressed to a stage of abscess formation in eight patients, which was detected during surgery. The correct diagnosis was delayed by more than three days in four patients due to a painless, inactive presentation or a misdiagnosis of DIOS. If contrast enema, a radioactive solution injected into the rectum, reveals compression of the cecum (a blind pouch-like structure at the beginning of the large intestine that has the appendix at its lower end), a diagnosis of appendicitis should be considered. (Consumer Summary produced by Reliance Medical Information, Inc.)

Barium enema

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