Periappendicitis is a significant clinical finding

Article Abstract:

Acute appendicitis is commonly discussed in the medical literature, but the same cannot be said for periappendicitis, inflammation in the tissues surrounding the appendix. The condition has been considered clinically insignificant, but may, in fact, merit further investigation. To better understand periappendicitis, 353 cases of periappendicitis were reviewed. Sixty-one of these patients had received a preoperative diagnosis other than appendicitis, and appendectomy was performed incidental to the treatment of other abnormalities. The remaining 292 patients had received a diagnosis of acute appendicitis. For 41 patients, however, periappendicitis was the only pathological finding. These cases were studied further; they included nine males and 32 females of an average age of 29 years. The appendices of 23 of these patients were abnormal, or involved with a local abscess or mass. Ten patients had appendices described as normal-appearing, and no information was available for another seven patients. Additional intraoperative findings were recorded in 26 patients, and bacterial cultures from eight patients were positive for the presence of organisms. Eighteen patients developed postoperative complications, with a greater percentage of males in this category than females. A brief review of other clinical findings regarding periappendicitis is provided. In contrast to other published reports, these patients with periappendicitis had significant morbidity. It seems likely that a histological diagnosis of periappendicitis can be associated with other abnormalities, especially if the patient is male, older than 30, and does not show quick resolution of symptoms. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Complications and side effects, Abdominal pain, Appendicitis, Appendectomy

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Glucagonoma syndrome is an underdiagnosed clinical entity

Article Abstract:

Glucagonoma, one of the rarest pancreatic islet cell tumors, secretes glucagon (a hormone that stimulates conversion of glycogen to glucose in the liver). This condition is characterized by elevated blood sugar, anemia, weight loss, a tendency to develop thromboembolism (blockage of a blood vessel by a clot), stomatitis (inflammation of the mouth), and a characteristic rash called necrolytic migratory erythema (NME). Because this condition is rare, it is frequently advanced before it is diagnosed. A report is presented of experience with seven patients with glucagonoma. The group consisted of four men and three women with an average age of 47 years. All patients had exhibited the characteristic skin rash from one to six years prior to diagnosis. Five of the six patients had stomatitis, and four had unexplained weight loss. At the time of surgery, five patients already had extensive disease; three underwent extensive surgery, and two only had a biopsy performed. Two of the patients who underwent extensive tumor-reducing surgery had prolonged survivals of 14 and 15 years. Two patients had single nodules that were removed, and these patients are free of disease at two and six years following surgery, and are considered cured. It is suggested that earlier recognition of the symptoms of glucagonoma can decrease patient mortality, and aggressive debulking surgery can prolong survival. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Diagnosis, Pancreatic tumors, Glucagonoma

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