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Acute appendicitis

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https://www.readbyqxmd.com/read/29346264/sonography-of-the-cecum-gateway-to-the-right-lower-quadrant
#1
R Brooke Jeffrey, Andrew L Wentland, Eric W Olcott
Sonography of the cecum has come of age largely as a consequence of the successful evolution of appendiceal sonography as a useful tool in the evaluation of patients with right lower-quadrant pain. At some medical centers, graded-compression sonography (GCS) has become the initial imaging study of choice in the assessment of these individuals. The cecum serves as a helpful anatomic landmark for localization of the appendix in these examinations-providing a sonographic starting point in the search for the appendix...
January 17, 2018: Ultrasound Quarterly
https://www.readbyqxmd.com/read/29344678/conservative-antibiotic-treatment-for-acute-uncomplicated-appendicitis-is-feasible
#2
Zvi Steiner, Genady Buklan, Michael Gutermacher, Ita Litmanovitz, Tal Landa, Shmuel Arnon
PURPOSE: Appendectomy versus conservative antibiotic treatment (CAT) for children with acute uncomplicated appendicitis (AUA) remains unresolved, with concerns regarding the practicality of CAT. We analyzed our center's experience with CAT for AUA, using a protocol with strict inclusion, exclusion and treatment criteria. METHODS: Non-randomized, prospective cohort study included all children admitted betwee 2014 and 2016, with clinical and laboratory tests suspicious for AUA...
January 17, 2018: Pediatric Surgery International
https://www.readbyqxmd.com/read/29340826/single-port-laparoscopic-surgery-in-uncomplicated-acute-appendicitis-a-randomized-controlled-trial
#3
Byung Mo Kang, Sung Il Choi, Bum-Soo Kim, Suk-Hwan Lee
BACKGROUND: Single-port laparoscopic surgery (SPLS) is an alternative, minimally invasive surgical approach for managing appendicitis. The aim of this randomized trial was to evaluate the safety and efficacy of SPLS in uncomplicated appendicitis. METHODS: Between December 2009 and November 2010, 194 patients with radiologically diagnosed acute appendicitis were randomly allocated to undergo either SPLS or multiport laparoscopic surgery (MPLS). Patients with intraoperative findings of perforated appendicitis were excluded from the analysis...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29336758/occult-appendiceal-neoplasms-in-acute-and-chronic-appendicitis-a-single-institution-experience-of-1793-appendectomies
#4
Jamie A Schwartz, Craig Forleiter, David Lee, Grace J Kim
The incidence of appendiceal neoplasms may have been underreported in the past. Patients undergoing incidental appendectomies or appendectomies for chronic appendicitis may be at higher risk for an incidental appendiceal neoplasm. To determine the incidence of occult appendiceal neoplasms and identify risk factors associated with this pathology, a retrospective review of a pathology specimen database was conducted from November 2007 to December 2011, in a single tertiary care hospital center. All patients with appendectomies were included for analysis (n = 1793)...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336754/predictors-and-outcomes-of-nondiagnostic-ultrasound-for-acute-appendicitis-in-children
#5
Richard Sola, Blair A Wormer, William E Anderson, Thomas M Schmelzer, Graham H Cosper
Ultrasound assessments of children with possible acute appendicitis (AA) are often nondiagnostic. We aimed to identify the predictors of nondiagnostic ultrasound and to investigate the outcomes. A retrospective review was conducted on children aged 4 to 17 years evaluated in 2013 for AA with ultrasound at a tertiary hospital pediatric emergency department. Demographics, clinical data, and outcomes were analyzed. Of 528 children, 194 (36.7%) had diagnostic ultrasounds and 334 (63.3%) had nondiagnostic ultrasounds...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336746/abdominal-splenosis-mimicking-carcinomatosis-in-a-patient-with-acute-appendicitis
#6
Yana M Schrank, Virgilio George, E Ramsay Camp
No abstract text is available yet for this article.
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29334144/acute-gastrointestinal-bleeding-from-appendiceal-diverticulitis-diagnosed-preoperatively-by-combined-short-interval-computed-tomography-and-colonoscopy-a-case-report
#7
Yutaro Ogawa, Naoki Asayama, Shinji Nagata
Colonic diverticular bleeding is the most common cause of lower gastrointestinal bleeding1,2 . Appendiceal diverticulosis is an uncommon clinical entity, with an incidence of 0.004%-2% in surgical pathologic specimens3,4 . Appendiceal diverticulitis in symptomatic patients should be treated with early resection, because of the risk of perforation and peritonitis; the rate of perforation is higher in appendicitis (27%) with diverticulosis than in appendicitis alone (6.6%)5 . Untreated appendiceal diverticulitis can also lead to massive gastrointestinal hemorrhage and abscess formation, and has a potential role in the development of pseudomyxoma peritonei...
January 15, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/29331965/right-iliac-fossa-pain-treatment-rift-study-protocol-for-an-international-multicentre-prospective-observational-study
#8
Dmitri Nepogodiev
INTRODUCTION: Patients presenting with right iliac fossa (RIF) pain are a common challenge for acute general surgical services. Given the range of potential pathologies, RIF pain creates diagnostic uncertainty and there is subsequent variation in investigation and management. Appendicitis is a diagnosis which must be considered in all patients with RIF pain; however, over a fifth of patients undergoing appendicectomy, in the UK, have been proven to have a histologically normal appendix (negative appendicectomy)...
January 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/29324635/diagnostic-value-of-serum-urokinase-type-plasminogen-activator-receptor-in-children-with-acute-appendicitis
#9
Mustafa Onur Oztan, Aysegul Aksoy Gokmen, Fatma Demet Arslan, Ebru Cakir, Ali Sayan, Elif Abay, Selçuk Kaya, Gokhan Koyluoglu
OBJECTIVES: Acute appendicitis (AA) is the most common surgical emergency in children. The accurate and timely diagnosis of AA in children can be challenging, and delayed diagnosis rates have been reported to range from 5.9% to 27.6%. Although combining clinical history and repeated physical examination with laboratory tests and radiographic imaging modalities help reach the diagnosis, novel biomarkers can support the surgeons' decision as well. The aims of this study were to evaluate a new plasma marker, urokinase-type plasminogen activator receptor (uPAR), to improve diagnostic accuracy in AA patients, and to determine a cutoff value of uPAR, which can safely include/exclude the diagnosis of AA...
January 11, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29324630/perforated-meckel-diverticulum-a-rare-cause-of-acute-abdomen-in-children
#10
Saurabh Talathi, David Kelly, Scott Anderson, Yoginder Vaid, Jose Mestre
Meckel diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract and the most common cause of gastrointestinal bleeding in children. Although it usually follows the rule of 2's, exceptions to this rule are reported in the literature. Often asymptomatic, MD is commonly an incidental finding during surgical interventions. When symptomatic, the most common presentation of this condition is painless rectal bleeding. A myriad of other nonspecific symptoms are however possible, especially in adults, thus making this diagnosis difficult...
January 11, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29324373/abdominal-ct-aided-diagnosis-of-acute-appendicitis-in-the-presence-of-mobile-cecum-a-case-report
#11
Kentaro Yazawa, Yuki Azuma, Tomohiro Kurokawa, Yuichiro Yoshioka, Giichiro Tsurita, Masaru Shinozaki
INTRODUCTION: A mobile cecum is a frequently encountered congenital anomaly. It is important to recognize this atypical position of the cecum as it may interfere with an accurate diagnosis of acute appendicitis. PRESENTATION OF CASE: A 48-year-old man presented with abdominal pain, anorexia, and fever. He had mild lower abdominal discomfort, and rebound tenderness in the suprapubic region, but no guarding or right lower quadrant findings. Laboratory tests identified an elevated white blood cell count (12350 cells/mL) and C-reactive protein level (4...
December 28, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29322168/patient-preferences-for-surgery-or-antibiotics-for-the-treatment-of-acute-appendicitis
#12
Alexis L Hanson, Ross D Crosby, Marc D Basson
Importance: Studies have compared surgical with nonsurgical therapy for acute uncomplicated appendicitis, but none of these studies have a patient-centered perspective. Objectives: To evaluate how patients might choose between surgical and nonsurgical therapy for acute uncomplicated appendicitis and to identify targets to make antibiotic treatment more appealing. Design, Setting, and Participants: This study comprised an online survey and an in-person sensitivity analysis survey...
January 10, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29315613/the-learning-curve-in-diagnosing-acute-appendicitis-with-emergency-sonography-among-novice-emergency-medicine-residents
#13
Jeehyun Kim, Kipum Kim, Jungwan Kim, Jungwoo Yoo, Wonjoon Jeong, Sunguk Cho, Kihyuk Joo, Yongchul Cho, Jinwoong Lee, Seung Ryu, Yeonho Yoo
PURPOSE: Ultrasonography (US) has good accuracy for diagnosing appendicitis when it is performed by emergency physicians. This study aimed to determine the amount of experience that is required to achieve competency in this field. METHODS: Three novice emergency medicine residents completed a 1-day training course regarding the US diagnosis of appendicitis. Then, they performed appendix US in the emergency department on patients complaining of right lower quadrant pain...
January 5, 2018: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/29314749/laparoscopic-appendectomy-during-the-third-trimester-case-presentation-and-literature-review
#14
Sena Iwamura, Hiroki Hashida, Tomoaki Yoh, Shoichi Kitano, Motoko Mizumoto, Koji Kitamura, Masato Kondo, Hiroyuki Kobayashi, Satoshi Kaihara, Ryo Hosotani
Acute appendicitis is the most common general surgical problem encountered during pregnancy. Laparoscopic appendectomy (LA) is widely accepted as a minimally invasive procedure for acute appendicitis. However, LA during the third trimester is associated with problems, including technical difficulty, risk of preterm delivery, and fetal loss. We successfully managed three cases of LA during the third trimester between 2011 and 2016. None of the cases required conversion to an open procedure, and none of the patients had postoperative complications and/or fetal loss...
January 4, 2018: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29308777/rare-complication-of-appendix-small-bowel-gangrene-caused-by-the-appendicular-knot
#15
R T Mohana, A A Zainal
Intestinal knot formation was first described by Riverius in 16th century and later by Rokitansky in 1836. We report a very rare cause of small bowel gangrene caused by appendiceal knotting on to the ileum in a previously healthy mid aged lady. Patient underwent laparatomy and right hemicolectomy and primary anastomosis. The intra operative findings were the appendix was twisting (knotting) the small bowel about 40cm from the terminal ileum and causing gangrene to the segment of small bowel. Appendicitis is a common condition and management is usually straightforward...
December 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/29306977/acute-appendicitis-in-childhood-oral-contrast-does-not-improve-ct-diagnosis
#16
Crystal R Farrell, Adam D Bezinque, Jared M Tucker, Erica A Michiels, Bradford W Betz
INTRODUCTION: We compared the diagnostic accuracy of CT performed without and with oral contrast for suspected appendicitis in children. METHODS: In this retrospective cohort study, we reviewed abdomen/pelvis CT scans with IV contrast performed between 2011 and 2015 for suspected appendicitis. Oral contrast was used routinely before August 2013 and eliminated from the CT protocol thereafter. Diagnostic accuracy of CT was compared with operative/pathology reports, and included a 30-day follow-up period for non-surgical patients...
January 6, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29306913/diagnosis-of-acute-pediatric-appendicitis-from-children-with-inflammatory-diseases-by-combination-of-metabolic-markers-and-inflammatory-response-variables
#17
Mengjie Yu, Tianxin Xiang, Xiaoping Wu, Shouhua Zhang, Wenlong Yang, Yu Zhang, Qiang Chen, Shuilin Sun, Baogang Xie
BACKGROUND: The discovery of new metabolic markers may be helpful for early diagnosis of acute pediatric appendicitis (APA). However, no studies have been reported regarding identification of potential metabolic markers for the APA diagnosis by metabonomics. METHODS: Serum samples of APA (n=32), non-appendicitis inflammation (NAI, n=32) and healthy children (HS, n=65) were analyzed by the 1H NMR-based metabonomics. A logistic regression model was established to screen the most efficient markers combinations for classification...
January 8, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/29306266/learning-curve-and-period-of-experience-required-for-the-competent-diagnosis-of-acute-appendicitis-using-abdominal-computed-tomography-a-prospective-observational-study
#18
Ju-Hyun Song, Hajin Cho, Jong-Hak Park, Sungwoo Moon, Joo Yeong Kim, Su-Jin Kim, Sung-Hyuk Choi
OBJECTIVE: To assess the learning curve of novice residents in diagnosing acute appendicitis using abdominal computed tomography (CT) scans. METHODS: This prospective observational study was conducted within a 4-month period from March 1 to June 30, 2015. After CT scans for right lower quadrant pain or similar acute abdomen were evaluated, postgraduate year 1 (PGY-1) residents completed an interpretation checklist. The primary outcome was evaluation of the learning curve for competent CT scan interpretation under suspicion of acute appendicitis...
December 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29303686/microbiologic-analysis-of-complicated-and-uncomplicated-acute-appendicitis
#19
Andrés García-Marín, Mercedes Pérez-López, Elena Martínez-Guerrero, Lorena Rodríguez-Cazalla, Antonio Compañ-Rosique
BACKGROUND: Microbiologic studies suggest that complicated (CAA) and uncomplicated (UAA) acute appendicitis are different entities. Routine peritoneal fluid cultures continue to be controversially related to a low positive rate, found mainly in UAA; to isolation of typical micro-organisms with expected susceptibilities; and to a community-acquired intra-abdominal infection. The aim of this study was to describe microbiologic isolates in CAA and UAA and the usefulness of peritoneal fluid cultures to determine the susceptibilities to our antibiotic therapy guidelines...
January 2018: Surgical Infections
https://www.readbyqxmd.com/read/29302510/a-case-of-mesenteric-cyst-in-a-4-year-old-child-with-acute-abdominal-pain
#20
Jae Woong Yoon, Du Young Choi, Yeon Kyun Oh, Seung Hyun Lee, Dong Baek Gang, Seung Taek Yu
Mesenteric cysts are rare intra-abdominal lesions occurring during childhood, which were first described in 1507. Cases of mesenteric cysts have been continuously reported, but these cases were very small in number. They are often asymptomatic and incidentally found while patients are undergoing work-up or receiving treatment for other conditions such as appendicitis, small-bowel obstruction, or diverticulitis; however, patients may still have lower abdominal pain and symptoms that are frequently associated with other abdominal conditions...
December 2017: Pediatric Gastroenterology, Hepatology & Nutrition
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