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Acute appendicitis

Maxim Avanesov, Nis Jesper Wiese, Murat Karul, Helena Guerreiro, Sarah Keller, Philip Busch, Frank Jacobsen, Gerhard Adam, Jin Yamamura
OBJECTIVES: To develop a routinely applicable severity index for the management of acute appendicitis in adults using combined clinical and radiological parameters and retroperitoneal space planes (RSP). METHODS: Two hundred consecutive patients with histologically proven acute appendicitis and available presurgical CT scans were analysed retrospectively. Two radiologists assessed all CT scans for morphologic sings of appendicitis and six RSP. Clinical parameters were age, body temperature, C-reactive protein (CRP), white blood cell count, and duration of symptoms...
March 14, 2018: European Radiology
Jae Min Lee, Beom Seok Kwak, Young Jin Park
Purpose: With varied reports on the impact of time to appendectomy on clinical outcomes, the purpose of this study was to determine the effect of preoperative in-hospital delay on the outcome for patients with acute appendicitis. Methods: A retrospective review of 1,076 patients who had undergone an appendectomy between January 2010 and December 2013 was conducted. Results: The outcomes of surgery and the pathologic findings were analyzed according to elapsed time...
February 2018: Annals of Coloproctology
Anupam B Kharbanda, Gabriela Vazquez-Benitez, Dustin W Ballard, David R Vinson, Uli K Chettipally, Mamata V Kene, Steven P Dehmer, Richard G Bachur, Peter S Dayan, Nathan Kuppermann, Patrick J O'Connor, Elyse O Kharbanda
OBJECTIVES: We sought to develop and validate a clinical calculator that can be used to quantify risk for appendicitis on a continuous scale for patients with acute abdominal pain. METHODS: The pediatric appendicitis risk calculator (pARC) was developed and validated through secondary analyses of 3 distinct cohorts. The derivation sample included visits to 9 pediatric emergency departments between March 2009 and April 2010. The validation sample included visits to a single pediatric emergency department from 2003 to 2004 and 2013 to 2015...
March 13, 2018: Pediatrics
Nicholas Yock Teck Soh, Nan Zun Teo, Carrie Jen Hsi Tan, Shivani Rajaraman, Marianne Tsang, Calvin Jian Ming Ong, Ramesh Wijaya
BACKGROUND: It is unclear if location of disease matters in perforated diverticulitis. Management guidelines for perforated diverticulitis currently do not make a distinction between right perforated diverticulitis (RPD) and left perforated diverticulitis (LPD). We aim to compare disease presentation and management outcomes between RPD and LPD. METHODS: This was a 10-year retrospective comparative cohort study of 99 patients with acute perforated diverticulitis between 2004 and 2013 in a single institution...
March 12, 2018: International Journal of Colorectal Disease
Avinoam Nevler, Yaniv Berger, Avital Rabinovitz, Oded Zmora, Moshe Shabtai, Danny Rosin, Mordechai Gutman
BACKGROUND: Acute appendicitis (AA) is one of the most common indications for emergency abdominal surgery. OBJECTIVES: To assess the diagnostic and prognostic value of serum bilirubin and liver enzyme levels in the management of acute appendicitis. METHODS: Consecutive emergency department patients referred for a surgical consult for suspected AA were prospectively enrolled in the study. Data regarding demographic, clinical and laboratory results were recorded...
March 2018: Israel Medical Association Journal: IMAJ
Hanan Goldberg, Gil N Bachar, Riad Majadla, Ofer Yossepowitch, Jack Baniel, Edward Ram
BACKGROUND: Right hydronephrosis secondary to acute appendicitis is an under-reported phenomenon with only several case reports published. OBJECTIVES: To assess the incidence of this phenomenon in our database of patients diagnosed with acute appendicitis. METHODS: Data were collected on 1092 patients who underwent surgery due to acute appendicitis between 2003 and 2007 in our tertiary medical center. The data entailed demographic, surgical, and hospitalization parameters including ultrasound or computed tomography examinations and presence of right hydronephrosis prior to surgery...
March 2018: Israel Medical Association Journal: IMAJ
M D Bolmers, C C van Rossem, R R Gorter, W A Bemelman, A A W van Geloven, H A Heij
PURPOSE: A laparoscopic approach for emergency appendectomy is increasingly used, in pediatric patients as well. The objective of this study is to audit the current state of diagnostic work-up, surgical techniques and its outcome in children with acute appendicitis. METHODS: A prospective consecutive observational cohort study was carried out in a 2-month study period. All patients under 18 years that were operated for suspected acute appendicitis were included...
March 9, 2018: Pediatric Surgery International
Cássio S Meira, José Maurício Dos Santos Filho, Caroline C Sousa, Pâmela S Anjos, Jéssica V Cerqueira, Humberto A Dias Neto, Rafael G da Silveira, Helena M Russo, Jean-Luc Wolfender, Emerson F Queiroz, Diogo R M Moreira, Milena B P Soares
4-(Nitrophenyl)hydrazone derivatives of N-acylhydrazone were synthesized and screened for suppress lymphocyte proliferation and nitrite inhibition in macrophages. Compared to an unsubstituted N-acylhydrazone, active compounds were identified within initial series when hydroxyl, chloride and nitro substituents were employed. Structure-activity relationship was further developed by varying the position of these substituents as well as attaching structurally-related substituents. Changing substituent position revealed a more promising compound series of anti-inflammatory agents...
February 25, 2018: Bioorganic & Medicinal Chemistry
Jamie J Coleman, Bryan W Carr, Tyrone Rogers, Matthew S Field, Ben L Zarzaur, Stephanie A Savage, Peter M Hammer, Brian L Brewer, David V Feliciano, Grace S Rozycki
BACKGROUND: Abdominal pain is a common reason patients seek treatment in emergency departments (ED), and computed tomography (CT) is frequently used for diagnosis; however, length of stay in the ED and risks of radiation remain a concern. The hypothesis of this study was the Alvarado Score (AS) could be used to reduce CT scans and decrease ED length of stay (LOS) for patients with suspected acute appendicitis (AA). METHODS: A retrospective review of patients who underwent CT to rule out AA from January 1st, 2015, to December 31st, 2015 was performed...
March 8, 2018: Journal of Trauma and Acute Care Surgery
Tishara Wijayanayaka, Jacob Davidson, Andreana Bütter
PURPOSE: The purpose of this study was to determine whether children with a positive ultrasound (US) for acute appendicitis but a negative clinical picture developed appendicitis requiring definitive management. METHODS: After obtaining IRB approval, we conducted a retrospective review of patients ≤17years who presented with possible acute appendicitis between April 1st, 2014, and December 31st, 2015. We included patients with a US suggestive of acute appendicitis based on size criteria but without concerning clinical features...
February 9, 2018: Journal of Pediatric Surgery
Adham do Amaral E Castro, Thelma Larocca Skare, Fernando Ide Yamauchi, Adriano Tachibana, Suheyla Pollyana Pereira Ribeiro, Eduardo Kaiser Ururahy Nunes Fonseca, Andressa Tamy Sakuma, Milena Rocha Peixoto, Mariana Athaniel Silva Rodrigues, Maria Angela M Barreiros
BACKGROUND: The C reactive protein (CRP) is one of the most accurate inflammatory markers in acute appendicitis (AA). Obesity leads to a pro-inflammatory state with increased CRP, which may interfere with the interpretation of this laboratory test in AA. AIM: To assess sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CRP in patients with AA and their correlation to body mass index (BMI) and body fat composition. METHOD: This is a retrospective study based on clinical records and imaging studies of 191 subjects with histopathologically confirmed AA compared to 249 controls who underwent abdominal computed tomography (CT)...
March 1, 2018: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Eylem Kuday Kaykisiz, Murat Baki Yildirim, Emrah Dadali, Hüseyin Kaykisiz, Erden Erol Ünlüer
The differential diagnosis of anuria in emergency department (ED) is broad. Secondary to intraabdominal mass pressure or infections, symptoms of micturation difficulties or disuria accompanying to back pain may arise with the interruption of sacral nerve stimulation. Here, we report a patient who admitted to ED with back pain and anuria and diagnosed acute appendicitis (AA) after advanced investigation despite of not to have any abdominal pain. A 36-year-old man admitted to our ED with a 6-h history of back pain and urination difficulty...
February 28, 2018: American Journal of Emergency Medicine
Dwayne T S Chang, Melissa Maluda, Lisa Lee, Chandrasiri Premaratne, Srisongham Khamhing
BACKGROUND: Early and accurate identification or exclusion of acute appendicitis is the key to avoid the morbidity of delayed treatment for true appendicitis or unnecessary appendicectomy, respectively. We aim (i) to identify potential predictive factors for positive and negative appendicectomies; and (ii) to analyse the use of ultrasound scans (US) and computed tomography (CT) scans for acute appendicitis. MATERIALS AND METHODS: All appendicectomies that took place at our hospital from the 1st of January 2013 to the 31st of December 2015 were retrospectively recorded...
March 6, 2018: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Hee Mang Yoon, Jung Heon Kim, Jong Seung Lee, Jeong-Min Ryu, Dae Yeon Kim, Jeong-Yong Lee
BACKGROUND: Appendicolith can cause appendiceal obstruction and acute appendicitis. Its high prevalence may be related to the high perforation rate in pediatric appendicitis. This study assessed the characteristics of appendicolith and its clinical significance in pediatric appendicitis. METHODS: A retrospective study was performed among children and adolescents younger than 17 years who were preoperatively diagnosed with appendicitis in the pediatric emergency department (ED)...
March 5, 2018: World Journal of Pediatrics: WJP
Toufik A Tabbara, Omar Y Alassaf, Mujtaba C Kaouas
INTRODUCTION: Acute epiploic appendagitis is a relatively rare disease that mimics a varied number of diseases. PRESENTATION OF CASE: In this paper we report a 24-year-old male who presented with epiploic appendagitis that might have been misdiagnosed by physicians due to its equivocal presentation imitating more common acute abdominal conditions like acute appendicitis or acute diverticulitis depending on the site of the inflamed appendage. DISCUSSION: The clinical presentation, investigations findings and both conservative and surgical interventions of the patient are mentioned within the report...
February 23, 2018: International Journal of Surgery Case Reports
Zsolt Szakács, Nándor Faluhelyi, András Fincsur, András Papp, Áron Vincze, Judit Bajor
The differential diagnosis of acute abdominal complaints is challenging in Crohn's disease. This is particularly true in patients in remission induced by biological therapy. In addition to the acute relapse of Crohn's disease, other common causes, such as acute appendicitis exhibiting similar and often atypical course, should be taken into consideration irrespective of the age. An ileocecal flare-up is unlikely to occur in patients with perianal Crohn's disease in remission induced by infliximab even if laboratory and radiological findings point towards this diagnosis...
March 2018: Orvosi Hetilap
Summaiya Zafar, Muhammad Usman Tariq, Zubair Ahmed
Enterobius vermicularis (EV) is a pinworm which commonly resides in the lumen of the intestinal tract and lays eggs on the perianal skin. However, rarely the worm can infest various other sites in the body and cases with infestation of such ectopic sites have been reported in literature. Rare cases of mesenteric lymph node involvement have also been reported. We report a case in a young male who presented with signs and symptoms of acute appendicitis. During surgery, enlarged mesenteric lymph nodes were identified...
January 2018: Journal of Ayub Medical College, Abbottabad: JAMC
Natalie Hutchings, Wendy Wood, Isabel Reading, Erin Walker, Jane M Blazeby, William Van't Hoff, Bridget Young, Esther M Crawley, Simon Eaton, Maria Chorozoglou, Frances C Sherratt, Lucy Beasant, Harriet Corbett, Michael P Stanton, Simon Grist, Elizabeth Dixon, Nigel J Hall
BACKGROUND: Currently, the routine treatment for acute appendicitis in the United Kingdom is an appendicectomy. However, there is increasing scientific interest and research into non-operative treatment of appendicitis in adults and children. While a number of studies have investigated non-operative treatment of appendicitis in adults, this research cannot be applied to the paediatric population. Ultimately, we aim to perform a UK-based multicentre randomised controlled trial (RCT) to test the clinical and cost effectiveness of non-operative treatment of acute uncomplicated appendicitis in children, as compared with appendicectomy...
March 2, 2018: Trials
Wissem Triki, Ahmed Itaimi, Imed Abbassi, Oussama Baraket, Sami Bouchoucha
Duplication of the vermiform appendix is a rare malformation. Few than 100 cases have been reported worldwide. It is usually diagnosed incidentally during emergency appendectomies due to inflammatory processes in the cecal appendix. We report a case of a woman presented with clinical features typical of acute appendicitis and surgical exploration revealed a double appendix. The operating surgeon should be vigilant of these rare anomalies to avoid serious clinical and medico legal consequences.
April 2017: La Tunisie Médicale
Dae Woon Song, Byung Kwan Park, Suk Won Suh, Seung Eun Lee, Jong Won Kim, Joong-Min Park, Hye Ryoun Kim, Mi-Kyung Lee, Yoo Shin Choi, Beom Gyu Kim, Yong Gum Park
PURPOSE: Essential treatment of acute appendicitis is surgical resection with the use of appropriate antibiotics. In order to effectively treat acute appendicitis, it is important to identify the microorganism of acute appendicitis and evaluate the effective antibiotics. METHODS: A total of 694 patients who underwent appendectomy for acute appendicitis and had positive microbial result between 2006 and 2015 were recruited. For microbial assessment, luminal contents of the appendix were swabbed after appendectomy...
February 27, 2018: International Journal of Colorectal Disease
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