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Acute appendicitis

Joey Chan Yiing Beh, Anandswaroop Srinivas Uppaluri, Beatrice Fang Ju Koh, Peng-Chung Cheow
Ingested foreign bodies tend to pass through the gastrointestinal tract without incidence, and vast majority of cases do not need intervention. Rarely, these foreign bodies drop into the appendix and not likely to re-enter the normal digestive tract. We describe a case of a 72-year-old male patient who presented with right iliac fossa pain of 3-day duration. Clinical examination suggested classic acute appendicitis. Blood test results revealed leukocytosis. Computed tomography of the abdomen and pelvis showed evidence of acute appendicitis and a linear hyperdensity (foreign body) perforating the appendix...
July 2016: Journal of Radiology Case Reports
Julian C Harnoss, Isabelle Zelienka, Pascal Probst, Kathrin Grummich, Catharina Müller-Lantzsch, Jonathan M Harnoss, Alexis Ulrich, Markus W Büchler, Markus K Diener
OBJECTIVE: The aim was to investigate available evidence regarding effectiveness and safety of surgical versus conservative treatment of acute appendicitis. SUMMARY OF BACKGROUND DATA: There is ongoing debate on the merits of surgical and conservative treatment for acute appendicitis. METHODS: A systematic literature search (Cochrane Library, Medline, Embase) and hand search of retrieved reference lists up to January 2016 was conducted to identify randomized and nonrandomized studies...
October 17, 2016: Annals of Surgery
Valirie Ndip Agbor, Tsi Njim, Leopold Ndemnge Aminde
BACKGROUND: Inguinal hernias in women of reproductive age containing the ovary are very rare. When they occur in this age group, they are mostly associated with malformations of the urogenital system. Prompt surgical intervention is the key to ensure survival of the ovary. Here we present a case of an ectopic ovary presenting like an acute appendicitis. CASE PRESENTATION: A 16-year-old Cameroonian girl presented at our emergency service with an acute exacerbation of a mild and intermittent right iliac fossa pain of 5 days' duration...
October 19, 2016: Journal of Medical Case Reports
James K Hamill, Jamie-Lee Rahiri, Gamage Gunaratna, Andrew G Hill
BACKGROUND: No enhanced recovery after surgery protocol has been published for laparoscopic appendectomy. This was a review of evidence-based interventions that could optimize recovery after appendectomy. METHODS: Interventions for the review Clinical pathway, fast-track or enhanced recovery protocols; needlescopic approach; single incision laparoscopic (SIL) approach; natural orifice transluminal endoscopic surgery (NOTES); regional nerve blocks; intraperitoneal local anaesthetic (IPLA); drains...
October 17, 2016: Surgical Endoscopy
R Guanà, L Lonati, S Garofalo, N Tommasoni, L Ferrero, A Cerrina, R Lemini, C Dallan, J Schleef
Introduction. Acute appendicitis is the most common surgical emergency in the pediatric population. The peak incidence occurs in the first decade of life, while it is uncommon to face appendicitis in children younger than 5 years of age. Laparoscopy is now demonstrated to be the optimal approach also to treat complicated appendicitis, but in very young children this standardized operation is not always easy to perform. Material and Methods. From January 2009 to December 2015 we operated on 525 acute appendicitis, with 120 patients less than 5 years of age...
2016: Surgery Research and Practice
Holly Depinet, Karen Copeland, Joseph Gogain, Halim Hennes, Norman A Paradis, Rebecca Andrews-Dickert, Cheryl W Vance, David S Huckins
BACKGROUND: The diagnosis of pediatric acute appendicitis can be difficult. Although scoring systems such as the Pediatric Appendicitis Score (PAS) are helpful, they lack adequate sensitivity and specificity as standalone diagnostics. When used for risk stratification, they often result in large percentages of moderate-risk patients requiring further diagnostic evaluation. METHODS: We applied a biomarker panel (the APPY1 Test) that has high sensitivity and negative predictive value (NPV) to patients with PAS in the moderate-risk range (3-7) and reclassified those patients with a negative result to the low-risk group...
August 10, 2016: American Journal of Emergency Medicine
Francisco Schlottmann, Romina Reino, Emmanuel E Sadava, Ana Campos Arbulú, Nicolás A Rotholtz
INTRODUCTION: Complicated appendicitis (CA) may be a risk factor for postoperative intra-abdominal abscess formation (IAA). In addition, several publications have shown an increased risk of postoperative collection after laparoscopic appendectomy. Most surgeons prefer to place a drain to collect contaminated abdominal fluid to prevent consequent abscess formation. We aimed to evaluate the utility of placing an intra-abdominal drain in laparoscopic appendectomy for complicated acute appendicitis...
October 12, 2016: International Journal of Surgery
Tao Peng, Liming Dong, Zhihua Zhu, Jing Cui, Qian Li, Xin Li, Heshui Wu, Chunyou Wang, Zhiyong Yang
RATIONALE AND OBJECTIVES: Some deep pelvic abscesses are not accessible through anterior or lateral approaches because of the presence of organs and structures. The objective of this study was to assess the feasibility, safety, tolerability, and efficacy of a percutaneous presacral space approach by reviewing our clinical experience and the literature. MATERIALS AND METHODS: The outcomes of 12 patients, who have undergone computed tomography (CT)-guided percutaneous presacral space drainage, were retrospectively reviewed, including demographic, clinical, and morphological data in the medical records...
October 12, 2016: Academic Radiology
Tomás Sánchez-Santana, Juan Antonio Del-Moral-Luque, Pablo Gil-Yonte, Luis Bañuelos-Andrío, Manuel Durán-Poveda, Gil Rodríguez-Caravaca
BACKGROUND: Antibiotic prophylaxis is the most suitable tool for preventing surgical site infection. This study assessed compliance with antibiotic prophylaxis in surgery for acute appendicitis, and the effect of this compliance on surgical site infection. MATERIAL AND METHODS: Prospective cohort study to evaluate compliance with antibiotic prophylaxis protocol in appendectomies. An assessment was made of the level of compliance with prophylaxis, as well as the causes of non-compliance...
October 13, 2016: Cirugia y Cirujanos
Bo Hyun Hwang, Younglim Kim, Gi-Bong Chae, Suk-Bae Moon
OBJECTIVE: The use of abdominal computed tomography (ACT) for nontraumatic abdominal pain in the pediatric emergency department is increasing to a remarkable extent, and every effort should be made to select patients who would benefit from ACT. The aim of this study was to investigate the clinical and laboratory predictors of positive CT yield in pediatric patients with nontraumatic abdominal pain. METHODS: The medical records of 739 pediatric patients who, between January 2009 and February 2014, underwent ACT for nontraumatic abdominal pain at the emergency department were reviewed retrospectively...
October 6, 2016: Pediatric Emergency Care
G Cocorullo, N Falco, R Tutino, T Fontana, G Scerrino, G Salamone, L Licari, G Gulotta
AIM: To evaluate the role of laparoscopy in the treatment of surgical emergency in old population. PATIENTS AND METHODS: Over-70 years-old patients submitted to emergency abdominal surgery from January 2013 to December 2014 were collected and grouped according to admission diagnoses. These accounted small bowel obstruction, colonic acute disease, appendicitis, ventral hernia, gastro-duodenal perforation, biliary disease. In each group it was analyzed the operation time (OT), the morbidity rate and the mortality rate comparing open and laparoscopic management using T-test and Chi-square test...
May 2016: Il Giornale di Chirurgia
L Segev, Y Segev, S Rayman, A Nissan, E Sadot
BACKGROUND: Acute appendicitis is the most common nonobstetric indication for surgical intervention during pregnancy. However, the current literature is scarce and composed of relatively small case series. We aimed to compare the presentation, management, and surgical outcomes of presumed acute appendicitis between a contemporary cohort of pregnant women and nonpregnant women of reproductive age. METHODS: The study group included 92 pregnant patients who underwent appendectomy for presumed acute appendicitis at a single tertiary medical center in 2000-2014...
October 11, 2016: World Journal of Surgery
B Lembcke
Despite sophisticated physical examination and laboratory support, diagnosis of acute appendicitis remained challenging in clinical practice with a negative appendectomy rate of 15 - 30 %. As a remarkable clue and as early as 1986, ultrasonography (US) has been proven a reliable diagnostic method that is also explicitly helpful in difficult cases with atypical presentation and enables to rule out many differential diagnoses.Recent publications emphasized the role of multidetector computed tomography (CT) resulting in a significant reduction of false negative findings at operation...
October 2016: Zeitschrift Für Gastroenterologie
Shin Ahn, Hyeji Lee, Wookjin Choi, Ryeok Ahn, Jung-Suk Hong, Chang Hwan Sohn, Dong Woo Seo, Yoon-Seon Lee, Kyung Soo Lim, Won Young Kim
OBJECTIVE: We tried to evaluate the accuracy of the heel drop test in patients with suspected appendicitis and tried to develop a new clinical score, which incorporates the heel drop test and other parameters, for the diagnosis of this condition. METHODS: We performed a prospective observational study on adult patients with suspected appendicitis at two academic urban emergency departments between January and August 2015. The predictive characteristics of each parameter, along with heel drop test results were calculated...
2016: PloS One
Hideki Katagiri, Alan Kawarai Lefor, Tadao Kubota, Ken Mizokami
AIM: To review clinical experience with barium appendicitis at a single institution. METHODS: A retrospective review of patients admitted with a diagnosis of acute appendicitis, from January 1, 2013 to December 31, 2015 was performed. Age, gender, computed tomography (CT) scan findings if available, past history of barium studies, pathology, and the presence of perforation or the development of complications were reviewed. If the CT scan revealed high density material in the appendix, the maximum CT scan radiodensity of the material is measured in Hounsfield units (HU)...
September 27, 2016: World Journal of Gastrointestinal Surgery
Jea Yeon Choi, Eell Ryoo, Jeong Hyun Jo, Tchah Hann, Seong Min Kim
PURPOSE: This study examined the risk factors of a delayed diagnosis of acute appendicitis in children undergoing an appendectomy. METHODS: This retrospective study involved children aged below 18 years, who underwent an appendectomy. After dividing them into a delayed diagnosis group and nondelayed diagnosis group according to the time interval between the initial hospital visit and final diagnosis, the risk factors of delayed diagnosis were identified using logistic regression analysis...
September 2016: Korean Journal of Pediatrics
Marija Kocic, Slavisa M Djuricic, Maja Djordjevic, Djordje Savic, Bozica Kecman, Adrijan Sarajlija
Almost any anatomical compartment may be involved in Gaucher disease (GD). Abdominal lymphadenopathy occurred during enzyme replacement therapy in more than a dozen children with GD so far. A fourteen-year-old boy from Serbia developed clinical signs of acute appendicitis six years after the onset of GD type 3 related abdominal lymphadenopathy. Ultrasound examination showed diffuse thickening of the intestinal wall in the ileocoecal region with periappendicular infiltration. An appendectomy was performed four months after conservative treatment with antibiotics...
September 30, 2016: Blood Cells, Molecules & Diseases
Alessandro Boscarelli, Simone Frediani, Silvia Ceccanti, Ilaria Falconi, Gabriele Masselli, Emanuele Casciani, Denis A Cozzi
In children, epiploic appendagitis has been seldom reported. We describe two children with clinical presentations mimicking appendicitis. A correct diagnosis was eventually achieved by magnetic resonance imaging (MRI) and confirmed at laparoscopy in the initial case. Our preliminary experience suggests that MRI is a valid and non-invasive alternative to computed tomography for characterization of unusual causes of pediatric abdominal pain in the acute hospital care setting.
September 20, 2016: Journal of Pediatric Surgery
Yuki Imaoka, Toshiyuki Itamoto, Yuji Takakura, Takahisa Suzuki, Satoshi Ikeda, Takashi Urushihara
BACKGROUND: Our previous retrospective study revealed the three preoperative predictors of complicated appendicitis (perforated or gangrenous appendicitis), which are body temperature ≥37.4 °C, C-reactive protein ≥4.7 mg/dl, and fluid collection surrounding the appendix on computed tomography. We reported here an additional prospective study to verify our ability to predict complicated appendicitis using the three preoperative predictors and thus facilitate better informed decisions regarding emergency surgery during night or holiday shifts...
2016: World Journal of Emergency Surgery: WJES
Chih-Chen Chang, Yon-Cheong Wong, Cheng-Hsien Wu, Huan-Wu Chen, Li-Jen Wang, Yu-Hsien Lee, Patricia Wanping Wu, Wiwan Irama, Wei Yuan Chen, Chee-Jen Chang
BACKGROUND: Low-dose computed tomography (LDCT) techniques can reduce exposure to radiation. Several previous studies have shown that radiation dose reduction in LDCT does not decrease the diagnostic performance for appendicitis among attending radiologists. But, the LDCT diagnostic performance for acute appendicitis in radiology residents with variable training levels has not been well discussed. OBJECTIVES: To compare inter-observer and intra-observer differences of diagnostic performance on non-enhanced LDCT (NE-LDCT) and contrast-enhanced standard dose CT (CE-SDCT) for acute appendicitis among attending and resident radiologists...
April 2016: Iranian Journal of Radiology: a Quarterly Journal Published By the Iranian Radiological Society
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