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Pediatric appendicitis

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https://www.readbyqxmd.com/read/29336754/predictors-and-outcomes-of-nondiagnostic-ultrasound-for-acute-appendicitis-in-children
#1
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/29331260/multifaceted-behavior-of-meckel-s-diverticulum-in-children
#2
Qingjiang Chen, Zhigang Gao, Lifeng Zhang, Yuebin Zhang, Tao Pan, Duote Cai, Qixing Xiong, Qiang Shu, Yunzhong Qian
PURPOSE/BACKGROUND: Meckel's diverticulum (MD) is one of the most common congenital malformations of gastrointestinal tract in children. However, the nonspecific clinical manifestations of MD often cause a diagnostic as well as therapeutic challenge to pediatric surgeon. This study aimed to review our experience in managing this disease while evaluating the management strategies. METHODS: We retrospectively analyzed the clinical data of all patients diagnosed with MD admitted to our center between January 2010 and December 2015...
December 5, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29324631/pediatric-appendicitis-association-of-chief-complaint-with-missed-appendicitis
#3
Zachary Drapkin, Jennifer Dunnick, Troy E Madsen, Matthew Bryce, Jeff E Schunk
OBJECTIVES: We evaluated the association between the emergency department (ED) triage chief complaint and rate of missed appendicitis in children. METHODS: We performed a retrospective chart review of patients who presented to a pediatric ED and were diagnosed with appendicitis over 5 years (July 1, 2009 to June 30, 2014). We reviewed the medical record for any additional ED visits in the 7 days preceding the diagnosis of appendicitis. Triage chief complaints were classified as "suggestive of appendicitis" (abdominal pain, right lower quadrant pain, or rule out appendicitis) or "nonspecific" (fever, vomiting, dehydration, etc)...
January 11, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29306977/acute-appendicitis-in-childhood-oral-contrast-does-not-improve-ct-diagnosis
#4
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
#5
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/29298941/sonography-and-computed-tomography-in-diagnosing-acute-appendicitis
#6
Mikayla E Hwang
PURPOSE: A systematic literature review was performed to evaluate the effectiveness of abdominal sonography and abdominal computed tomography (CT) in diagnosing acute appendicitis in adult and pediatric patients. METHODS: Peer-reviewed literature published between 1986 and 2014 was searched using multiple medical literature databases. Studies included in this review were conducted on human patients; included more than 50 patients; reported diagnostic values; evaluated pediatric patients, adults, or both (pregnant women excluded); and used histological results from surgery or clinical follow-up as a reference standard...
January 2018: Radiologic Technology
https://www.readbyqxmd.com/read/29283967/pediatric-appendicitis-is-referral-to-a-regional-pediatric-center-necessary
#7
Maggie M Hodges, Clay Cothren Burlew, Shannon N Acker, Ernest E Moore, Genie E Roosevelt, Anna Schubert, Lauren R S Hill, David A Partrick, Denis Bensard
BACKGROUND: Acute appendicitis is the most common emergent surgical procedure performed among children in the US, with an incidence exceeding 80,000 cases per year. Appendectomies are often performed by both pediatric surgeons and adult general/trauma acute care surgeons (TACS surgeons). We hypothesized that children undergoing appendectomy for acute appendicitis have equivalent outcomes whether a pediatric surgeon or a TACS surgeon performs the operation. METHODS: A retrospective chart review was performed for patients 6-18 years of age, who underwent appendectomy at either a regional children's hospital (CHCO, n=241) or an urban safety net hospital (n=347) between July 2010 and June 2015...
December 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29273882/the-oral-microbiome-the-relevant-reservoir-for-acute-pediatric-appendicitis
#8
Carlotta Blod, Nadine Schlichting, Sara Schülin, Anne Suttkus, Nicole Peukert, Catalina Suzana Stingu, Christian Hirsch, Wieland Elger, Martin Lacher, Ulf Bühligen, Steffi Mayer
PURPOSE: The oral microbiome has been related to numerous extra oral diseases. Recent studies detected a high abundance of oral bacteria in inflamed appendices in pediatric patients. To elucidate the role of oral bacteria in acute pediatric appendicitis, we studied the oral and appendiceal microbiome of affected children compared to healthy controls. METHODS: Between January and June 2015, 21 children undergoing appendectomy for acute appendicitis and 28 healthy controls were prospectively enrolled in the study...
December 22, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29273360/the-diagnostic-value-of-hepcidin-to-predict-the-presence-and-severity-of-appendicitis-in-children
#9
Margarita Kaiser, Magdalena Schroeckenfuchs, Christoph Castellani, Gert Warncke, Holger Till, Georg Singer
BACKGROUND: The aim of this study was to determine the diagnostic capacity of hepcidin in pediatric acute appendicitis and its accuracy as a predictor of the severity of appendicitis. MATERIALS AND METHODS: In children with appendicitis (n = 39), leukocytes, platelet count, and the serum levels of C-reactive protein (CRP) and hepcidin were compared to a control group (n = 25) of patients with unspecific abdominal pain. Additionally, parameters were compared between children with simple (n = 17) and complicated appendicitis (n = 22)...
February 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29249008/secondary-imaging-for-suspected-appendicitis-after-equivocal-ultrasound-time-to-disposition-of-mri-compared-to-ct
#10
James F Martin, David J Mathison, Paul C Mullan, Hansel J Otero
PURPOSE: The purpose of this study was to compare MRI to CT as a secondary imaging modality for children age 5 years and older with suspected appendicitis after an equivocal abdominal ultrasound in terms of (1) the time to ED disposition decision, (2) surgery consultation rate, and (3) imaging test accuracy. METHODS: We retrospectively studied children with suspected appendicitis and equivocal ultrasound results who underwent MR or CT as secondary imaging in a pediatric emergency department over two-consecutive 9-month periods...
December 16, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/29243544/communication-is-key-the-utility-of-a-revised-neuropsychological-report-format
#11
Katherine T Baum, Christian von Thomsen, Megan Elam, Christel Murphy, Melissa Gerstle, Cynthia A Austin, Dean W Beebe
OBJECTIVE: The neuropsychological report is a critical tool for communicating evaluation results to multiple audiences who have varying knowledge about neuropsychology and often have limited ability to review long, complex reports. Considerable time is spent writing these reports and challenges persist related to readability, length/complexity, and billable clinical time (which may be capped by third-party payors or families' ability to pay). METHODS: This quality improvement effort systematically evaluated the redesign of pediatric neuropsychological reports in an outpatient clinic serving primarily medical populations...
December 15, 2017: Clinical Neuropsychologist
https://www.readbyqxmd.com/read/29241960/trends-in-common-surgical-procedures-at-children-s-and-nonchildren-s-hospitals-between-2000-and-2009
#12
Heather L Short, Samir Sarda, Curtis Travers, Jason M Hockenberry, Ian McCarthy, Mehul V Raval
PURPOSE: Though growth in children's surgical expenditures has been documented, procedure-specific differences in volume and costs at children's hospitals (CH) and non-hildren's hospitals (NCH) have not been explored. Our purpose was to compare trends in volume and costs of common pediatric surgical procedures between CH and NCH. METHODS: We performed a review of the 2000-2009 Kids' Inpatient Database identifying all cases of appendectomy for uncomplicated appendicitis (AP), tonsillectomy and adenoidectomy (TA), fundoplication (FP), humeral fracture repair (HFR), pyloromyotomy (PYL), and cholecystectomy (CHOLE)...
November 23, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29241958/time-to-appendectomy-for-acute-appendicitis-a-systematic-review
#13
REVIEW
Danielle B Cameron, Regan Williams, Yimin Geng, Ankush Gosain, Meghan A Arnold, Yigit S Guner, Martin L Blakely, Cynthia D Downard, Adam B Goldin, Julia Grabowski, Dave R Lal, Roshni Dasgupta, Robert Baird, Robert L Gates, Julia Shelton, Tim Jancelewicz, Shawn J Rangel, Mary T Austin
OBJECTIVE: The goal of this systematic review by the American Pediatric Surgical Association Outcomes and Evidence-Based Practice Committee was to develop recommendations regarding time to appendectomy for acute appendicitis in children within the context of preventing adverse events, reducing cost, and optimizing patient/parent satisfaction. METHODS: The committee selected three questions that were addressed by searching MEDLINE, Embase, and the Cochrane Library databases for English language articles published between January 1, 1970 and November 3, 2016...
November 20, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29230341/pancreatic-laceration-in-a-pediatric-patient-an-unexpected-diagnosis
#14
Michelle J Hong, Lauren M Porter, Debra D Esernio-Jenssen, Andrew C Miller, Marna Rayl Greenberg
Pediatric pancreatic injuries are rare. We present an atypical case that occurred in a 4-year-old male. The child presented with a twenty-four-hour history of vomiting that had progressed to right lower quadrant abdominal pain on examination in the emergency department. The initial differential was gastroenteritis versus appendicitis. An abnormality on the ultrasonography and an elevated lipase level eventually led to an MRI showing a complete transection through the posterior margin of the pancreas. The patient was admitted to pediatric surgery and underwent a successful distal pancreatectomy with preservation of the spleen...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/29223673/risk-stratification-in-pediatric-perforated-appendicitis-prospective-correlation-with-outcomes-and-resource-utilization
#15
Yasmine Yousef, Fouad Youssef, Trish Dinh, Kartikey Pandya, Hayden Stagg, Michael Homsy, Robert Baird, Jean-Martin Laberge, Dan Poenaru, Pramod Puligandla, Kenneth Shaw, Sherif Emil
PURPOSE: Despite a wide spectrum of severity, perforated appendicitis in children is typically considered a single entity in outcomes studies. We performed a prospective cohort study to define a risk stratification system that correlates with outcomes and resource utilization. METHODS: A prospective study was conducted of all children operated for perforated appendicitis between May 2015 and December 2016 at a tertiary free-standing university children's hospital...
November 14, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29205688/integration-of-radiological-findings-and-a-clinical-score-in-pediatric-appendicitis
#16
Derya Aydin, Caner Turan, Ali Yurtseven, Petek Bayindir, Bade Toker, Zafer Dokumcu, Murat Sezak, Eylem Ulas Saz
BACKGROUND: The efficacy of ultrasonography (US) and abdominal X-ray in combination with PAS is complicated in the diagnosis of acute appendicitis. Abdominal X-ray is as useful as US with clinical assessment when evaluated by experienced pediatric radiologist in acute appendicitis. We aimed to determine the value of US and abdominal X-ray for appendicitis in children when combined with clinical assessment based on the Pediatric Appendicitis Score (PAS). We also aimed to establish a practical pathway for acute appendicitis in childhood...
December 5, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/29180169/sarcopenia-in-children-with-perforated-appendicitis
#17
Joseph J López, Jennifer N Cooper, Brett Albert, Brent Adler, Denis King, Peter C Minneci
BACKGROUND: Decreased skeletal muscle mass, or sarcopenia, has been shown to be associated with worse postoperative recovery and a higher risk of complications in adult surgical patients. We hypothesized that pediatric patients with complicated appendicitis may experience sarcopenic changes over the course of their treatment. METHODS: The medical records and computed tomography scans of 36 pediatric complex appendicitis patients who had both preoperative and postoperative computerized tomography scans at our hospital were reviewed...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29173776/out-of-africa-insights-from-a-prospective-pediatric-surgery-database
#18
REVIEW
Stephen W Bickler
In this year's Robert E. Gross lecture, I describe how experiences early in my career at a government referral hospital in Banjul, The Gambia, influenced my research. Collecting prospective data on all children presenting to the hospital with surgical problems allowed me to gain an understanding of the epidemiology of childhood surgical conditions in sub-Saharan Africa and an appreciation for the inherent challenges of delivering surgical care in settings of limited resources. Based on findings from this database, my research over the past 20years has focused on developing strategies for improving surgical care in low-income countries and better understanding the geographical variations that occur in some of the most common surgical conditions in high-income countries (e...
October 23, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29168372/tuba-ovarian-auto-amputation-caused-by-ovarian-teratoma-in-an-adolescent-girl
#19
Ahmet Atıcı, Engin Yılmaz, Ayşe Karaman, Sema Apaydın, Çağatay Evrim Afşarlar
Atıcı A, Yılmaz E, Karaman A, Apaydın S, Afşarlar ÇE. Tuba-ovarian auto-amputation caused by ovarian teratoma in an adolescent girl. Turk J Pediatr 2017; 59: 90-92. Ovarian auto-amputation is an extremely rare condition commonly encountered in the perinatal period. Spontaneous or secondary torsion of the ovary caused by an ovarian lesion may result in infarction and subsequent auto-amputation of the ovary. This paper demonstrates a case that underwent laparoscopic appendectomy with an incidental calcified auto-amputated right ovary...
2017: Turkish Journal of Pediatrics
https://www.readbyqxmd.com/read/29159839/increased-renal-echogenicity-in-children-with-appendicitis
#20
Hila Tal, Daniel Ben-Mordechay, Aviva Ben-Shlush, Lisa Raviv-Zilka, Michalle Soudack
OBJECTIVES: Ultrasound (US) is an important modality for the detection of acute appendicitis in children but has limited sensitivity and specificity. Therefore, additional US findings may contribute to the diagnosis. In our experience, children with acute appendicitis often have increased renal cortical echogenicity on US imaging. The purpose of this study was to examine the association of increased renal cortical echogenicity with appendicitis. METHODS: This study included 240 consecutive pediatric patients with no renal or liver disease who underwent US examinations for suspected appendicitis between February 2014 and January 2016...
November 21, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
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