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Pediatric appendicitis

Derek B Wall, Carlos Ortega
BACKGROUND: Even in metropolitan areas, on-call pediatric surgeons may not always be immediately available for surgical care of appendicitis, potentially leading to delays in care. In 2012, the in-house trauma group at a suburban Level 1 trauma center (none with formal pediatric fellowship training) assumed surgical care of 5-10 year-old children with appendicitis, who had previously been cared for by pediatric surgeons. We propose to compare the outcomes of the trauma and pediatric surgery groups...
March 16, 2018: Journal of Trauma and Acute Care Surgery
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
Maurizio Pacilli, Catherine J Bradshaw, Simon A Clarke
INTRODUCTION: Medium-term intravenous access in children is normally achieved by means of repeated multiple peripheral intravenous cannula insertions or peripherally inserted central catheters. Long peripheral cannulas might offer an alternative to these devices in children. Our aim was to clarify whether long peripheral cannulas provide reliable medium-term intravenous access avoiding the need for multiple peripheral intravenous cannulations or peripherally inserted central catheter insertion in children undergoing surgery...
March 1, 2018: Journal of Vascular Access
Nusrat S Shommu, Craig N Jenne, Jaime Blackwood, Ari R Joffe, Dori-Ann Martin, Graham C Thompson, Hans J Vogel
Various limitations hinder the timely and accurate diagnosis of appendicitis in pediatric patients. The present study aims to investigate the potential of metabolomics and cytokine profiling for improving the diagnosis of pediatric appendicitis. Serum and plasma samples were collected from pediatric patients for metabolic and inflammatory mediator analyses respectively. Targeted metabolic profiling was performed using Proton Nuclear Magnetic Resonance Spectroscopy and Flow Injection Analysis Mass Spectrometry/Mass Spectrometry and targeted cytokine/chemokine profiling was completed using a multiplex platform to compare children with and without appendicitis...
2018: PloS One
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
Nusrat S Shommu, Craig N Jenne, Jaime Blackwood, Dori-Ann Martin, Ari R Joffe, Robin Eccles, Mary Brindle, Ijab Khanafer, Hans J Vogel, Graham C Thompson
Multiplexed profiling approaches including various 'omics' platforms are becoming a new standard of biomarker development for disease diagnosis and prognosis. The present study applied an integrated metabolomics and cytokine profiling approach as a potential aid to the identification of pediatric appendicitis. Metabolic analysis using serum (n = 121) and urine (n = 102) samples, and cytokine analysis using plasma (n = 121) samples from children presenting to the Emergency Department with abdominal pain were performed...
March 6, 2018: Scientific Reports
Kristin Gee, Sandra Ngo, Lorrie Burkhalter, Alana L Beres
BACKGROUND: Appendicitis is the most common gastrointestinal pediatric surgical emergency. With the introduction of laparoscopic techniques in the 1990s, recovery, pain, and hospital stay after laparoscopic procedures have been significantly reduced. While many laparoscopic procedures are performed as outpatient surgeries, pediatric appendectomy patients continue to be hospitalized for postoperative observation. Our goal was to evaluate the safety and feasibility of same day discharge after laparoscopic appendectomy for uncomplicated appendicitis...
February 9, 2018: Journal of Pediatric Surgery
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
Cristina Oana Mărginean, Lorena Elena Meliţ, Emoke Horvath, Horea Gozar, Mihaela Ioana Chinceşan
RATIONALE: Non-Hodgkin lymphoma remains an unpredictable condition in pediatric patients. PATIENT CONCERNS: Our first case describes an 8-year-old boy with a history of iron deficiency anemia, admitted in our clinic for recurrent abdominal pain, weight loss, loss of appetite, diarrheic stools, and fever. The second case also describes an 8-year-old boy admitted for abdominal pain and vomiting. The 3rd case refers to a 4 years and 10 months old boy admitted in our clinic with abdominal pain and loss of appetite, who was initially admitted in the Pediatrics Surgery Clinic with the suspicion of appendicitis...
February 2018: Medicine (Baltimore)
Rick R van Rijn
No abstract text is available yet for this article.
March 2018: Radiology
Belén Aneiros Castro, Indalecio Cano Novillo, Araceli García Vázquez, Pedro Yuste García, Eduardo Ferrero Herrero, Andrés Gómez Fraile
INTRODUCTION: Subhepatic appendicitis in children is an unusual condition that can be challenging for the pediatric surgeons to treat. The aim of our study was to compare the outcomes of laparoscopic appendectomies based on the position of the appendix. METHODS: The data of 1736 patients who had undergone laparoscopic appendectomy in our tertiary center were retrospectively reviewed. We compared two groups: subhepatic location (n = 56) and non-subhepatic location (n = 1680)...
February 19, 2018: Asian Journal of Endoscopic Surgery
Harun Arslan, Zülküf Akdemir, Alpaslan Yavuz, Fahri Gökçal, Cemal Parlakgümüş, Necat İslamoglu, Hüseyin Akdeniz
BACKGROUND In the present study, the role and efficiency of strain elastography (SE) were evaluated in diagnosis and staging of acute appendicitis in pediatric patients. MATERIAL AND METHODS We enrolled 225 pediatric patients with suspected clinical and laboratory findings of acute appendicitis. Gray-scale sonographic findings were recorded and staging was made by the colorization method of SE imaging. Appendectomy was performed in all patients and the results of the surgical pathology were compared with the imaging findings...
February 11, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Anupam B Kharbanda, Eric W Christensen, Nanette C Dudley, Lalit Bajaj, Michelle D Stevenson, Charles G Macias, Manoj K Mittal, Richard G Bachur, Jonathan E Bennett, Kelly Sinclair, Brianna McMichael, Peter S Dayan
OBJECTIVE: The use of computed tomography (CT) and ultrasound (US) in patients with acute abdominal pain has substantial variation across pediatric emergency departments (ED). This study compares the cost of diagnosing and treating suspected appendicitis across a multi-center network of children's hospitals. METHODS: This study is a secondary analysis using de-identified data of a prospective, observational study of patients with suspected appendicitis at nine pediatric EDs...
February 10, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Maria Escolino, Francois Becmeur, Amulya Saxena, Holger Till, George W Holcomb, Ciro Esposito
BACKGROUND: There is a limited and conflicting evidence about the most appropriate method for appendiceal stump closure during laparoscopic appendectomy (LA). We aimed to compare endoloop (EL) versus endostapler (ES) for stump closure during LA for complicated perforated appendicitis in children. METHODS: We retrospectively reviewed the records of 708 patients (463 boys and 245 girls with an average age of 9.8 years) who underwent LA for complicated appendicitis in 5 international centers of Pediatric Surgery over a 5-years period (January 2011-December 2016)...
February 5, 2018: Surgical Endoscopy
Edward Clarkson, Jason Zutty, Mehul V Raval
Appendectomy is the most common abdominal surgical procedure performed in children in the United States. In order to assist care providers in creating treatment plans for the postoperative management of pediatric appendicitis, we have developed a predictive statistical model of outcomes on which we have built a prototype decision aid application. The model, trained on 3724 anonymized care records and evaluated on a separate set of 2205 cases from a tertiary care center, achieves 97.0% specificity, 25.1% true sensitivity, and 58...
February 5, 2018: Journal of Medical Systems
Konstantinos S Mylonas, Peter T Masiakos
No abstract text is available yet for this article.
February 2, 2018: Annals of Surgery
Bryan E Love, Monica Camelo, Sarvenaz Nouri, Diego Kriger, Daniel Ludi, Henry Nguyen
The use of ultrasound to diagnose appendicitis in pediatric patients has been growing with the improvement of ultrasound technology and operator skills, but its utility in the increasingly obese pediatric population has not been thoroughly investigated. A retrospective review of all pediatric (≤18 years old) patients with appendicitis who were admitted at a single hospital from 2014 to 2016 was conducted. Patients were stratified into body mass index (BMI) percentile categories based on the centers for disease control guidelines...
October 1, 2017: American Surgeon
Katherine J Baxter, Hannah T M H Nguyen, Mark L Wulkan, Mehul V Raval
Importance: The pediatric perforated appendix rate is a quality metric measured by the Agency for Healthcare Research and Quality (AHRQ) that reflects access to care. The association of health care utilization prior to presentation with appendicitis is unknown. Objective: To determine whether increased health care utilization prior to presentation with appendicitis is associated with lower perforated appendicitis rates in children. Design, Setting, and Participants: Retrospective cohort study of privately insured children drawn from large employer and insurance company administrative data found in the Truven MarketScan national insurance claims database...
January 31, 2018: JAMA Surgery
Su-Ann Lui, Yoke Lin Nyo, V P Mali
Mesenteric lymphatic malformations are rare benign tumors that are most commonly found in children. The presentation of these tumors can be variable. It has been suggested that mesenteric lymphatic malformations are congenital; however, there is evidence that their size may be increased by infection. A 3-year 10-month-old boy presented with rhinorrhea and cough followed by acute abdominal pain. Ultrasonography revealed a lobulated mass in the lower abdomen. Computerized tomography scan of the abdomen diagnosed an inflamed appendix with perforation...
January 2018: Journal of Indian Association of Pediatric Surgeons
Sara Schülin, Nadine Schlichting, Carlotta Blod, Sabine Opitz, Anne Suttkus, Catalina Suzana Stingu, Kathryn Barry, Martin Lacher, Ulf Bühligen, Steffi Mayer
Intestinal microbiota is involved in metabolic processes and the pathophysiology of various gastrointestinal disorders. We aimed to characterize the microbiome of the appendix in acute pediatric appendicitis comparing extraluminal and intraluminal samples.Between January and June 2015, 29 children (3-17 years, mean age 10.7 ± 3.4 years, sex M:F = 2.6:1) undergoing laparoscopic appendectomy for acute appendicitis were prospectively included in the study. Samples for bacterial cultures (n = 29) and 16S ribosomal desoxyribonucleic acid (rDNA) sequencing (randomly chosen n = 16/29) were taken intracorporeally from the appendiceal surface before preparation ("extraluminal") and from the appendiceal lumen after removal ("intraluminal")...
December 2017: Medicine (Baltimore)
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