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Pediatric appendicitis

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https://www.readbyqxmd.com/read/29141286/ultrasound-features-of-secondary-appendicitis-in-pediatric-patients
#1
Lyo Min Kwon, Kwanseop Lee, Soo Kee Min, Soo Min Ahn, Hong Il Ha, Min-Jeong Kim
Purpose: The purpose of this study was to evaluate the ultrasonographic findings of secondary appendicitis (SA) and to discuss the differential findings compared with primary appendicitis. Methods: In this study, we analyzed the ultrasonographic findings of 94 patients under 15 years old of age treated at our institution from May 2005 to May 2014 who had bowel inflammation and an inflamed appendix with a maximal outer diameter >6 mm that improved with nonsurgical treatment (the SA group)...
August 25, 2017: Ultrasonography
https://www.readbyqxmd.com/read/29130739/trans-umbilical-laparoscopic-assisted-appendectomy-in-the-pediatric-population-comparing-single-incision-and-2-trocar-techniques
#2
Mariana Borges-Dias, Leonor Carmo, Ruben Lamas-Pinheiro, Tiago Henriques-Coelho, José Estevão-Costa
INTRODUCTION: Trans-umbilical laparoscopic-assisted appendectomy (TULAA) combines advantages of open surgery with benefits of laparoscopy and can be performed either by single-incision or with two trocars; the present study aims to compare outcomes and cost of these techniques in a pediatric serie. MATERIAL AND METHODS: Patients undergoing TULAA between July 2013 and June 2014 were retrospectively reviewed. There were two groups: A (single-incision) - one umbilical trocar for a telescope with inbuilt working channel; and B (2-trocar) - one umbilical trocar for a 'standard' telescope plus a supra-pubic trocar for instruments...
November 13, 2017: Minimally Invasive Therapy & Allied Technologies: MITAT
https://www.readbyqxmd.com/read/29112539/correlating-abdominal-wall-thickness-and-body-mass-index-to-predict-usefulness-of-right-lower-quadrant-ultrasound-for-evaluation-of-pediatric-appendicitis
#3
Jeannie K Kwon, Nowice Trexler, Joan Reisch, Cory M Pfeifer, Jason Ginos, Jerry Allen Powell, Jennifer Veltkamp, Alvin Anene, Neil Fernandes, Li Ern Chen
OBJECTIVES: To inform selective and efficient use of appendix ultrasound (US) beyond adult parameters of body mass index (BMI) of less than 25 kg/m, we correlate abdominal wall thickness (AWT) with age and BMI to generate parameters for male and female children. Information presented in chart format can aid in the decision to utilize US for the evaluation of appendicitis. METHODS: In this observational study, 1600 pediatric computed tomography scans of the abdomen and pelvis were analyzed to obtain measurements of AWT in the right lower quadrant...
November 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29106922/measuring-anatomic-severity-in-pediatric-appendicitis-validation-of-the-american-association-for-the-surgery-of-trauma-appendicitis-severity-grade
#4
Matthew C Hernandez, Stephanie F Polites, Johnathon M Aho, Nadeem N Haddad, Victor Y Kong, Humza Saleem, John L Bruce, Grant L Laing, Damian L Clarke, Martin D Zielinski
OBJECTIVE: To assess whether the American Association for the Surgery of Trauma (AAST) grading system accurately corresponds with appendicitis outcomes in a US pediatric population. STUDY DESIGN: This single-institution retrospective review included patients <18 years of age (n = 331) who underwent appendectomy for acute appendicitis from 2008 to 2012. Demographic, clinical, procedural, and follow-up data (primary outcome was measured as Clavien-Dindo grade of complication severity) were abstracted...
October 26, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29103787/a-prospective-same-day-discharge-protocol-for-pediatric-appendicitis-adding-value-to-a-common-surgical-condition
#5
Yangyang R Yu, Carolyn M Smith, Kimberly K Ceyanes, Bindi J Naik-Mathuria, Sohail R Shah, Adam M Vogel, Kathleen E Carberry, Jed G Nuchtern, Monica E Lopez
PURPOSE: Standardized clinical pathways for simple appendicitis decrease length of stay and result in cost savings. We performed a prospective cohort study to assess a same day discharge (SDD) protocol for children with simple appendicitis. METHODS: All children undergoing laparoscopic appendectomy for simple appendicitis after protocol implementation (February 2016 to January 2017) were assessed. Length of stay (LOS), 30-day resource utilization (ED visits and hospital readmissions), patient satisfaction, and hospital accounting costs for SDD were compared to non-SDD patients...
October 9, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29100501/trends-in-diagnostic-approaches-for-pediatric-appendicitis-nationwide-population-based-study
#6
Chih-Cheng Luo, Wen-Kuei Chien, Chen-Sheng Huang, Hung-Chieh Lo, Sheng-Mao Wu, Hung-Chang Huang, Ray-Jade Chen, Hsun-Chin Chao
BACKGROUND: To define the benefits of different methods for diagnosis of pediatric appendicitis in Taiwan, a nationwide cohort study was used for analysis. METHODS: We identified 44,529 patients under 18 years old who had been hospitalized with a diagnosis of acute appendicitis between 2003 and 2012. We analyzed the percentages of cases in which ultrasound (US) and/or computed tomography (CT) were performed and non-perforated and perforated appendicitis were diagnosed for each year...
November 3, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/29068764/in-pursuit-of-the-most-cost-effective-pediatric-laparoscopic-appendectomy-the-effect-of-disposable-instrument-choice-on-operative-time-and-surgeon-controllable-cost
#7
Emily E Abbott, Jonathan C Chan, Judith Boura, Nathan M Novotny
BACKGROUND: There is a movement toward cost savings in healthcare worldwide. Surgeons can affect two main cost variables in an operation (controllable cost): disposables and time. Our hypothesis is that increasing disposable costs do not change outcome or operative time, but simply increases controllable cost. METHODS: We retrospectively reviewed patients younger than the age of 18 years undergoing laparoscopic appendectomies for nonperforated appendicitis from January 2013 to November 2016...
October 25, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29064344/low-infection-related-re-admission-rates-in-a-retrospective-of-4725-children-with-appendicitis-using-a-clinical-pathway-in-a-tertiary-care-pediatric-center
#8
Nikolas E Marino, Kate Davenport, Mary Hilfiker, Simone Langness, Timothy Fairbanks, Erin Stucky Fisher, Robert Newbury, Allyson Andrews, Alan Wells, Juan D Chaparro, John S Bradley
BACKGROUND: Standardization of antibiotic management of appendicitis in tertiary care pediatric centers has been associated with improved outcomes. Rady Children's Hospital-San Diego implemented an appendicitis clinical pathway in 2005. We evaluated infection-related re-admission risk factors since 2010, when an electronic medical record was established, with the aim to optimize the clinical pathway. METHODS: Between January 2010 and August 2015, 4725 children with a diagnosis of appendicitis were evaluated for demographic data, pathology diagnoses, culture results, and inpatient and oral step-down antibiotic therapy regimens...
October 24, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29043693/-post-appendectomy-intra-abdominal-abscesses-six-years-experience-in-a-pediatric-surgery-department
#9
A Coelho, C Sousa, A S Marinho, J Barbosa-Sequeira, M Recaman, F Carvalho
OBJECTIVES: Post-appendectomy intra-abdominal abscesses are estimated to complicate up to 4.2% of acute non-perforated appendicitis and between 6.7% and 28% acute perforated appendicitis. This study was performed with the aim to review and characterize post-appendectomy intra-abdominal abscesses in our Pediatric Surgery department; to calculate their incidence and to evaluate the efficacy of the treatment modality. MATERIAL AND METHODS: A retrospective analysis of all patients, under 18 years and with the diagnosis of intra-abdominal abscess post-appendectomy, between January 2010 and December 2015 was performed, taking in account initial surgical approach, type of acute appendicitis, length of hospital stay and the treatment applied...
July 20, 2017: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/29043692/-appendicitis-versus-nonspecific-acute-abdominal-pain-diagnostic-accuracy-of-ultrasound
#10
M Prada Arias, J L Vázquez, A Salgado Barreira, J Gómez Veiras, S García Saavedra, P Fernández Eire, M Montero Sánchez, J R Fernández Lorenzo
PURPOUSE: The aim of this study is to assess the diagnostic accuracy of ultrasound to differentiate appendicitis from nonspecific acute abdominal pain, that is the most common process requiring differential diagnosis in clinical practice. MATERIAL AND METHODS: Patients admitted for suspicion of appendicitis were prospectively evaluated in our hospital during two years (2013-2014). Cases of nonspecific acute abdominal pain and appendicitis assessed by ultrasound were enrolled in the study...
July 20, 2017: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/29016242/early-predictors-of-abscess-development-after-perforated-pediatric-appendicitis
#11
Catherine M Dickinson, Nathan A Coppersmith, Francois I Luks
BACKGROUND: Approximately one-third of children with appendicitis present with advanced disease or perforation. Whereas this increases the risk for post-operative complications and re-admission, it is not yet possible to predict early on who will develop an abdominal abscess. We sought to identify specific risk factors for this complication, in an attempt to streamline post-operative care. PATIENTS AND METHODS: We reviewed the records of all cases of perforated appendicitis over a 12-month period at a tertiary children's hospital...
October 10, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28988360/correction-to-challenges-in-minor-tbi-and-indications-for-head-ct-in-pediatric-tbi-an-update
#12
Navneet Singh, Ash Singhal
The published version of this article unfortunately contained an error.An error in the Abstract was introduced during corrections stage when a "Conclusion" section appended is from a different article and was not provided from authors.
October 7, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28985868/clinical-and-socioeconomic-factors-associated-with-negative-pediatric-appendicitis
#13
Genia Dubrovsky, Josh Rouch, Nhan Huynh, Scott Friedlander, Yang Lu, Steven L Lee
BACKGROUND: Misdiagnosing appendicitis may lead to unnecessary surgery. The study evaluates the risk factors for negative appendectomies, as well as the clinical and socioeconomic consequences of negative appendectomy across three states. MATERIALS AND METHODS: Data were obtained from the California, New York, and Florida State Inpatient Databases 2005-2011. Patients (<18 years) who underwent nonincidental appendectomies (n = 156,660) were evaluated with hierarchical and multivariate negative binomial regression analyses on outcomes including hospital cost, length of stay (LOS), and associated morbidity...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28985855/safety-of-perioperative-ketorolac-administration-in-pediatric-appendectomy
#14
Hibbut-Ur-Rauf Naseem, Robert Michael Dorman, George Ventro, David H Rothstein, Kaveh Vali
BACKGROUND: Recent studies in adults undergoing gastrointestinal surgeries show an increased rate of complications with the use of ketorolac. This calls into question the safety of ketorolac in certain procedures. We sought to evaluate the impact of perioperative ketorolac administration on outcomes in pediatric appendectomy. METHODS: The Pediatric Health Information System database was queried for patients aged 5-17 y with a primary diagnosis of appendicitis and a primary procedure of appendectomy during the period 2010-2014...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28982533/radiology-report-disclaimers-increase-the-use-of-abdominal-ct-in-the-work-up-of-pediatric-abdominal-pain
#15
Scott M Alter, Brian Walsh, Patrick J Lenehan, Richard D Shih
OBJECTIVE: Pediatric abdominal pain is commonly evaluated in the emergency department (ED) initially by ultrasonography (U/S). Radiology reports often include commentary about U/S limitations and possible need for additional testing or evaluation independent of study interpretation. We sought to determine if presence of a "disclaimer" is associated with additional imaging. METHODS: Design: Retrospective cohort. SETTING: Community ED with volume of 85,000 annual visits...
September 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28976457/revisiting-the-appendiceal-diameter-via-ultrasound-for-the-diagnosis-of-acute-appendicitis
#16
Henry P Chicaiza, Laurie Malia, Christine H Mulvey, Sharon R Smith
OBJECTIVES: This study aims to investigate the optimal outer appendiceal diameter via ultrasound for the diagnosis of acute appendicitis. METHODS: A retrospective chart review was conducted on patients (ages, 2-18 years) presenting to an urban pediatric emergency department between January 1, 2009 and December 31, 2010 with suspected acute appendicitis. Children were considered as having "suspected acute appendicitis" if they (1) presented with acute abdominal pain and had either a surgical consult or an abdominal ultrasound, or (2) presented or transferred with the stated suspicion of acute appendicitis...
October 2, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28963916/case-based-simulation-in-mri-for-suspected-appendicitis-in-children
#17
Hansel J Otero, Anilawan Smitthimedhin, Crystal C Wang, Mark D Heitzmann
PURPOSE: To establish the effect on diagnostic confidence of a simulation setting, in which radiologists re-interpret anonymized pediatric MRI cases. MATERIALS: In this IRB-approved study, participants completed surveys rating confidence before and after interpreting 10 MRI cases for suspected appendicitis in children. RESULTS: 18 radiologists (4 faculty, 5 fellows, and 9 residents) correctly identified an average of 7.44 cases (range 5-9)...
September 22, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28958280/differences-in-the-management-of-perforated-appendicitis-in-children-by-race-and-insurance-status
#18
Randi L Lassiter, Robyn M Hatley
This study was conducted to assess whether race and socioeconomic status influence the management method used to treat pediatric perforated appendicitis. Nonelective pediatric admissions with a primary diagnosis of appendicitis were analyzed using data from the 2001-2010 Nationwide Inpatient Sample. Bivariate and multivariate analyses were used to determine the association between race, insurance status, median household income, rural/metropolitan location, and the risk adjusted odds of undergoing surgery, laparoscopic appendectomy, percutaneous drainage, or neither surgery nor percutaneous drainage...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28952357/nonoperative-management-of-appendicitis
#19
Andrew Scott, Steven L Lee, Daniel A DeUgarte, Stephen B Shew, James C Y Dunn, Shant Shekherdimian
We evaluated the outcomes for nonoperative management (NOM) of all children with suspected nonperforated appendicitis, including those patients with an appendicolith. Parents of all children with suspected nonperforated appendicitis were offered NOM versus laparoscopic appendectomy. NOM included administration of intravenous antibiotics and hospital admission. If no improvement within 24 hours, laparoscopic appendectomy was performed. Primary outcomes were initial success rate and recurrence rate. Fifty patients selected NOM...
March 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28951011/biomarkers-to-estimate-the-probability-of-complicated-appendicitis
#20
Meghan C Daly, Daniel von Allmen, Hector R Wong
BACKGROUND: The conventional paradigm that all children with appendicitis require an appendectomy is being challenged by the idea that some patients may be successfully managed non-operatively. The study aimed to determine if matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinase (TIMPs) are candidate biomarkers for estimating the probability of complicated appendicitis in pediatric patients. METHODS: The study was a single-institution, prospective cohort study...
September 9, 2017: Journal of Pediatric Surgery
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