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Pediatric appendicitis

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https://www.readbyqxmd.com/read/28935397/standardization-of-care-for-pediatric-perforated-appendicitis-improves-outcomes
#1
Yasmine Yousef, Fouad Youssef, Michael Homsy, Trish Dinh, Kartikey Pandya, Hayden Stagg, Robert Baird, Jean-Martin Laberge, Dan Poenaru, Pramod Puligandla, Kenneth Shaw, Sherif Emil
BACKGROUND: The treatment of perforated appendicitis in children is characterized by significant variability in care, morbidity, resource utilization, and outcomes. We prospectively studied how minimization of care variability affects outcomes. METHODS: A clinical pathway for perforated appendicitis, in use for three decades, was further standardized in May 2015 by initiation of a disease severity classification, refinement of discharge criteria, standardization of the operation, and establishment of criteria for use of postoperative total parenteral nutrition, imaging, and invasive procedures...
September 5, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28927978/approaching-zero-implications-of-a-computed-tomography-reduction-program-for-pediatric-appendicitis-evaluation
#2
K Tinsley Anderson, Marisa Bartz-Kurycki, Mary T Austin, Akemi Kawaguchi, Susan D John, Lillian S Kao, KuoJen Tsao
PURPOSE: Because of awareness of iatrogenic radiation exposure, there is a national trend of diminishing computed tomography (CT) use for pediatric suspected appendicitis. The purpose of this study was to evaluate the effects of a CT reduction program for evaluation of appendicitis. METHODS: A multidisciplinary group (emergency medicine, radiology, and surgery) at a children's hospital developed a reduction program which included: ultrasound (U/S) first (2012), magnetic resonance imaging (MRI) second (2014), and standardized U/S reports (2016)...
September 5, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28884300/what-every-radiologist-should-know-about-adnexal-torsion
#3
Guillaume Ssi-Yan-Kai, Anne-Laure Rivain, Caroline Trichot, Marie-Chantal Morcelet, Sophie Prevot, Xavier Deffieux, Jocelyne De Laveaucoupet
Adnexal torsion is the fifth most common gynecologic surgical emergency, requiring clinician and radiologist awareness. It involves the rotation of the ovarian tissue on its vascular pedicle leading to stromal edema, hemorrhagic infarction, and necrosis of the adnexal structures with the subsequent sequelae. Expedient diagnosis poses a difficult challenge because the clinical presentation is variable and often misleading. Adnexal torsion can mimic malignancy as it can take a subacute, intermittent, or chronic course, and thereby can be complicated to diagnose...
September 7, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28872570/when-fever-leukocytosis-and-right-lower-quadrant-pain-is-not-appendicitis
#4
Jeanette Kurbedin, Lawrence Haines, Marla C Levine, Eitan Dickman
Mesenteric cystic lymphangioma (MCL) is an uncommon, benign, slow-growing abdominal tumor that is derived from the lymphatic vessels (World J Gastroenterol. 2012;18:6328-6332, Radiographics. 1994;14:729-737). It is most often diagnosed in the head and neck of affected children. Rarely, a lymphangioma can develop within the small bowel (Pan Afr Med J. 2012;12:7). The clinical presentation of patients with an abdominal MCL can range from asymptomatic to acute abdominal pain (J Korean Surg Soc. 2012;83:102-106)...
September 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28851284/anesthetic-management-of-a-pediatric-patient-with-electron-transfer-flavoprotein-dehydrogenase-deficiency-etfdh-and-acute-appendicitis-case-report-and-review-of-the-literature
#5
Emmanuel Lilitsis, Elisavet Astyrakaki, Evaggelos Blevrakis, Sofia Xenaki, George Chalkiadakis, Emmanuel Chrysos
BACKGROUND: Mitochondria are the energy producing organelles practically in every human cell except erythrocytes. Indeed mitochondria are widespread in high energy requiring organs like brain, heart and muscles. Currently there are no clinical trials supporting with clear evidence which is the most suitable surgical or anesthetic management of a patient with known mitochondrial disease presenting with surgical disorders. This condition poses possible hazardous problems to the medical attention of those patients...
August 29, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28826614/diagnostic-performance-of-ultrasonography-for-pediatric-appendicitis-a-night-and-day-difference
#6
Kate Louise M Mangona, R Paul Guillerman, Victor S Mangona, Jennifer Carpenter, Wei Zhang, Monica Lopez, Robert C Orth
RATIONALE AND OBJECTIVES: For imaging pediatric appendicitis, ultrasonography (US) is preferred because of its lack of ionizing radiation, but is limited by operator dependence. This study investigates the US diagnostic performance during night shifts covered by radiology trainees compared to day shifts covered by attending radiologists. MATERIALS AND METHODS: Appy-Scores (1 = completely visualized normal appendix; 2 = partially visualized normal appendix; 3 = nonvisualized appendix with no inflammatory changes in the expected region of the appendix; 4 = equivocal; 5a = nonperforated appendicitis; 5b = perforated appendicitis) from 2935 US examinations (2161:774, day-to-night) from July 2013 to 2014 were correlated with the intraoperative diagnoses and the clinical follow-up...
August 18, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28822111/erratum-to-scoring-system-for-differentiating-perforated-and-non-perforated-pediatric-appendicitis
#7
Einat Blumfield, Daniel Yang, Joshua Grossman
No abstract text is available yet for this article.
October 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28816891/computed-tomography-use-plateaus-among-children-with-emergency-visits-for-abdominal-pain
#8
Jahan Fahimi, Aaron E Kornblith, Hemal Kanzaria, Andrew Herring, Ralph C Wang
OBJECTIVES: Abdominal pain is a common pediatric complaint to emergency departments (EDs), and clinicians often rely on imaging for diagnosis. Studies have demonstrated an increase in computed tomography (CT) in this population. Following emphasis on radiation reduction by researchers and organizations, this study evaluates recent national trends in CT use among pediatric patients presenting to EDs with abdominal pain. METHODS: This is a cross-sectional analysis of ED patients 18 years or younger with chief complaint of abdominal pain in the National Hospital Ambulatory Medical Care Survey from 2008 to 2011...
August 14, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28816771/primary-omental-torsion-in-a-pediatric-patient-case-report-and-review-of-the-literature
#9
Emad S Madha, Timothy D Kane, Mioara D Manole
Primary omental torsion is a rare cause of acute abdominal pain with a clinical presentation resembling acute appendicitis. Here, we report the case of a 7-year-old child presenting with right lower quadrant pain. Primary omental torsion was discovered upon laparoscopy, and the torsed omentum was excised without postoperative complications. Potential causes, contributing factors, diagnosis, and treatment are discussed.
July 3, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28815859/performance-of-mri-for-suspected-appendicitis-in-pediatric-patients-and-negative-appendectomy-rate-a-systematic-review-and-meta-analysis
#10
Jeong Rye Kim, Chong Hyun Suh, Hee Mang Yoon, Ah Young Jung, Jin Seong Lee, Jung Heon Kim, Jeong-Yong Lee, Young Ah Cho
PURPOSE: To evaluate in pediatric patients the diagnostic performance of magnetic resonance imaging (MRI) for suspected appendicitis and its negative appendectomy rate. MATERIALS AND METHODS: The study involved diagnostic accuracy studies that used MRI for pediatric patients with suspected appendicitis. Various field strengths and sequences were used in each included study. The diagnostic accuracy of MRI in pediatric patients with suspected appendicitis and negative appendectomy rate were assessed...
August 17, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28814624/outcomes-of-nonoperative-management-of-uncomplicated-appendicitis
#11
Richard G Bachur, Susan C Lipsett, Michael C Monuteaux
BACKGROUND AND OBJECTIVES: Nonoperative management (NOM) of uncomplicated pediatric appendicitis has promise but remains poorly studied. NOM may lead to an increase in resource utilization. Our objective was to investigate the trends in NOM for uncomplicated appendicitis and study the relevant clinical outcomes including subsequent appendectomy, complications, and resource utilization. METHODS: Retrospective analysis of administrative data from 45 US pediatric hospitals...
June 2, 2017: Pediatrics
https://www.readbyqxmd.com/read/28807208/imaging-for-acute-appendicitis-at-nonpediatric-centers-exposes-children-to-excess-radiation
#12
Faidah Badru, Nicholas Piening, Alvin To, Perry Xu, Colleen Fitzpatrick, Kaveer Chatoorgoon, Gustavo Villalona, Jose Greenspon
BACKGROUND: Radiation exposure is the reason for the decreased utilization of computed tomography (CT) in pediatric centers (PCs). We sought to compare the radiation dose exposure of CT imaging performed at outside hospitals (OH) versus PC in pediatric patients with acute appendicitis (AA). MATERIAL AND METHODS: A retrospective review of all patients managed at our PC for AA from January 2011 to March 2016 was performed. Patients who had CT imaging for AA at OH were compared to those who underwent CT for appendicitis at our PC...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28807192/does-compliance-with-antibiotic-prophylaxis-in-pediatric-simple-appendicitis-matter
#13
Krislynn M Mueck, Luke R Putnam, Kathryn T Anderson, Kevin P Lally, KuoJen Tsao, Lillian S Kao
BACKGROUND: Institutional protocols for preincisional antibiotic prophylaxis can standardize care and improve outcomes. However, challenges remain in compliance with such protocols for urgent or emergent operations. We hypothesized that compliance with an institutional protocol for antibiotic prophylaxis for appendectomy for appendicitis in pediatric patients results in reduced surgical site infections (SSIs) after simple appendectomy. METHODS: This retrospective study assessed all pediatric patients (≤18 y) who underwent appendectomy for confirmed simple appendicitis at a tertiary children's hospital between 2012 and 2015...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28796552/diagnostic-accuracy-of-mri-versus-ct-for-the-evaluation-of-acute-appendicitis-in-children-and-young-adults
#14
Sonja Kinner, Perry J Pickhardt, Erica L Riedesel, Kara G Gill, Jessica B Robbins, Douglas R Kitchin, Timothy J Ziemlewicz, John B Harringa, Scott B Reeder, Michael D Repplinger
OBJECTIVE: Appendicitis is frequently diagnosed in the emergency department, most commonly using CT. The purpose of this study was to compare the diagnostic accuracy of contrast-enhanced MRI with that of contrast-enhanced CT for the diagnosis of appendicitis in adolescents when interpreted by abdominal radiologists and pediatric radiologists. SUBJECTS AND METHODS: Our study included a prospectively enrolled cohort of 48 patients (12-20 years old) with nontraumatic abdominal pain who underwent CT and MRI...
October 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28762291/water-permeability-is-a-measure-of-severity-in-acute-appendicitis
#15
Nicola Pini, Viktoria A Pfeifle, Urs Kym, Simone Keck, Virginie Galati, Stefan Holland-Cunz, Stephanie J Gros
Acute appendicitis is the most common indication for pediatric abdominal emergency surgery. Determination of the severity of appendicitis on clinical grounds is challenging. Complicated appendicitis presenting with perforation, abscess or diffuse peritonitis is not uncommon. The question remains why and when acute appendicitis progresses to perforation. The aim of this study was to assess the impact of water permeability on the severity of appendicitis. We show that AQP1 expression and water permeability in appendicitis correlate with the stage of inflammation and systemic infection parameters, leading eventually to perforation of the appendix...
December 2017: Journal of Enzyme Inhibition and Medicinal Chemistry
https://www.readbyqxmd.com/read/28759405/outcomes-of-nonoperative-management-of-uncomplicated-appendicitis
#16
MULTICENTER STUDY
Richard G Bachur, Susan C Lipsett, Michael C Monuteaux
BACKGROUND AND OBJECTIVES: Nonoperative management (NOM) of uncomplicated pediatric appendicitis has promise but remains poorly studied. NOM may lead to an increase in resource utilization. Our objective was to investigate the trends in NOM for uncomplicated appendicitis and study the relevant clinical outcomes including subsequent appendectomy, complications, and resource utilization. METHODS: Retrospective analysis of administrative data from 45 US pediatric hospitals...
July 2017: Pediatrics
https://www.readbyqxmd.com/read/28746196/retrospective-review-of-laparoscopic-versus-open-surgery-in-the-treatment-of-appendiceal-abscess-in-pediatric-patients-laparoscopic-versus-open-surgery-for-appendiceal-abscess
#17
COMPARATIVE STUDY
Ping Li, Yan Han, Yang Yang, Hongjie Guo, Fabao Hao, Yan Tang, Chunbao Guo
Laparoscopic appendectomy (LA) has become well accepted, but the role of LA for appendicitis upon presentation with an abscess remains undefined. This study was to assess the postoperative recovery and complications following LA in pediatric patients with appendiceal abscess in comparison with open appendectomy (OA).We conducted a retrospective review of patients presented with appendiceal abscess between 2005 and 2016. Propensity score matching (PSM) was conducted to adjust for any potential selection bias for the surgical approaches...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28740395/diagnostic-reliability-of-pediatric-appendicitis-score-ultrasound-and-low-dose-computed-tomography-scan-in-children-with-suspected-acute-appendicitis
#18
Ashraf Othman Sayed, Nancy Selim Zeidan, Dalia Monir Fahmy, Hossam A Ibrahim
BACKGROUND: Diagnosis of appendicitis in children is clinically challenging. Computed tomography (CT) is the gold standard for diagnosis; however, radiation exposure early in life is a concern with this technique. Therefore, in this study, we aimed to evaluate the diagnostic reliability of low-dose CT, pediatric appendicitis score (PAS), and abdominal ultrasound (US) in children with acute appendicitis, to reach a safe diagnosis. PATIENTS AND METHODS: This retrospective study was conducted on 140 children who were admitted with clinically suspected acute appendicitis (45 with positive appendicitis and 95 children with negative appendicitis)...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28725923/assessing-3d-t2-fse-sequence-for-identification-of-the-normal-appendix-working-toward-a-single-sequence-mr-appendicitis-protocol
#19
Nattinee Leelakanok, Andrew S Phelps, Matthew A Zapala, Kambrie Kato, Michael Ohliger, Yi Li, Jesse Courtier
PURPOSES: To assess the ability of a single isotropic 3D T2 FSE sequence to identify the normal appendix in children with potential implication as alternative second-line modality in pediatric appendicitis. MATERIALS AND METHODS: Retrospective review of MR abdomino-pelvis or pelvis in children from Oct 2014-Dec 2016 was done. Only exams with 3D T2 FSE sequence performed on a single scanner type were selected. Patients with history of post appendectomy, studies in which field of view did not include ileocecal valve, with technical and protocol errors, or with fat-saturated acquisition were excluded...
July 19, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28693849/impact-of-outpatient-management-following-appendectomy-for-acute-appendicitis-an-acs-nsqip-p-analysis
#20
Cristen N Litz, Laurie Stone, Roberta Alessi, Nebbie E Walford, Paul D Danielson, Nicole M Chandler
BACKGROUND: In 2012, a same-day discharge protocol following appendectomy for acute appendicitis was initiated. Our objective was to determine the success of the protocol by reviewing the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) outcomes following protocol development. METHODS: The 2015 NSQIP-P Participant Use Data File was queried to identify patients with acute appendicitis who underwent appendectomy. Outcomes were compared to institutional outcomes...
June 30, 2017: Journal of Pediatric Surgery
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