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Pediatric appendicitis

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https://www.readbyqxmd.com/read/28302361/unexpected-findings-after-surgery-for-suspected-appendicitis-rarely-change-treatment-in-pediatric-patients-results-from-a-cohort-study
#1
Ramon R Gorter, Paul van Amstel, Johanna H van der Lee, Patick van der Voorn, Roel Bakx, Hugo A Heij
BACKGROUND: To determine if non-operative treatment is safe in children with acute appendicitis, we evaluated the incidence of unexpected findings after an appendectomy in children, and the influence they have on subsequent treatment. METHODS: A historical cohort study (January 2004-December 2014) was performed including children, aged 0-17 years, who underwent an appendectomy for the suspicion of acute appendicitis. Patients were divided based upon histopathological examination...
March 6, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28283724/radiation-dose-associated-with-ct-guided-drain-placement-for-pediatric-patients
#2
Cody J Schwartz, Ari J Isaacson, Lynn Ansley Fordham, Marija Ivanovic, J Bradford Taylor, Robert G Dixon
BACKGROUND: To date, there are limited radiation dose data on CT-guided procedures in pediatric patients. OBJECTIVE: Our goal was to quantify the radiation dose associated with pediatric CT-guided drain placement and follow-up drain evaluations in order to estimate effective dose. MATERIALS AND METHODS: We searched the electronic medical record and picture archiving and communication system (PACS) to identify all pediatric (<18 years old) CT-guided drain placements performed between January 2008 and December 2013 at our institution...
March 10, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28277414/implementation-of-an-electronic-clinical-decision-support-tool-for-pediatric-appendicitis-within-a-hospital-network
#3
Marissa A Hendrickson, Andrew R Wey, Philippe R Gaillard, Anupam B Kharbanda
OBJECTIVES: Computed tomography (CT) has been widely used in the evaluation of children with suspected appendicitis, but concerns about ionizing radiation have increased interest in ultrasound for these patients. We sought to assess the effectiveness of an appendicitis electronic clinical decision support (E-CDS) system in increasing ultrasound and decreasing CT use in children evaluated in emergency departments (EDs) for suspected appendicitis. METHODS: This was a preintervention and postintervention analysis of an E-CDS implemented into an electronic health record system shared by an academic, tertiary-care children's hospital and a community hospital...
March 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28259382/regional-variation-in-rates-of-pediatric-perforated-appendicitis
#4
Samir Sarda, Heather L Short, Jason M Hockenberry, Ian McCarthy, Mehul V Raval
BACKGROUND: While trends in perforated appendicitis (PA) rates have been studied, regional variability in pediatric admissions for PA remains unknown. METHODS: A retrospective, cross-sectional analysis of the 2006-2012 Kids' Inpatient Database was conducted to examine variation in PA admission rates by region of the United States and insurance status. PA rates were calculated and reported as per 1000 admissions in accordance with national quality measure specifications...
February 21, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28258881/ultrasound-for-diagnosis-of-appendicitis-in-a-community-hospital-emergency-department-has-a-high-rate-of-nondiagnostic-studies
#5
Scott M Alter, Brian Walsh, Patrick J Lenehan, Richard D Shih
BACKGROUND: Radiation concerns are changing the way emergency physicians evaluate patients. This is especially prevalent in pediatrics, and exemplified by abdominal pain management. Large academic center-based studies suggest appendix ultrasound (U/S) is sensitive and specific for appendicitis, with low nondiagnostic rates. OBJECTIVES: We sought to determine the diagnostic rate of appendix U/S and incidence of follow-up computed tomography (CT) imaging for pediatric patients at a community hospital...
February 28, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28254405/early-appendectomy-shortens-antibiotic-course-and-hospital-stay-in-children-with-early-perforated-appendicitis
#6
Hsin-Yu Tsai, Hsun-Chin Chao, Wan-Ju Yu
BACKGROUND: The optimal management of perforated appendicitis in the pediatric population has been controversial. This study aimed to compare the therapeutic efficacy between conservative treatment (CS) and early appendectomy (EA) in pediatric perforated appendicitis, and to determine whether surgical intervention is an optimal treatment modality for early perforated appendicitis in children. METHODS: Patients treated between January 2012 and April 2014, aged 0-18 years, with an imaging-based diagnosis of perforated appendicitis were retrospectively reviewed...
February 1, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28248766/discordant-rates-of-surgeon-versus-pathologist-visual-diagnosis-of-perforation-with-pediatric-appendicitis
#7
William Bonadio
No abstract text is available yet for this article.
March 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28223114/imaging-utilization-for-the-diagnosis-of-appendicitis-in-stand-alone-children-s-hospitals%C3%A2-in%C3%A2-the-united-states-trends-and-costs
#8
Hansel J Otero, Lauren Crowder
OBJECTIVE: To describe the imaging utilization patterns for the diagnosis of appendicitis among children's hospitals in the United States over the last 10 years (2005-2014). METHODS: All patients with a primary discharge diagnosis of appendicitis included in a large administrative database of 45 pediatric institutions in the United States between 2005 and 2014 were selected. Demographics, imaging utilization, and costs were described. RESULTS: In all, 96,786 children with appendicitis (59% boys, 41% girls; mean age: 9...
February 10, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28214369/diagnostic-accuracy-of-history-physical-exam-laboratory-tests-and-point-of-care-ultrasound-for-pediatric-acute-appendicitis-in-the-emergency-department-a-systematic-review-and-meta-analysis
#9
Roshanak Benabbas, Mark Hanna, Jay Shah, Richard Sinert
BACKGROUND: Acute appendicitis (AA) is the most common surgical emergency in children. Accurate and timely diagnosis is crucial but challenging due to atypical presentations and the inherent difficulty of obtaining a reliable history and physical examination in younger children. OBJECTIVES: To determine the utility of history, physical exam, laboratory tests, Pediatric Appendicitis Score (PAS) and Emergency Department-Point-of-Care Ultrasound (ED-POCUS) in the diagnosis of AA in ED pediatric patients...
February 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28207968/mri-vs-ultrasound-as-the-initial-imaging-modality-for-pediatric-and-young-adult-patients-with-suspected-appendicitis
#10
Daniel Imler, Christine Keller, Shyam Sivasankar, Nancy Ewen Wang, Shreyas Vasanawala, Matias Bruzoni, James Quinn
BACKGROUND: While ultrasound (US), given its lack of ionizing radiation is currently the recommended initial imaging study of choice for the diagnosis of appendicitis in pediatric and young adult patients, it does have significant shortcomings. US is time intensive, operator dependent, and results in frequent inconclusive studies, thus necessitating further imaging, and admission for observation or repeat clinical visits. A rapid focused Magnetic Resonance Imaging (MRI) for appendicitis has been shown to have definitive sensitivity and specificity, similar to Computed tomography (CT) but without radiation and offers a potential alternative to US...
February 16, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28204893/gastrointestinal-system-manifestations-in-juvenile-systemic-lupus-erythematosus
#11
Hafize Emine Sönmez, Asuman Nur Karhan, Ezgi Deniz Batu, Yelda Bilginer, Ersin Gümüş, Hülya Demir, Aysel Yüce, Seza Özen
Systemic lupus erythematosus (SLE) is an autoimmune disease which may involve gastrointestinal system (GIS). The aim of this study was to present GIS manifestations of pediatric SLE patients. The medical files of 69 children with SLE followed between January 2011 and January 2016 were reviewed. All fulfilled the Systemic Lupus International Collaborating Clinics criteria. All patients (≤18 years of age) with GIS manifestations were included. GIS manifestations were observed in 19 (27.5%) out of 69 SLE patients and present at the time of SLE diagnosis in 13 (68...
February 16, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28185747/lack-of-utility-of-measuring-serum-bilirubin-concentration-in-distinguishing-perforation-status-of-pediatric-appendicitis
#12
William Bonadio, Santina Bruno, David Attaway, Logesh Dharmar, Derek Tam, Peter Homel
BACKGROUND: Pediatric appendicitis is a common, potentially serious condition. Determining perforation status is crucial to planning effective management. PURPOSE: Determine the efficacy of serum total bilirubin concentration [STBC] in distinguishing perforation status in children with appendicitis. METHODS: Retrospective review of 257 cases of appendicitis who received abdominal CT scan and measurement of STBC. RESULTS: There were 109 with perforation vs 148 without perforation...
January 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28185689/imaging-of-acute-pelvic-pain-in-girls-ovarian-torsion-and-beyond-%C3%A2
#13
REVIEW
Lena Naffaa, Tejaswini Deshmukh, Shanthan Tumu, Chris Johnson, Kevin P Boyd, Arthur B Meyers
Identifying the etiology of acute pelvic pain in girls is often clinically challenging. Particularly in young girls, it is often difficult to determine if acute pelvic symptoms are originating from a gynecologic source or from a genitourinary or gastrointestinal etiology based on the child's clinical examination alone. Therefore, imaging plays a key role in establishing a diagnosis and in directing medical and surgical treatment. Pediatric gynecologic conditions, which can present acutely with pain or mass or both include ovarian torsion, hematometrocolpos, pelvic inflammatory disease, inguinal hernias containing an ovary or the uterus or both, adnexal cysts, pregnancy, vaginal foreign bodies, and ovarian vein thrombosis...
December 21, 2016: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28164589/diagnostic-value-of-d-dimer-combined-with-wbc-count-neutrophil-percentage-and-crp-in-differentiating-between-simple-and
#14
Xiangmao Bu, Jiahong Chen, Yanzhen Wan, Lili Xu
BACKGROUND: Acute appendicitis is the most common surgical emergency in pediatrics. In this study, we aimed to evaluate the diagnostic value of D-dimer in differentiating between simple and other severe acute appendicitis in children combined with white blood cell (WBC) count, neutrophil percentage, and C-reactive protein (CRP). METHODS: A retrospective study enrolled 327 consecutive patients who underwent appendectomy for acute appendicitis (aged 13 days to 14 years) in Qingdao Women & Children's Hospital from Jan 2013 to Dec 2014...
September 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28151844/impact-of-percutaneous-drainage-on-outcome-of-intra-abdominal-infection-associated-with-pediatric-perforated-appendicitis
#15
William Bonadio, Miriam Langer, Julie Cueva, Astrid Haaland
BACKGROUND: Perforated appendicitis can result in potentially serious complications requiring prolonged medical care. The optimal approach to successfully managing this condition is controversial. METHODS: Review of 80 consecutive cases of pediatric acute perforated appendicitis with intra-abdominal infection [IAI] medically managed with parenteral antibiotics and percutaneous drainage [PD] during a 7-year period. RESULTS: All patients received broad spectrum parenteral antibiotic therapy...
January 31, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28123249/imaging-in-acute-appendicitis-what-when-and-why
#16
REVIEW
Jyotindu Debnath, R A George, R Ravikumar
Acute appendicitis (AA) is the commonest cause of pain abdomen requiring surgical intervention. Diagnosis as well as management of acute appendicitis is mired in controversies and contradictions even today. Clinicians often face the dilemma of balancing negative appendectomy rate and perforation rate if the diagnosis is based on clinical scoring alone. Laboratory results are often non-specific. Imaging has an important role not only in diagnosing appendicitis and its complication but also suggesting alternate diagnosis in appropriate cases...
January 2017: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28108797/diagnostic-utility-of-intravenous-contrast-for-mr-imaging-in-pediatric-appendicitis
#17
Gray R Lyons, Pooja Renjen, Gulce Askin, Ashley E Giambrone, Debra Beneck, Arzu Kovanlikaya
BACKGROUND: Magnetic resonance imaging (MRI) is increasingly employed as a diagnostic modality for suspected appendicitis in children. However, there is uncertainty as to which MRI sequences are sufficient for safe, timely and accurate diagnosis. Several recent studies have described different MRI protocols, including exams both with and without the use of intravenous contrast. OBJECTIVE: We hypothesized that intravenous contrast may be useful in some patients but could be safely omitted in others...
January 21, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28091700/computed-tomography-localization-of-the-appendix-in-the-pediatric-population-relative-to-the-lumbar-spine
#18
John Davis, Albert T Roh, Matthew B Petterson, Tammy R Kopelman, Samantha L Matz, Daniel G Gridley, Mary J Connell
BACKGROUND: Computed tomography (CT) is commonly used to evaluate suspected acute appendicitis. Although very effective, CT uses ionizing radiation, exposing patients to an increased risk of cancer. OBJECTIVE: This study assessed the potential for decreasing the field of view of the CT (and therefore the dose to the patient) in the evaluation of suspected acute appendicitis in children. MATERIALS AND METHODS: This study was a retrospective review of prospectively collected data from 212 consecutive patients who underwent CT for suspected acute appendicitis...
January 14, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28062934/focused-ct-using-a-height-adjusted-metric-and-the-umbilicus-as-a-landmark-for-children-undergoing-evaluation-for-appendicitis
#19
Suzanne Roberts, Abigail F Nixon, James A Meltzer, Einat Blumfield
BACKGROUND: Confirmation of appendicitis in children often requires CT. A focused CT scan that is limited to the lower abdomen/pelvis might help to reduce radiation exposure. OBJECTIVE: To determine the position of the appendix relative to the umbilicus and derive a height-adjusted threshold for a focused CT that would identify most appendices. MATERIALS AND METHODS: We conducted a retrospective study of children younger than 18 years who underwent a CT scan for suspected appendicitis...
January 6, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28049113/update-on-pediatric-overuse
#20
Eric R Coon, Paul C Young, Ricardo A Quinonez, Daniel J Morgan, Sanket S Dhruva, Alan R Schroeder
As concerns over health care-related harms and costs continue to mount, efforts to identify and combat medical overuse are needed. Although much of the recent attention has focused on health care for adults, children are also harmed by overuse. Using a structured PubMed search and manual tables of contents review, we identified important articles on pediatric overuse published in 2015. These articles were evaluated according to the quality of the methods, the magnitude of clinical effect, and the number of patients potentially affected and were categorized into overdiagnosis, overtreatment, and overutilization...
February 2017: Pediatrics
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