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Pediatric appendicitis

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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
#1
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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/28688655/pediatric-laparoscopic-appendectomy-risk-factors-and-costs-associated-with-nationwide-readmissions
#5
Jessica L Buicko, Joshua Parreco, Samantha N Abel, Michael A Lopez, Juan E Sola, Eduardo A Perez
BACKGROUND: Previous studies of readmission after pediatric laparoscopic appendectomy have been limited to individual hospitals or noncompeting public pediatric hospitals. The purpose of this study was to evaluate the risk factors and costs associated with nonelective, 30-d readmissions in pediatric patients nationwide across public and private hospitals. MATERIALS AND METHODS: The Nationwide Readmission Database for 2013 was queried for all patients under the age of 18 y with a diagnosis of acute appendicitis undergoing laparoscopic appendectomy...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28685263/scoring-system-for-differentiating-perforated-and-non-perforated-pediatric-appendicitis
#6
Einat Blumfield, Daniel Yang, Joshua Grossman
OBJECTIVES: Appendicitis is the most common indication for emergency pediatric surgery and its most significant complication is perforation. Perforated appendicitis (PA) may be managed conservatively, whereas non-perforated appendicitis (NP) is managed surgically. Recent studies have shown that ultrasound (US) is effective for differentiating between PA and NP, and does not expose pediatric patients to ionizing radiation. The purpose of this study is to enhance the accuracy of differentiation with a novel scoring system based on clinical, laboratory, and US findings...
July 7, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28678998/association-of-same-day-discharge-with-hospital-readmission-after-appendectomy-in-pediatric-patients
#7
Sarah B Cairo, Mehul V Raval, Marybeth Browne, Holly Meyers, David H Rothstein
Importance: Appendectomy is the most common abdominal operation performed in pediatric patients in the United States. Studies in adults have suggested that same-day discharge (SDD) after appendectomy is safe and does not result in higher-than-expected hospital readmissions. Objective: To evaluate the influence of SDD on 30-day readmission rates following appendectomy for acute appendicitis in pediatric patients. Design, Setting, and Participants: This retrospective cohort study used the American College of Surgeons National Surgical Quality Improvement Program-Pediatric database to evaluate 30-day readmission rates among pediatric patients who underwent an appendectomy for acute, nonperforated appendicitis...
July 5, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28674919/creating-diagnostic-criteria-for-perforated-appendicitis-using-cross-sectional-imaging
#8
Joseph T Church, Megan A Coughlin, Alexis G Antunez, Ethan A Smith, Steven W Bruch
INTRODUCTION: Preoperative determination of perforated versus acute appendicitis can be difficult. We compared CT and MRI performance in diagnosing perforated appendicitis, and created diagnostic criteria. METHODS: We retrospectively reviewed all pediatric patients who underwent appendectomy within one day of CT or MRI between 1/1/2013 and 1/16/2016. True diagnosis was determined by pathology report. Findings on CT/MRI were grouped into "hard" findings (abscess, pneumoperitoneum, extruded fecalith, appendiceal wall with visible hole) and "soft" findings (extensive/diffuse inflammation/free fluid, phlegmon)...
July 3, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28654543/extended-versus-narrow-spectrum-antibiotics-in-the-management-of-uncomplicated-appendicitis-in-children-a-propensity-matched-comparative-effectiveness-study
#9
Danielle B Cameron, Patrice Melvin, Dionne A Graham, Charity C Glass, Stephanie K Serres, Matthew P Kronman, Jacqueline M Saito, Shawn J Rangel
OBJECTIVE: The aim of this study was to compare the effectiveness of extended versus narrow spectrum antibiotics in preventing surgical site infections (SSIs) and hospital revisits in children with uncomplicated appendicitis. SUMMARY OF BACKGROUND DATA: There is a paucity of high-quality evidence in the pediatric literature comparing the effectiveness of extended versus narrow-spectrum antibiotics in the prevention of SSIs associated with uncomplicated appendicitis...
June 26, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28637571/workforce-issues-in-pediatric-surgery
#10
Don K Nakayama
High salaries indicate a demand for pediatric surgeons in excess of the supply, despite only a slight growth in the pediatric-age population and a sharp increase in numbers of trainees. Top-level neonatal intensive care units require 24-hour-7-day pediatric surgical availability, so hospitals are willing to pay surgeons a premium and engage high-priced locum tenens surgeons to fill vacancies in coverage. With increased supply comes an erosion of the numbers of cases performed by trainees and surgeons in practice...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28635516/concentration-of-uhcl1-in-the-serum-of-children-with-acute-appendicitis-before-and-after-surgery-and-its-correlation-with-crp-and-prealbumin
#11
Ewa Matuszczak, Marzena Tylicka, Wojciech Dębek, Anna Tokarzewicz, Ewa Gorodkiewicz, Adam Hermanowicz
Ubiquitin-mediated protein degradation plays a crucial role in various cellular processes, including signal transduction, cell differentiation, and stress response. Ubiquitin C-terminal hydrolase 1 (UCHL1) is a unique deubiquitinating enzyme that has both hydrolase and ligase activities. The aim of this study was the determination of UCHL1 concentration in serum of children with appendicitis, before and after the surgery. MATERIAL AND METHODS: 42 children with acute appendicitis, who were managed at the Pediatric Surgery Department, between 2013 and 2014, were randomly included into the study (age 9 months up to 14 years, mean age 2...
February 27, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28631157/performance-characteristics-of-magnetic-resonance-imaging-without-contrast-agents-or-sedation-in-pediatric-appendicitis
#12
Ryne A Didier, Katharine L Hopkins, Fergus V Coakley, Sanjay Krishnaswami, David M Spiro, Bryan R Foster
BACKGROUND: Magnetic resonance imaging (MRI) has emerged as a promising modality for evaluating pediatric appendicitis. However optimal imaging protocols, including roles of contrast agents and sedation, have not been established and diagnostic criteria have not been fully evaluated. OBJECTIVE: To investigate performance characteristics of rapid MRI without contrast agents or sedation in the diagnosis of pediatric appendicitis. MATERIALS AND METHODS: We included patients ages 4-18 years with suspicion of appendicitis who underwent rapid MRI between October 2013 and March 2015 without contrast agent or sedation...
June 19, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28628705/time-to-appendectomy-and-risk-of-complicated-appendicitis-and-adverse-outcomes-in-children
#13
Stephanie K Serres, Danielle B Cameron, Charity C Glass, Dionne A Graham, David Zurakowski, Mahima Karki, Seema P Anandalwar, Shawn J Rangel
Importance: Management of appendicitis as an urgent rather than emergency procedure has become an increasingly common practice in children. Controversy remains as to whether this practice is associated with increased risk of complicated appendicitis and adverse events. Objective: To examine the association between time to appendectomy (TTA) and risk of complicated appendicitis and postoperative complications. Design, Setting, and Participants: In this retrospective cohort study using the Pediatric National Surgical Quality Improvement Program appendectomy pilot database, 2429 children younger than 18 years who underwent appendectomy within 24 hours of presentation at 23 children's hospitals from January 1, 2013, through December 31, 2014, were studied...
June 19, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28610706/ultrasound-guided-bilateral-rectus-sheath-block-vs-conventional-local-analgesia-in-single-port-laparoscopic-appendectomy-for-children-with-nonperforated-appendicitis
#14
Caroline Maloney, Michelle Kallis, Ibrahim Abd El-Shafy, Aaron M Lipskar, John Hagen, Michelle Kars
INTRODUCTION: Despite its minimally invasive approach, laparoscopic surgery can cause considerable pain. Regional analgesic techniques such as the rectus sheath block (RSB) offer improved pain management following elective umbilical hernia repair in the pediatric population. This effect has not been examined in laparoscopic single-incision surgery in children. We sought to compare the efficacy of bilateral ultrasound-guided RSB versus local anesthetic infiltration (LAI) in providing postoperative pain relief in pediatric single-incision transumbilical laparoscopic assisted appendectomy (TULA) with same-day discharge...
June 2, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28609109/accuracy-and-radiation-dose-reduction-of-limited-range-ct-in-the-evaluation-of-acute-appendicitis-in-pediatric-patients
#15
Michael Jin, Thomas R Sanchez, Ramit Lamba, Ghaneh Fananapazir, Michael T Corwin
OBJECTIVE: The purpose of this article is to determine the accuracy and radiation dose reduction of limited-range CT prescribed from the top of L2 to the top of the pubic symphysis in children with suspected acute appendicitis. MATERIALS AND METHODS: We performed a retrospective study of 210 consecutive pediatric patients from December 11, 2012, through December 11, 2014, who underwent abdominopelvic CT for suspected acute appendicitis. Two radiologists independently reviewed the theoretic limited scans from the superior L2 vertebral body to the top of the pubic symphysis, to assess for visualization of the appendix, acute appendicitis, alternative diagnoses, and incidental findings...
June 13, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28591014/is-an-rct-the-best-way-to-investigate-the-effectiveness-of-nonoperative-management-of-pediatric-appendicitis
#16
Peter C Minneci, Katherine J Deans
No abstract text is available yet for this article.
July 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28578474/differentiating-perforated-from-non-perforated-appendicitis-on-contrast-enhanced-magnetic-resonance-imaging
#17
Daniel G Rosenbaum, Gulce Askin, Debra M Beneck, Arzu Kovanlikaya
BACKGROUND: The role of magnetic resonance imaging (MRI) in pediatric appendicitis is increasing; MRI findings predictive of appendiceal perforation have not been specifically evaluated. OBJECTIVE: To assess the performance of MRI in differentiating perforated from non-perforated appendicitis. MATERIALS AND METHODS: A retrospective review of pediatric patients undergoing contrast-enhanced MRI and subsequent appendectomy was performed, with surgicopathological confirmation of perforation...
June 3, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28574593/early-versus-delayed-appendicectomy-for-appendiceal-phlegmon-or-abscess
#18
REVIEW
Yao Cheng, Xianze Xiong, Jiong Lu, Sijia Wu, Rongxing Zhou, Nansheng Cheng
BACKGROUND: Appendiceal phlegmon and abscess account for 2% to 10% of acute appendicitis. People with appendiceal phlegmon or abscess usually need an appendicectomy to relieve their symptoms and avoid complications. The timing of appendicectomy for appendiceal phlegmon or abscess is controversial. OBJECTIVES: To assess the effects of early versus delayed appendicectomy for appendiceal phlegmon or abscess, in terms of overall morbidity and mortality. SEARCH METHODS: We searched the Cochrane Library (CENTRAL; 2016, Issue 7), MEDLINE Ovid (1950 to 23 August 2016), Embase Ovid (1974 to 23 August 2016), Science Citation Index Expanded (1900 to 23 August 2016), and the Chinese Biomedical Literature Database (CBM) (1978 to 23 August 2016)...
June 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28554816/a-pre-operative-clinical-scoring-system-to-distinguish-perforation-risk-with-pediatric-appendicitis
#19
William Bonadio, Syeda Shahid, Lior Vardi, Carly Buckingham, Allison Kornblatt, Chloe Free, Peter Homel
IMPORTANCE: Appendicitis is a common, potentially serious pediatric disease. An important factor in determining management strategy [whether/when to perform appendectomy, duration of antibiotic therapy/hospitalization, etc.] and predicting outcome is distinguishing whether perforation is present. OBJECTIVE: The objective was to determine efficacy of commonly assessed pre-operative variables in stratifying perforation risk in children with appendicitis. DESIGN: A retrospective analysis of consecutive cases was performed...
May 22, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28550935/looped-suture-versus-stapler-device-in-pediatric-laparoscopic-appendectomy-a-comparative-outcomes-and-intraoperative-cost-analysis
#20
Punam P Parikh, Jun Tashiro, Amy E Wagenaar, Miosotys Curbelo, Eduardo A Perez, Holly L Neville, Anthony R Hogan, Juan E Sola
BACKGROUND: Appendiceal ligation during pediatric laparoscopic appendectomy (LA) may be performed using looped suture versus stapler. Controversy regarding the utility of either method exists. Clinical outcomes and cost analysis of LA with both methods were compared. METHODS: All pediatric LA were performed from fiscal years 2013 and 2014 by two pediatric surgeons. While one surgeon used looped suture, the other used stapler exclusively. chi-Square tests were performed to analyze associations...
May 20, 2017: Journal of Pediatric Surgery
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