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https://www.readbyqxmd.com/read/29431586/drain-failure-in-intra-abdominal-abscesses-associated-with-appendicitis
#1
Christopher B Horn, Adrian A Coleoglou Centeno, Jarot J Guerra, John E Mazuski, Grant V Bochicchio, Isaiah R Turnbull
BACKGROUND: Previous studies have suggested that percutaneous drainage and interval appendectomy is an effective treatment for appendicitis with associated abscess. Few studies to date have analyzed risk factors for failed drain management. We hypothesized that older patients with more co-morbidities would be at higher risk for failing conservative treatment. METHODS: The 2010-2014 editions of the National Inpatient Sample (NIS) were queried for patients with diagnoses of peri-appendiceal abscesses...
February 12, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29430565/discharge-prescription-patterns-of-opioid-and-nonopioid-analgesics-after-common-surgical-procedures
#2
Michael J Nooromid, Eddie Blay, Jane L Holl, Karl Y Bilimoria, Julie K Johnson, Mark K Eskandari, Jonah J Stulberg
Introduction: Recent literature has shown a wide variation in the prescribing patterns of opioids after elective surgery. We conducted an evaluation of discharge opioid prescribing after elective surgical procedures to determine whether opioid-prescribing patterns varied at our institution. Method: A single academic medical center retrospective review of patients undergoing laparoscopic cholecystectomy, laparoscopic appendectomy, open umbilical hernia repair, simple mastectomy, or thyroidectomy between July 2015 and July 2016...
January 2018: Pain Reports (Baltimore, Md.)
https://www.readbyqxmd.com/read/29428963/efficacy-of-strain-elastography-in-diagnosis-and-staging-of-acute-appendicitis-in-pediatric-patients
#3
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
https://www.readbyqxmd.com/read/29428693/do-acute-care-surgeons-need-bariatric-surgical-training-to-ensure-optimal-outcomes-in-obese-patients-with-nonbariatric-emergencies
#4
Andrea Pakula, Ruby Skinner
INTRODUCTION: Acute care surgeons care for the entire breadth of the American adult population, including obese patients. As the population gets heavier, more patients will present to acute case surgeons with nonbariatric surgical emergencies. Do these surgeons need bariatric training to properly care for obese population? OBJECTIVES: To evaluate our experience in obese population requiring acute surgery and compare outcomes based on surgeon expertise in bariatric surgery...
December 14, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29427374/economic-analysis-of-diagnostic-imaging-in-pediatric-patients-with-suspected-appendicitis
#5
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
https://www.readbyqxmd.com/read/29423825/non-operative-treatment-of-appendicitis-public-perception-and-decision-making
#6
Emer P O'Connell, Annmarie White, Paul Cromwell, Emma Carroll, Waqar Khan, Ronan Waldron, Iqbal Z Khan, Kevin Barry
BACKGROUND: Appendectomy has for many years been the accepted treatment of appendicitis. In recent years, non-operative management of appendicitis (NOTA) has been reported as an effective treatment option. AIMS: We aimed to assess the perspectives of public hospital attendees regarding the diagnosis and treatment options for appendicitis. METHODS: We conducted a cross-sectional survey of outpatients over a 10-week period (December 2016-March 2017)...
February 8, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29423152/suppurative-appendicitis-presenting-acute-scrotal-pain-a-rare-condition-may-confuse-surgeons
#7
Shahriar Najafizadeh-Sari, Hamidreza Mehdizadeh, Mohammad Sadegh Bagheri-Baghdasht, Shahram Manoochehry
Scrotal pain presentation has many differential diagnoses such as testicular torsion is surgical emergency. For this reason, it is necessary for surgeons to differentiate between diseases for choosing the best treatment approach. We have reported a rare condition of 19-year-old male case had an atypical scrotal pain presentation of appendicitis. He was admitted to emergency service with 4 days history of pain in abdomen and testis. In physical examination, there is tenderness in right lower quadrant, right inguinal region and scrotum...
October 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29420399/appendiceal-endometriosis-and-ectopic-pregnancy-occurring-simultaneously
#8
Anat Chemerinski, Daniel Lubin, Sevelle Holder, Divya Shah
BACKGROUND: In the setting of a known ectopic pregnancy, severe abdominal pain with clinical concern for rupture is an indication for emergency surgery. In rare cases, appendiceal pathology may occur simultaneously. CASE: A woman with a known ectopic pregnancy presented to the emergency department with a clinical picture consistent with its rupture. At the time of surgery, an appendectomy also was performed owing to concern for concurrent appendicitis; histopathologic examination revealed appendiceal endometriosis...
February 5, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29419955/-predictive-factors-of-gangrenous-post-appendectomy-intra-abdominal-abscess-a-case-control-study
#9
J Serradilla, A Bueno, C De la Torre, E Domínguez, A Sánchez, B Nava, M Álvarez, M López Santamaría, L Martínez
BACKGROUND: Acute appendicitis is the most frequent surgical urgency in children. Frequently, it can be complicated with an intraabdominal abscess that will require a longer and expensive treatment. Our aim is to know if it is possible to predict this complication before its beginning. MATERIAL AND METHODS: Retrospective case-control study with patients treated between 2011 and 2016, paired according to their own characteristics (age, sex and weight), clinical aspects (symptoms, time of their onset, physical examination) and type of appendicitis (gangrenous)...
February 1, 2018: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/29404732/endoloop-versus-endostapler-what-is-the-best-option-for-appendiceal-stump-closure-in-children-with-complicated-appendicitis-results-of-a-multicentric-international-survey
#10
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
https://www.readbyqxmd.com/read/29404704/a-visual-decision-support-tool-for-appendectomy-care
#11
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
https://www.readbyqxmd.com/read/29402880/adenocarcinoma-in-a-blind-loop-of-the-ileum-53-years-after-an-ileotransversostomy-procedure
#12
Ryohei Takei, Ichiro Onishi, Ryosuke Zaimoku, Naoki Makita, Yasumichi Yagi, Masato Kayahara
BACKGROUND Primary small bowel cancer is a rare malignancy; the common histopathological types are carcinoid and adenocarcinoma. Inflammatory bowel diseases and familial adenomatous polyposis are known risk factors for small bowel cancer. Additionally, cases of surgery-induced small bowel adenocarcinoma are sometimes reported after ileostomy. CASE REPORT A 84-year-old woman, who had undergone ileotransversostomy for intestinal obstruction due to postoperative adhesion following appendectomy at the age of 31 years, was referred to our hospital for further examination after experiencing abdominal pain in the right lower quadrant for 2 weeks...
February 6, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29398631/enhancing-confidence-in-graduating-general-surgery-residents-establishing-a-chief-surgery-resident-service-at-an-independent-academic-medical-center
#13
Benjamin T Jarman, Colette T O'Heron, Kara J Kallies, Thomas H Cogbill
OBJECTIVE: Providing opportunities for autonomy to enhance the development of independence and confidence during surgery residency remains among the greatest challenges of the current training paradigm. The objective of this study was to evaluate the implementation and outcomes of a chief resident service (CRS). DESIGN: A CRS was designed with operative, call and office responsibilities. Supervision and evaluation were consistent with institutional guidelines. CRS operative logs from 2011 to 2014 were compared with logs from the participants' first year in practice...
February 2, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29395151/outcome-of-initially-nonoperative-treatment-for-acute-simple-appendicitis-in-children
#14
Ramon R Gorter, Johanna H van der Lee, Florence A C J Heijsters, Huibert A Cense, Roel Bakx, C M Frank Kneepkens, Marc H Wijnen, Alida F W van der Steeg, Klaas H In't Hof, Martin Offringa, Hugo A Heij
PURPOSE: To compare the outcome of initially nonoperative treatment with immediate appendectomy for simple appendicitis in children. METHODS: Between September 2012 and June 2014 children aged 7-17 years with a radiologically confirmed simple appendicitis were invited to participate in a multicentre prospective cohort study in which they were treated with an initially nonoperative treatment strategy; nonparticipants underwent immediate appendectomy. In October 2015, their rates of complications and subsequent appendectomies, and health-related quality of life (HRQOL) were assessed...
December 24, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29393074/laparoscopic-appendectomy-for-the-treatment-of-acute-appendicitis-a-single-center-experience
#15
Giuseppe Carbotta, Antonella Del Vecchio, Antonio Prestera, Rita Laforgia, Maria Grazia Sederino, Giovanni Casamassima, Marina Minafra, Salvatore Fedele, Giovanni Balducci, Nicola Palasciano
AIM: The aim of our study is to compare the pre, intra- and post-operative variables of the two surgical techniques, to demonstrate if laparoscopic appendectomy can be considered safer and associated to better outcome. MATERIAL OF STUDY: A retrospective analysis of 175 patients has been carried out. Alvarado score, time of surgery, analgesic therapy and length of hospital stay calculated. Finally, postoperative complications were recorded. RESULTS: From January 2011 - April 2016 175 patients were enrolled: 128pts underwent laparoscopic technique and 47pts open technique...
January 31, 2018: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29391281/appendicitis-grade-operative-duration-and-hospital-cost
#16
Courtney M Collins, Daniel L Davenport, Cynthia L Talley, Andrew C Bernard
BACKGROUND: The American Association for the Surgery of Trauma (AAST) established a grading system for appendicitis to allow prediction of risk and outcome, to assist in quality improvement and resource management, and to provide a framework for research. Grading is determined in clinical, imaging, operative, and pathologic categories but has not been completely validated. Our aim was to validate appendicitis grade with respect to duration of symptoms, operative duration and hospital costs...
January 29, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29391104/management-and-outcomes-of-appendectomy-during-pregnancy
#17
Roy P Won, Scott Friedlander, Steven L Lee
Acute appendicitis is a common nonobstetric indication for surgical intervention during pregnancy with serious potential complications for the mother and fetus. The aim of this study was to evaluate the presentation, management practices, outcomes, and costs of appendectomy during pregnancy. We did a retrospective analysis of 62,118 nonincidental appendectomies performed in women (age 15-45 years) identified from the California State Inpatient Database (2005-2011). Primary outcomes included diagnosis or type of appendicitis, use of laparoscopy, morbidity, length of stay, and cost...
October 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29391101/comparative-analysis-of-laparoscopic-and-open-approaches-in-emergency-abdominal-surgery
#18
Anaar Siletz, Jonathan Grotts, Catherine Lewis, Areti Tillou, Henry Magill Cryer, Ali Cheaito
The objective of this study was to evaluate usage and outcomes of emergency laparoscopic versus open surgery at a single tertiary academic center. Over a three-year period 165 patients were identified retrospectively using National Surgical Quality Improvement Program results. Appendectomies and cholecystectomies were excluded. Open and laparoscopic approaches were compared regarding preoperative and operative characteristics, the development of postoperative complications, 30-day mortality, and length of hospital stay...
October 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29387882/association-of-health-care-utilization-with-rates-of-perforated-appendicitis-in-children-18-years-or-younger
#19
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
https://www.readbyqxmd.com/read/29384958/the-intra-and-extraluminal-appendiceal-microbiome-in-pediatric-patients-a-comparative-study
#20
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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