fatal acute appendicitis in adolescents

COVID-19 is to date a global pandemic that can affect all age groups; gastrointestinal symptoms are quite common in patients with COVID-19 and a new clinical entity defined as Multisystem Inflammatory Syndrome in Children (MIS-C) has been described in children and adolescents previously affected by COVID-19. Presenting symptoms of this new disease include high fever and severe abdominal pain that can mimic more common causes of abdominal pain; patients can rapidly deteriorate presenting severe cardiac dysfunction and multiorgan failure...

RATIONALE: Mesenteric venous thrombosis is an uncommon but potentially fatal condition that can cause bowel ischemia. It results from a systemic hypercoagulable state or abdominal infection draining into the portal venous system. Several cases regarding portomesenteric venous thrombosis as a complication of appendicitis were reported in adults, but there are far fewer reports in pediatric patients. The mortality rate of the condition is high if untreated, especially in children, reaching up to 50%...

AIMS: Although inflammation contributes to cardiovascular disease, the associations of appendectomy and tonsillectomy, which remove mucosa-associated lymphoid tissue, with risk of acute myocardial infarction (AMI) are unknown. Our aim was to assess the association between these operations performed in childhood and AMI risk later in life. METHODS AND RESULTS: We conducted a prospective matched cohort study among all Swedish residents born between 1955 and 1970. A national register identified all appendectomies and tonsillectomies...

OBJECTIVE: Abdominal pain in systemic lupus erythematosus (SLE) patients has rarely been analyzed in pediatric populations. We planned to investigate the potential differences between childhood-onset and adult-onset SLE patients who were hospitalized because of acute abdominal pain. METHODS: A retrospective study including 23 childhood-onset SLE patients with 38 admissions and 88 adult-onset SLE patients with 108 admissions from 1999 to 2008 were conducted in our hospital...

BACKGROUND: Acute abdominal conditions are a common reason for emergency admission of children. Little is available in the literature about such conditions in our subregion, especially Ghana. OBJECTIVE: The aim of this study was to investigate the range of emergency abdominal surgical conditions amongst children in the subregion, with particular reference to Komfo Anokye Teaching Hospital, Kumasi, Ghana. A prospective survey of all children older than 1 year undergoing an emergency abdominal surgery was carried out...

This paper analyses the experience of the Paediatric Surgery Department from the Emergency Hospital in Craiova regarding the clinical and therapeutical evaluation of 55 cases with appendicular plastron admitted in our department between 1997-2006. We analyse both the evolution and the complications in managing these cases, together with particular aspects of differential diagnosis related to this group of age. These 55 cases were children aged between 2 and 15 years with a 15 days average hospitalization period...

BACKGROUND AND AIMS: There are several reports showing a continuing fall in the incidence of acute appendicitis in the western countries. Our aim was to study the trend of the incidence of acute appendicitis in the Greek population over 30 years. METHODS: We analyzed the data referring to the years 1970-1999 on the incidence and mortality of acute appendicitis for the entire Greek population. Data were retrieved from the Annual Bulletin for the Social Welfare and Health Statistics of the National Statistics Service of Greece...

A 14 7/12-year-old boy with acute myeloblastic leukemia M3v was admitted with disseminated intravascular coagulation, otitis media, lobar pneumonia, and splenomegaly. After induction therapy, M2 bone marrow was attained but splenomegaly persisted. Abdominal ultrasonography, which revealed diffuse splenomegaly at admission, showed splenic nodular lesions at the end of the induction therapy. The lesions persisted after M1 bone marrow was attained. He developed acute appendicitis and was operated. Ultrasonography-guided aspiration biopsy revealed nonspecific purulent abscess...

The number of in-hospital deaths in children aged 0 to 14 years from acute appendicitis in England and Wales has fallen from an annual average of 36.2 in 1963 through 1967 to 1.8 in 1993 through 1997, and the case-fatality rate from 1.06 to 0.16 per 1,000 discharges, a reduction of 85%. During these 4 decades, the child population has fallen by 8.5%, and the number of children discharged from the hospital with a diagnosis of acute appendicitis by 63%. These data highlight a trend noted in Scotland in the first 50 years of the 20th century...

Most cases of malignant mesothelioma present with obvious diffuse tumor, and the presence of grossly visible diffuse tumor is usually cited as an important criterion for making the diagnosis. We report four cases of unsuspected malignant mesothelioma of the peritoneum presenting as localized acute inflammatory lesions. The clinical diagnoses were acute appendicitis in two cases, acute cholecystitis in the third case, and incarcerated umbilical hernia in the fourth case. In all cases tumor was not evident at initial surgical exploration or on gross pathologic examination, and the diagnosis was only made on microscopic examination of the resected specimens...

Nontyphoidal salmonellosis has a wide variety of clinical presentations. With the aim of describing the detailed clinical presentations of gastroenteritis caused by nontyphoidal Salmonella spp., findings for 126 patients (1-94 years of age; 37.0 years on average) were analyzed. Nontyphoidal salmonellosis is prevalent from April to October in Akita, when the mean atmospheric temperature exceeds 10 degrees C. On physical examination, 3 patients had rebound tenderness and muscle guarding on their abdominal wall; 1 of these patients underwent surgery for associated acute appendicitis...

BACKGROUND: Negative appendectomy (NA)--the nonincidental removal of a normal appendix--occurs commonly but the associated clinical- and system-level costs are not well studied. HYPOTHESIS: The frequency of adverse clinical outcomes and associated financial burden of hospitalizations during which NA is performed is greater than previously recognized and varies widely among demographic groups. DESIGN: Population-based, retrospective cohort study...

AIMS: A retrospective study was used to compare laparoscopic appendectomy for perforated appendicitis to open operation. METHODS: Between July 1991 and June 1999 a total of 734 patients, all over 14 years of age, underwent operation for acute appendicitis. Of these patients, 125 (17%) displayed perforated appendicitis and were treated with either a laparoscopic appendectomy (n = 80; total conversion rate 36/80, 45%) or a primary open procedure (n = 45). RESULTS: Due to selection, the 3 treatment groups (laparoscopic, laparoscopy with conversion, open operation) showed differences with respect to gender, duration of symptoms, proportion of obese patients and patients with generalized peritonitis...

This is a retrospective study covering 11,142 acute appendicitis patients, operated in the emergency surgery section of the Emergency Medicine Institute "Pirogov" over the period 1986 through 1995. Overall mortality amounts to 0.29 per cent (32 deceased). The dynamic patterns of mortality undergo regression analysis. The basic factors having an impact on thanatogenesis are comprehensively discussed, namely advanced age, premorbidity background, form of appendicitis and postoperative complications. Late diagnosis is the most important factor leading to peritonitis development...

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The article generalizes the first experience in successful laparoscopic appendectomies in children carried out by the method suggested by F. Götz et al. which we modified and adapted to pediatric practice. In all cases of acute appendicitis the laparoscopic manipulation began with the diagnostic stageo by performing two abdominal punctures with small-diameter trocars. Laparoscopic appendectomy was undertaken only in recognized destructive appendicitis. It was conducted 205 times in children 2 to 14 years old in various localization of the vermiform process, including subhepatic and retroperineal...

We compared aspoxicillin, a new broad-spectrum penicillin derivative, with piperacillin in severe abdominal infection. Aspoxicillin 4 g administered tds (n = 52) or piperacillin 4 g qds (n = 53) usually as monotherapy were randomly given to patients suffering from perforated appendicitis, acute cholecystitis, ulcer or colon perforation, or intra-abdominal abscess. Blood, tissue and exudate cultures were obtained when applicable for pathogen identification and susceptibility testing. The efficacy rates were similar in the two study groups...

Death due to appendicitis is still a significant occurrence. The stage when the disease is diagnosed and operation occurs has a decisive influence on the mortality. In our series of 9,652 cases of appendicitis, 26 patients died (0.27%)-ten (0.12%) of nonperforative appendicitis, and 16 (1.18%) of perforative appendicitis. Both the patients and the physician can delay treatment. The proportion of fatal cases is six times as great in perforative appendicitis is in those operated on in time. The deaths in those with a perforated appendix were usually caused by the basic disease or the surgical procedure, while in patients with unperforated appendixes, death was most commonly caused by other concomitant diseases...

1556 children with acute appendicitis are reported. 118 of these were perforated (7.5%). There was one fatal case (0.06%). Perforation was found more frequently in children under one year of age. The complications of infection in this situation are discussed.

A 13-year-old girl with previously undiagnosed fructose intolerance was operated on for acute appendicitis. Postoperatively she received several infusions containing fructose or sorbitol. Haematemesis occurred on the fourth postoperative day, as well as tarry stools and jaundice. Blood sugar was 2 mg/100 ml, Quick test 3%, liver enzymes were markedly elevated, serum bilirubin was over 9 mg/100 ml, and there was a metabolic acidosis. Despite intensive treatment, including haemodialysis and plasmapheresis, she died on the 11th postoperative day...