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appendicitis in adolescents

Valirie Ndip Agbor, Tsi Njim, Leopold Ndemnge Aminde
BACKGROUND: Inguinal hernias in women of reproductive age containing the ovary are very rare. When they occur in this age group, they are mostly associated with malformations of the urogenital system. Prompt surgical intervention is the key to ensure survival of the ovary. Here we present a case of an ectopic ovary presenting like an acute appendicitis. CASE PRESENTATION: A 16-year-old Cameroonian girl presented at our emergency service with an acute exacerbation of a mild and intermittent right iliac fossa pain of 5 days' duration...
October 19, 2016: Journal of Medical Case Reports
Cassidy M Dahn, William K Milne
Appendicitis is diagnosed in 1 to 8 percent of children presenting to the Emergency Department (ED) for abdominal pain and is the most common condition requiring emergent abdominal surgery in childhood. The adolescent age group has the highest prevalence.(1) The diagnosis of appendicitis can be missed in children over 50% of the time leading to higher complication rates including perforation. Yet, the negative appendectomy rate (NAR) is not negligible, particularly in children under five years of age (NAR up to 17%) and post-menarchal females (NAR up to 5%)...
July 21, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Małgorzata Mizerska-Wasiak, Piotr Skrzypczyk, Agnieszka Kisiel, Małgorzata Pańczyk-Tomaszewska, Maria Roszkowska-Blaim
UNLABELLED: Henoch-Schönlein purpura (HSP) is the most common pediatric autoimmune vasculitis. Gastrointestinal symptoms of HSP including abdominal pain, diarrhea, and vomiting may precede skin changes by several days. We present diagnostic challenges in two adolescents with HSP and severe abdominal symptoms necessitating surgical intervention before the development of skin changes. CASE REPORT 1: A 15-year old boy with 7 day history of abdominal pain, and bloody vomiting (1-2 x per day) without diarrhea...
June 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Ji Hoon Park, Bohyoung Kim, Mi Sung Kim, Hyuk Jung Kim, Yousun Ko, Soyeon Ahn, Murat Karul, Joel G Fletcher, Kyoung Ho Lee
PURPOSE: To compare radiologists' diagnostic performance and confidence, and subjective image quality between filtered back projection (FBP) and iterative reconstruction (IR) at 2-mSv appendiceal CT. METHODS: The institutional review board approved this retrospective study and waived the requirement for informed consent. We included 107 adolescents and young adults (age, 29.8 ± 8.5 years; 64 females) undergoing 2-mSv CT for suspected appendicitis. Appendicitis was pathologically confirmed in 42 patients...
July 2016: Abdominal Radiology
Marina Deuker, Frederik C Roos, Allegra Großmann, Patrick Faé, Joachim W Thüroff, Raimund Stein
INTRODUCTION: Long-term outcomes are of special concern in children after urinary diversion. In a single institution study we evaluated retrospectively the long-term outcomes of urinary diversion in children, in whom the ileocecal segment had been used, in respect to complications of the efferent segment. METHODS: The Mainz pouch was used in 107 children for continent urinary diversion. Indications were neurogenic bladder (53%, 57/107), exstrophy-epispadias complex (25%, 27/107), malignancy (13%, 14/107), and others (9%, 9/107)...
August 2016: Journal of Pediatric Urology
David Mills, Bazak Sharon, Kari Schneider
Tubo-ovarian abscess (TOA) in non-sexually active female adolescents is a rare presentation to the pediatric emergency department. In the following case, bilateral TOA secondary to Streptococcus constellatus was diagnosed in a 13-year-old virginal female. The patient was seen 4 months before presentation for interventional radiology-guided drainage and antibiotic treatment for an intra-abdominal abscess due to suspected appendiceal rupture. Exploratory laparotomy on the most recent presentation demonstrated an appendix with inflammation and serositis on pathology report, a concern for chronic appendicitis with microperforation and subsequent bacterial translocation of the bilateral ovaries...
June 2, 2016: Pediatric Emergency Care
Alessia Ferrarese, Alessandro Falcone, Mario Solej, Dario Bono, Paolo Moretto, Najada Dervishi, Veltri Andrea, Stefano Enrico, Mario Nano, Valter Martino
INTRODUCTION: Acute appendicitis is the most common cause of acute abdomen in adolescents, with an overall incidence of 7%. Two such tools are used to diagnose acute appendicitis: ultrasound and Computer Tomography imaging. End point of this study was to verify the accuracy of ultrasound imaging in the diagnosis of acute appendicitis with respect to intraoperative observations and the respective clinical and laboratory findings in young and in the elderly. METHODS: We considered all the appendectomies for acute appendicitis performed between 1 January 2010 and 1 January 2015...
September 2016: International Journal of Surgery
Carin E Reust, Amy Williams
Acute abdominal pain accounts for approximately 9% of childhood primary care office visits. Symptoms and signs that increase the likelihood of a surgical cause for pain include fever, bilious vomiting, bloody diarrhea, absent bowel sounds, voluntary guarding, rigidity, and rebound tenderness. The age of the child can help focus the differential diagnosis. In infants and toddlers, clinicians should consider congenital anomalies and other causes, including malrotation, hernias, Meckel diverticulum, or intussusception...
May 15, 2016: American Family Physician
Jan-Hendrik Gosemann, A Lange, J Zeidler, J Blaser, C Dingemann, B M Ure, M Lacher
BACKGROUND: Meta-analyses indicate advantages of laparoscopic compared to open appendectomy. Nationwide analyses on results of laparoscopic appendectomy are scarce and studies from Germany are not available. This observational cohort study based on a nationwide insurance database was performed to analyze results of pediatric laparoscopic versus open appendectomy in general use. METHODS: Data were extracted from the largest German statutory health insurance TK (∼9 million clients) in a 3-year period (2010-2012)...
August 2016: Langenbeck's Archives of Surgery
Divya Mirchandani, Jolanta Kulpa, Nayaab Khawar, Israel Kochin, Pramod Narula, Revathy Sundaram
While colorectal carcinoma is a common gastrointestinal cancer in adults, it is rare in pediatrics with an incidence of 1 : 1,000,000 and represents a fraction of neoplasms encountered in children. Malignant neoplasms represent a major cause of mortality in the pediatric age group. While presenting with weight loss, iron deficiency, rectal bleeding, abdominal pain, and change in bowel habits, or symptoms similar to acute appendicitis, the working diagnosis may be considered to be anorexia. This case illustrates the importance of considering colon cancer among other disease entities as a cause of unintentional weight loss in adolescents...
2016: Case Reports in Pediatrics
Jaebong Lee, Yousun Ko, Soyeon Ahn, Ji Hoon Park, Hwa Jung Kim, Seung-Sik Hwang, Kyoung Ho Lee
PURPOSE: To retrospectively compare ultrasound (US) and CT as the preoperative first-line imaging modality in terms of negative appendectomy rate (NAR) and appendiceal perforation rate (APR) in adolescents and adults with suspected appendicitis. METHODS: We included 2,030 patients in 11 sites who underwent appendectomy following US (n = 102) or CT (n = 1,928). Propensity-score (PS) adjusted and matched comparisons were conducted. Matching was performed with 1:1 and 1:3 ratios...
September 2016: Journal of Clinical Ultrasound: JCU
RoseAnn L Scheller, Holly E Depinet, Mona L Ho, Richard W Hornung, Jennifer L Reed
OBJECTIVES: Acute appendicitis is common in the pediatric population and is difficult to diagnose in adolescent females. The validated Pediatric Appendicitis Score (PAS) has unclear utility in female adolescents. The purpose of this study is to determine the sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of the PAS for female adolescents compared to all other patients. METHODS: This study examined a retrospective observational cohort of patients ages 3 to 21 years in a pediatric emergency department with prospectively assigned PAS from an existing database...
May 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Julia Dratva, Seraina Caviezel, Emmanuel Schaffner, Robert Bettschart, Nino Kuenzli, Christian Schindler, Arno Schmidt-Trucksäss, Daiana Stolz, Elisabeth Zemp, Nicole Probst-Hensch
OBJECTIVE: Inflammatory risk factors in childhood, e.g. obesity, impact on carotid artery intima media thickness (CIMT), an early indicator of atherosclerosis. Little is known on potential infectious origins in childhood. We investigated the association between number of reported different childhood infectious diseases and CIMT in adolescence. STUDY DESIGN: 288 SAPALDIA offspring (8-21years) underwent a clinical examination in 2010-2011: anthropometry, blood pressure, CIMT, blood draw (cardiovascular biomarkers, cotinine)...
December 2015: Atherosclerosis
Mohammad Ayub Jat, Farhan Khashim Al-Swailmi, Yasir Mehmood, Majid Alrowaili, Shehab Alanazi
BACKGROUND AND OBJECTIVE: Appendicectomy for acute appendicitis is one of the most commonly performed surgical procedures. Acute appendicitis has remained a clinical entity and an ongoing diagnostic challenge. A retrospective study was performed to determine histological diagnosis, demographic data, the rate of perforated appendicitis and negative appendicectomies. METHODS: Histopathological records of 480 resected appendices submitted to histopathology department at Arar Central Hospital in the Northern Border Province of Saudi Arabia over the period of 3 years from July 2011 to June 2014 were reviewed retrospectively, to determine acute appendicitis, complication (gangrene, perforation) rate, negative appendicectomy rate, histopathological diagnosis and unusual finding on histology...
July 2015: Pakistan Journal of Medical Sciences Quarterly
Napoleon Patel, Lisbet D Suarez, Sakshi Kapur, Leonard Bielory
Hereditary Angioedema (HAE) is a rare autosomal dominant (AD) disease characterized by deficient (type 1) or nonfunctional (type 2) C1 inhibitor protein. The disorder is associated with episodes of angioedema of the face, larynx, lips, abdomen, or extremities. The angioedema is caused by the activation of the kallikrein-kinin system that leads to the release of vasoactive peptides, followed by edema, which in severe cases can be life threatening. The disease is usually not diagnosed until late adolescence and patients tend to have frequent episodes that can be severely impairing and have a high incidence of morbidity...
2015: Case Reports in Immunology
Han Toh, Jagdish Menghraj Shahani, Ayesha Jabeen Ali
A 15-year-old girl developed symptoms suggestive of malignant hyperthermia during a laparoscopic appendicectomy for acute appendicitis. The triad of masseter spasm, hypercarbia and hyperthermia within 30 minutes of exposure to triggering factors was present and was treated successfully with dantrolene. She is among a handful of cases known locally. The problems faced in the post-acute phase included the development of thrombophlebitis due to dantrolene use in our patient, as well as paucity of testing centres for malignant hyperthermia both locally and in the region...
September 2014: National Medical Journal of India
Massimo Tonolini, Federica Villa, Sonia Ippolito, Marina Petullà, Roberto Bianco
Laparoscopic appendectomy is increasingly accepted as the preferred surgical treatment for acute appendicitis and represents one of the most common emergency operations performed in both adult and paediatric populations. However, in patients with perforated appendicitis laparoscopy is associated with an increased incidence of postoperative intraabdominal infections compared to open appendectomy. Nowadays urgent imaging is commonly requested by surgeons when postoperative complications are suspected. Due to the widespread use of laparoscopy, in hospitals with active surgical practices clinicians and radiologists are increasingly faced with suspected postappendectomy complications...
February 2015: Insights Into Imaging
Karen S Fernández, Jennifer H Aldrink, Mark Ranalli, Frederick B Ruymann, Donna A Caniano
BACKGROUND: Carcinoid tumors (CTs) are rare in the pediatric population and are generally noted as an incidental finding on histopathologic examination. Cure is usually achieved with wide surgical excision. Second primary malignancies (SPM) of the gastrointestinal tract after CTs have been reported in 13% to 33% of affected adults. The risk of SPM appears highest after small bowel or appendiceal CTs and usually presents within 7 years from diagnosis. PURPOSE: The purpose of this study was to investigate the natural history of CTs in pediatric patients treated at a major children's hospital and to determine whether children and adolescents with primary CTs developed SPM during routine long-term follow-up...
March 2015: Journal of Pediatric Hematology/oncology
Siegal Sadetzki, Chelsea Eastman Langer, Revital Bruchim, Michael Kundi, Franco Merletti, Roel Vermeulen, Hans Kromhout, Ae-Kyoung Lee, Myron Maslanyj, Malcolm R Sim, Masao Taki, Joe Wiart, Bruce Armstrong, Elizabeth Milne, Geza Benke, Rosa Schattner, Hans-Peter Hutter, Adelheid Woehrer, Daniel Krewski, Charmaine Mohipp, Franco Momoli, Paul Ritvo, John Spinelli, Brigitte Lacour, Dominique Delmas, Thomas Remen, Katja Radon, Tobias Weinmann, Swaantje Klostermann, Sabine Heinrich, Eleni Petridou, Evdoxia Bouka, Paraskevi Panagopoulou, Rajesh Dikshit, Rajini Nagrani, Hadas Even-Nir, Angela Chetrit, Milena Maule, Enrica Migliore, Graziella Filippini, Lucia Miligi, Stefano Mattioli, Naohito Yamaguchi, Noriko Kojimahara, Mina Ha, Kyung-Hwa Choi, Andrea 't Mannetje, Amanda Eng, Alistair Woodward, Gema Carretero, Juan Alguacil, Nuria Aragones, Maria Morales Suare-Varela, Geertje Goedhart, A Antoinette Y N Schouten-van Meeteren, A Ardine M J Reedijk, Elisabeth Cardis
The rapid increase in mobile phone use in young people has generated concern about possible health effects of exposure to radiofrequency (RF) and extremely low frequency (ELF) electromagnetic fields (EMF). MOBI-Kids, a multinational case-control study, investigates the potential effects of childhood and adolescent exposure to EMF from mobile communications technologies on brain tumor risk in 14 countries. The study, which aims to include approximately 1,000 brain tumor cases aged 10-24 years and two individually matched controls for each case, follows a common protocol and builds upon the methodological experience of the INTERPHONE study...
2014: Frontiers in Public Health
Takatsugu Yamamoto, Yukiko Kurashima, Kazunori Ohata, Masato Okawa, Shogo Tanaka, Takahiro Uenishi
BACKGROUND: Some investigators recently introduced transumbilical single-incisional laparoscopic appendectomy (SILA), however, those SILA require expensive surgical instruments, or difficult technique. We uniquely propose performing SILA using with endolinear stapler, and compare the clinical results of the present SILA with those of conventional laparoscopic appendectomy. MATERIALS AND METHODS: In brief, the skin of the umbilical hollow is cut, the anterior layer of the rectus sheath and subcutaneous fat is exfoliated widely, and the linea alba is opened...
June 2014: Osaka City Medical Journal
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