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appendicitis in adolescents

Sonja Kinner, Perry J Pickhardt, Erica L Riedesel, Kara G Gill, Jessica B Robbins, Douglas R Kitchin, Timothy J Ziemlewicz, John B Harringa, Scott B Reeder, Michael D Repplinger
OBJECTIVE: Appendicitis is frequently diagnosed in the emergency department, most commonly using CT. The purpose of this study was to compare the diagnostic accuracy of contrast-enhanced MRI with that of contrast-enhanced CT for the diagnosis of appendicitis in adolescents when interpreted by abdominal radiologists and pediatric radiologists. SUBJECTS AND METHODS: Our study included a prospectively enrolled cohort of 48 patients (12-20 years old) with nontraumatic abdominal pain who underwent CT and MRI...
August 10, 2017: AJR. American Journal of Roentgenology
Clemens-Magnus Meier, Helge Latz, Jens Kraemer, Stefan Wagenpfeil, Stefan Graeber, Matthias Glanemann, Arne Simon
PURPOSE: To our knowledge, there is no German study, which has examined the relationship between a postponement of surgery (from emergency service to standard working time) and the corresponding risk of postoperative complications in children and adolescents with acute appendicitis. The aim of this study is to examine if surgery of acute appendicitis in childhood can be postponed from night shift to the next working day without negative effects for the patient. METHODS: In a retrospective analysis (September 2001 to June 2007), the files of 225 paediatric surgical patients with acute appendicitis have been analysed concerning history, histology, course of treatment and development of complications...
July 27, 2017: Langenbeck's Archives of Surgery
Tareq Maraqa, Mohamed Mohamed, Daniel Coffey, Gul R Sachwani-Daswani, Crystal Alvarez, Leo Mercer
Pyosalpinx is a severe sequel of chronic pelvic inflammatory disease, whereby the fallopian tubes become filled with pus.(1 2) Pyosalpinx often affects sexually active women and rarely is seen in celibate adolescent girls.(3) We report a case of a 12-year-old girl with no prior sexual history who presented to our emergency department with complaints of severe right lower quadrant pain of 1-day duration. Ultrasonography and CT scan of the abdomen and pelvis revealed free fluid collections in the pelvis without visualisation of the appendix...
June 24, 2017: BMJ Case Reports
Dae Yong Yi, Kyung Hoon Lee, Sung Bin Park, Jee Taek Kim, Na Mi Lee, Hyery Kim, Sin Weon Yun, Soo Ahn Chae, In Seok Lim
OBJECTIVES: Computed tomography should be performed after careful consideration due to radiation hazard, which is why interest in low dose CT has increased recently in acute appendicitis. Previous studies have been performed in adult and adolescents populations, but no studies have reported on the efficacy of using low-dose CT in children younger than 10 years. METHODS: Patients (n=475) younger than 10 years who were examined for acute appendicitis were recruited...
April 23, 2017: Jornal de Pediatria
Rossana Helbling, Elisa Conficconi, Marina Wyttenbach, Cecilia Benetti, Giacomo D Simonetti, Mario G Bianchetti, Flurim Hamitaga, Sebastiano A G Lava, Emilio F Fossali, Gregorio P Milani
Acute nonspecific, or primary, mesenteric lymphadenitis is a self-limiting inflammatory condition affecting the mesenteric lymph nodes, whose presentation mimics appendicitis or intussusception. It typically occurs in children, adolescents, and young adults. White blood count and C-reactive protein are of limited usefulness in distinguishing between patients with and without mesenteric lymphadenitis. Ultrasonography, the mainstay of diagnosis, discloses 3 or more mesenteric lymph nodes with a short-axis diameter of 8 mm or more without any identifiable underlying inflammatory process...
2017: BioMed Research International
Carren Melinder, Ayako Hiyoshi, Katja Fall, Jonas Halfvarson, Scott Montgomery
OBJECTIVE: To determine if low psychosocial stress resilience in adolescence (increasing chronic stress arousal throughout life) is associated with an increased inflammatory bowel disease (IBD) risk in adulthood. Subclinical Crohn's disease (CD) and ulcerative colitis (UC) can exist over many years and we hypothesise that psychosocial stress may result in conversion to symptomatic disease through its proinflammatory or barrier function effects. DESIGN: National register-based cohort study of men followed from late adolescence to middle age...
January 27, 2017: BMJ Open
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
Arathi Mohan, Paul A Karam, Martin R Buta, Sarah Worley, Federico G Seifarth
BACKGROUND: To compare surgical outcomes of pediatric patients aged 0-15 with acute appendicitis treated with single-port, transumbilical, extracorporeal laparoscopically assisted appendectomy (SP) with young adult patients aged 16-21. MATERIALS AND METHODS: Single center retrospective chart review in patients 21 years and younger with a pre-operative diagnosis of appendicitis who underwent SP between January 2010 and December 2015. Patients were divided into two groups based on age...
December 2016: International Journal of Surgery
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
No abstract text is available yet for this article.
January 2017: 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
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