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sepsis for appendicitis

Kishore Rajaguru, Daniel Tan Ee Lee
BACKGROUND: The incarceration of an appendix within an inguinal hernia sac is known as Amyand's hernia. Appendicitis in Amyand's hernia accounts for 0.1 % of the cases. An aggressive necrotizing infection of the genitalia and perineum, called Fournier's gangrene, can rapidly progress to sepsis and death. We describe a rare case of Fournier's gangrene complicating Amyand's inguinal hernia which has rarely been reported in the literature. CASE PRESENTATION: This case report describes the presentation and management of a 47-year-old Chinese man who presented with pus discharge from his right inguinoscrotal region and lower abdominal pain with clinical signs of Fournier's gangrene...
September 22, 2016: Journal of Medical Case Reports
W-X Shao, Q Ye, X-J Wang
OBJECTIVE: The aim of this study was to explore the value of laboratory indexes in the differential diagnosis of Henoch-Schoenlein purpura (HSP). METHODS: Patients with HSP hospitalized at the Children's Hospital of Zhejiang University School of Medicine between January 2010 and December 2014 were enrolled in this prospective study. In addition, septic patients with rash and patients with urticaria, simple hematuria, and acute appendicitis hospitalized during the same period were selected at random as differential diagnosis subjects, and healthy children were selected as normal controls...
July 21, 2016: Zeitschrift Für Rheumatologie
Peter C Jenkins, Mary K Oerline, Andrew J Mullard, Michael J Englesbe, Darrell A Campbell, Mark R Hemmila
BACKGROUND: The aim of this study was to determine hospital variation in clinical outcomes after appendectomy for acute appendicitis. METHODS: Using data from the Michigan Surgical Quality Collaborative, we selected patients with procedure codes for open or laparoscopic appendectomy with a diagnosis of acute appendicitis (2006 to 2011). We used multivariate regression models for risk adjustment of patient-level factors and reliability adjustment for sample size differences between hospitals...
May 6, 2016: American Journal of Surgery
Matti Tolonen, Ville Sallinen, Panu Mentula, Ari Leppäniemi
PURPOSE: The aim of this study was to analyse preoperative risk factors for mortality or intensive care unit admission to describe severe peritonitis. METHODS: This was a single academic centre retrospective study of consecutive adult patients operated for diffuse secondary peritonitis between 2012 and 2013. Patients with appendicitis or cholecystitis were excluded. Independent risk factors were identified using binary and ordinal logistic regression. RESULTS: A total of 223 patients were analysed...
August 2016: Langenbeck's Archives of Surgery
M F Scriba, G L Laing, J L Bruce, B Sartorius, D L Clarke
INTRODUCTION/BACKGROUND: This study compares planned repeat laparotomy (PR) with on-demand repeat laparotomy (OD) in a developing world setting. MATERIALS AND METHODS: This study was conducted over a 30-month study period (December 2012-May 2015) at Greys Hospital, Pietermaritzburg, South Africa. All trauma and general surgery adult patients requiring a single relaparotomy were included in this study. Prospectively gathered data entered into an established electronic registry were retrospectively analysed...
July 2016: World Journal of Surgery
Alain Chichom-Mefire, Tabe Alain Fon, Marcelin Ngowe-Ngowe
BACKGROUND: Acute diffuse peritonitis is a common surgical emergency worldwide and a major contributor to non-trauma related death toll. Its causes vary widely and are correlated with mortality. Community acquired peritonitis seems to play a major role and is frequently related to hollow viscus perforation. Data on the outcome of peritonitis in the tropics are scarce. The aim of this study is to analyze the impact of tropic latitude causes of diffuse peritonitis on morbidity and mortality...
2016: World Journal of Emergency Surgery: WJES
Laura A Boomer, Jennifer N Cooper, Seema Anandalwar, Sara Childress Fallon, Daniel Ostlie, Charles M Leys, Shawn Rangel, Peter Mattei, Susan W Sharp, Shawn D St Peter, J Ruben Rodriguez, Brian Kenney, Gail E Besner, Katherine J Deans, Peter C Minneci
OBJECTIVES: To investigate the association between time to appendectomy and the risk of surgical site infections (SSIs) in children with appendicitis across multiple NSQIP-Pediatrics institutions. BACKGROUND: Several recently published single institution retrospective studies have reported conflicting relationships between delaying appendectomy and the risk of increasing surgical site infections (SSI) in both children and adults. This study combines data from NSQIP-Pediatrics with institutional data to perform a multi-institutional analysis to examine the effects of delaying appendectomy on surgical site infections...
July 2016: Annals of Surgery
C Güsgen, R Schwab, A Willms
Secondary diffuse peritonitis still has a high morbidity and mortality even now; therefore, the various strategies and options for the different surgical therapies are undergoing an evidence-based review. Laparoscopic lavage without resection of the focus of sepsis for example is a profoundly different approach in the treatment of diffuse peritonitis from the damage control-based strategy of surgery with initial laparostomy and deferred anastomosis. The evidential data for minimally invasive therapy are comparatively well-reviewed for appendicitis, cholecystitis and ulcerated perforation of the stomach and duodenum...
January 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Zhobin Moghadamyeghaneh, Grace Hwang, Mark H Hanna, Joseph C Carmichael, Steven Mills, Alessio Pigazzi, Michael J Stamos
BACKGROUND: Unplanned readmission of patients who undergo appendectomy is a relatively frequent occurrence. Our aim was to report the most common reasons and the predictors of unplanned readmission after appendectomy. METHODS: The National Surgical Quality Improvement Program database was used to examine the clinical data of patients undergoing emergent and/or urgent appendectomy during 2012 to 2013. Multivariate regression analysis was performed to identify the predictors of unplanned readmission...
September 2016: American Journal of Surgery
Phil Hider, Leona Wilson, John Rose, Thomas G Weiser, Russell Gruen, Stephen W Bickler
BACKGROUND: Surgery is a crucial component of health systems, yet its actual contribution has been difficult to define. We aimed to link use of national hospital service with national epidemiological surveillance data to describe the use of surgical procedures in the management of a broad spectrum of conditions. METHODS: We compiled Australian Modification-International Classification of Diseases-10 codes from the New Zealand National Minimum Dataset, 2008-11. Using primary cause of admission, we aggregated admissions to 91 hospitals into 119 disease states and 22 disease subcategories of the WHO Global Health Estimate (GHE)...
April 27, 2015: Lancet
Andrzej Żyluk, Wojciech Jagielski
Authors report a case of 54-years-old patient, who presented to the hospital due to three-day history of weakness, abdominal pain and diarrhea. His general shape was severe, abdomen was tender at palpation in hypogastrium, peritoneal signs were positive, and blood tests showed highly elevated markers of inflammation, including procalcitonin, what suggested the sepsis. Despite unclear clinical picture, the presence sepsis was an argument to give the patient surgery. Intraoperatively, perforated appendix was found, being in mass with the omentum and small bowel...
May 2015: Polski Przeglad Chirurgiczny
Phil Hider, Leona Wilson, John Rose, Thomas G Weiser, Russell Gruen, Stephen W Bickler
BACKGROUND: Surgery is a crucial component of health systems, yet its contribution has been difficult to define. We linked national hospital service utilization with national epidemiologic data to describe the use of surgical procedures in the management of a broad spectrum of conditions. METHODS: We compiled International Classification of Diseases-10-Australian Modification codes from the New Zealand National Minimum Dataset, 2008-2011. Using primary cause of admission, we aggregated hospitalizations into 119 disease states and 22 disease subcategories of the World Health Organization Global Health Estimate (GHE)...
July 2015: Surgery
Tushar Samdani, Tiffany T Fancher, Frederic M Pieracci, Soumitra Eachempati, Laila Rashidi, Garrett M Nash
Interval appendectomy (IA) is a controversial subject, with little consensus on its use in patients undergoing treatment for malignancy. We sought to determine the frequency of recurrent appendicitis in cancer patients managed nonoperatively (NOM) during index hospitalization (IHA) for acute appendicitis (AA). Clinical presentation, cancer treatment, and follow-up were collected from electronic medical records of patients with CT scan-confirmed AA treated at a single institution between August 1999 and August 2009...
May 2015: American Surgeon
Will Cobb, Barrie Keeler, Johan Aris Chandran, Bob Soin
Recurrent appendicitis can occur up to 40 years after appendicectomy. A history of appendicectomy has often led to late diagnosis, as sepsis is attributed to other organs, usually the urinary tract. A case of a patient presenting with retained faecolith and recurrent/stump appendicitis 2 years after laparoscopic appendicectomy is presented. The case for having a low threshold for early CT scanning in patients post-appendicectomy presenting with sepsis to prevent delay in diagnosis is made, and this case is a useful reminder for surgeons to dissect as far as possible to the appendix base...
2015: BMJ Case Reports
Elizabeth Snyder, Vanda Amado, Mário Jacobe, Greg D Sacks, Matias Bruzoni, Domingos Mapasse, Daniel A DeUgarte
BACKGROUND: As surgery becomes incorporated into global health programs, it will be critical for clinicians to take into account already existing surgical care systems within low-income countries. To inform future efforts to expand the local system and systems in comparable regions of the developing world, we aimed to describe current patterns of surgical care at a major urban teaching hospital in Mozambique. METHODS: We performed a retrospective review of all general surgery patients treated between August 2012 and August 2013 at the Hospital Central Maputo in Maputo, Mozambique...
October 2015: Journal of Surgical Research
Yiping W Han
Fusobacterium nucleatum is an anaerobic oral commensal and a periodontal pathogen associated with a wide spectrum of human diseases. This article reviews its implication in adverse pregnancy outcomes (chorioamnionitis, preterm birth, stillbirth, neonatal sepsis, preeclampsia), GI disorders (colorectal cancer, inflammatory bowel disease, appendicitis), cardiovascular disease, rheumatoid arthritis, respiratory tract infections, Lemierre's syndrome and Alzheimer's disease. The virulence mechanisms involved in the diseases are discussed, with emphasis on its colonization, systemic dissemination, and induction of host inflammatory and tumorigenic responses...
February 2015: Current Opinion in Microbiology
Marguerite Carter, Babek Meshkat, Sherif El-Masry
A 62-year-old man presented via the emergency department with a 1-week history of back pain, on a background of non-insulin-dependent diabetes mellitus and rectal carcinoma for which he had undergone abdominoperineal resection, chemotherapy and radiotherapy. He exhibited signs of sepsis, midline lumbar spine tenderness and reduced hip flexion. CT of the abdomen and pelvis showed a presacral collection contiguous with the tip of the appendix, and MRI lumbar spine revealed abscess invation into the epidural space extending to T9...
2014: BMJ Case Reports
Anita Novak, Zana Rubic, Varja Dogas, Ivana Goic-Barisic, Marina Radic, Marija Tonkic
Anaerobic bacteria play a significant role in many endogenous polymicrobial infections. Since antimicrobial resistance among anaerobes has increased worldwide, it is useful to provide local susceptibility data to guide empirical therapy. The present study reports recent data on the susceptibility of clinically relevant anaerobes in a University Hospital Centre (UHC) Split, Croatia. A total of 63 Gram-negative and 59 Gram-positive anaerobic clinical isolates from various body sites were consecutively collected from January to December 2013...
February 2015: Anaerobe
G P Hadley
Peritonitis is a progressive disease leading inexorably from local peritoneal irritation to overwhelming sepsis and death unless this trajectory is interrupted by timely and effective therapy. In children peritonitis is usually secondary to intraperitoneal disease, the nature of which varies around the world. In rich countries, appendicitis is the principal cause whilst in poor countries diseases such as typhoid must be considered in the differential diagnosis. Where resources are limited, the clinical diagnosis of peritonitis mandates laparotomy for diagnosis and source control...
December 2014: Seminars in Pediatric Surgery
R P Arias-Llorente, P Flórez-Díez, M Oviedo-Gutiérrez, M Suárez-Rodríguez, M Costa-Romero, G Solís-Sánchez, E García-López
Appendicitis in the neonatal period is extremely rare. Its low incidence together with non-specific clinical symptoms often mean the diagnosis is delayed, leading to increased rates of peritonitis and mortality. We report the case of a 33-week premature infant, small for gestational age (1180 g at birth), clinically stable and receiving exclusive enteral feeding, who presented clinical manifestations of necrotizing enterocolitis at 14 days of life. Acute phase reactants were elevated and abdominal radiography showed pneumoperitoneum...
January 1, 2014: Journal of Neonatal-perinatal Medicine
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