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sepsis for appendicitis

M F Scriba, G L Laing, J L Bruce, D L Clarke
BACKGROUND: When multiple repeat laparotomies are required to manage intra-abdominal sepsis, questions about futility of treatment frequently arise. This study focuses specifically on patients who required two or more repeat laparotomies and describes the spectrum of disease necessitating multiple repeat laparotomies and the associated outcomes in the hope of clarifying the issue. METHOD: This study was conducted over a 20-month period (December 2012 - July 2014) at Greys Hospital in Pietermaritzburg, South Africa...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
Peter Jones, James Le Fevre, Alana Harper, Susan Wells, Joanna Stewart, Elana Curtis, Papaarangi Reid, Shanthi Ameratunga
AIM: To determine whether implementation of a national health target called Shorter Stays in Emergency Departments impacted on clinical markers of quality of care. METHOD: A retrospective pre- and post-intervention study from 2006 to 2012 examined quality of care metrics for five different indicators at different sites in relation to the implementation of the target using a general linear model for times to treatment. Explanatory variables included period (pre- or post-target), ethnicity, age, deprivation and severity of condition...
May 12, 2017: New Zealand Medical Journal
Fayza Haider, Barrak Ayoub, Mariam Al Kooheji, Mona Al Juffairi, Safa Al-Shaikh
BACKGROUND: Acute appendicitis in a neonate and premature baby is still considered a rare entity as diagnosis is always made after surgical exploration for acute abdominal findings mimicking necrotizing enterocolitis. Our reported case is a premature baby who had a perforated appendix with no evidence of peritonitis. CASE PRESENTATION: We describe the case of a premature Bahraini girl born at 29 weeks of gestation by spontaneous vaginal delivery to a 39-year-old G6P5 mother...
May 5, 2017: Journal of Medical Case Reports
Pablo G Scapellato, Pedro Pessacq, Alejandra Corso, Fernando Pasteran, Melina Rapoport, Walter Vasen, Corina Nemirovsky, Aníbal Calmaggi
Antibiotic treatment for acute appendicitis is empirically chosen, based on epidemiological information. Resistance rates are different between regions and there are limited data on the situation in Argentina. As a part of a multicenter, observational study of abdominal infections, we performed the analysis of adult patients diagnosed with appendicitis, enrolled in 16 centers of 5 provinces, between Jan/01/2014 and Jun/30/2015. The aim was to analyze the prevalent aerobic pathogens, their resistance rates and the antimicrobial prescription pattern...
2017: Medicina
Benjamin T Chandler, Evan J Ryer, Benjamin M Keyser, James R Elmore
INTRODUCTION: While acute appendicitis is a common surgical problem, the simultaneous occurrence of appendicitis and an infected iliac artery pseudoaneurysm is exceedingly rare. We report the successful treatment of an infected right external iliac artery pseudo aneurysm in the 1setting of acute appendicitis. PRESENTATION OF CASE: The patient is an 83-year-old male who presents with severe sepsis, right lower quadrant and right leg pain. Additional past medical history is significant for rectal cancer status post resection and radiation therapy in 1997...
2017: International Journal of Surgery Case Reports
Anestis Charalampopoulos, Ioannis Dimopoulos, Nikolaos Koliakos, Konstantinos Kopanakis, Theodoros Liakakos And
Backround: Surgical treatment of appendicitis remains the standard treatment, but many cases respond conservatively. Our purpose was the clarification of the clinical, laboratory and imaging characteristics of uncomplicated cases undergoing successful conservative treatment without recurrence. Methods: 105 adult patients (66 female, 39 male) with non-complicated acute appendicitis. Symptom duration, clinical abdominal examination, body temperature, inflammatory markers, imaging studies results and in-hospital treatment were recorded...
January 2017: Chirurgia
B Ndofor, S Mokotedi, M Koto
BACKGROUND: The objective of the study was to compare the outcomes of patients with generalised purulent peritonitis from complicated appendicitis diagnosed intraoperatively who were managed laparoscopically to those managed via the open approach in a single institution. METHOD: Data were collected from all cases admitted at Sebokeng Hospital, Johannesburg, over the past two years (2008 and 2009) with an intraoperative diagnosis of generalised purulent peritonitis from complicated appendicitis...
September 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
S Green, V Y Kong, D L Clarke, B Sartorius, J Odendaal, J L Bruce, G L Laing, P Brysiewicz, W Bekker, E Harknett
BACKGROUND: Sepsis is a leading cause of morbidity and mortality worldwide, and the incidence appears to be increasing. In the resource-limited environment in low- and middle-income countries, the management of surgical sepsis (SS) continues to represent a significant portion of the workload for most general surgeons. OBJECTIVE: To describe the spectrum of SS seen at a busy emergency department, and categorise the outcomes. METHODS: The Pietermaritzburg Metropolitan Trauma Service (PMTS) and Pietermaritzburg Metropolitan Surgical Service (PMSS) in KwaZulu-Natal Province, South Africa (SA), maintain a prospective electronic registry...
January 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
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
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...
May 2017: 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...
November 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
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