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Perforated appendicitis

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https://www.readbyqxmd.com/read/27922766/diagnostic-value-of-high-mobility-group-box-1-hmgb1-protein-in-acute-and-perforated-appendicitis
#1
Shabanali Alizadeh, Ali Ghazavi, Ali Ganji, Ghasem Mosayebi
AIM: Acute appendicitis is the most common cause of abdominal surgical emergencies. Early diagnosis of appendicitis can reduce perforation and mortality rate. High-mobility group box 1 (HMGB1) protein has been identified as a pro-inflammatory factor and its elevated serum levels have been noted in different diseases. So, the aim of this study was to determine the serum levels of HMGB1 in patients with acute and perforated appendicitis in compare to normal appendix. MATERIAL AND METHODS: For this purpose, serum samples were obtained from 81 patients with primary criteria-based appendicitis 6 hr before and 72 hr after appendectomy, in which serum levels of HMGB1 were analyzed by enzyme-linked immunosorbent assay...
December 6, 2016: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/27916376/factors-predictive-of-complicated-appendicitis-in-children
#2
Xuan-Binh D Pham, Veronica F Sullins, Dennis Y Kim, Blake Range, Amy H Kaji, Christian M de Virgilio, Steven L Lee
BACKGROUND: The ability to predict whether a child has complicated appendicitis at initial presentation may influence clinical management. However, whether complicated appendicitis is associated with prehospital or inhospital factors is not clear. We also investigate whether hyponatremia may be a novel prehospital factor associated with complicated appendicitis. MATERIALS AND METHODS: A retrospective review of all pediatric patients (≤12 y) with appendicitis treated with appendectomy from 2000 to 2013 was performed...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27913053/intestinal-metaplasia-of-appendiceal-endometriosis-is-not-uncommon-and-may-mimic-appendiceal-mucinous-neoplasm
#3
Monika Vyas, Serena Wong, Xuchen Zhang
Endometriosis of the appendix can be an incidental finding or a cause of appendicitis, intussusception, perforation or retention mucocele. Intestinal metaplasia of appendiceal endometriosis may occur, which can lead to a misdiagnosis of low-grade appendiceal mucinous neoplasm. On a retrospective search of the pathology database from 2001 to 2015, we identified 78 appendiceal endometriosis cases and intestinal metaplasia was present in 10/78 (13%) cases. In most of the cases (90%), the foci of intestinal metaplasia were mainly localized close to the mucosa...
October 25, 2016: Pathology, Research and Practice
https://www.readbyqxmd.com/read/27908462/a-rare-case-of-perforated-sub-hepatic-appendicitis-a-challenging-differential-diagnosis-of-acute-abdomen-based-on-the-combination-of-appendicitis-and-maldescent-of-the-caecum
#4
Costanza Chiapponi, Olof Jannasch, Manuela Petersen, Wiebke Lessel, Christiane Bruns, Frank Meyer
Unusual locations of the appendix vermiformis can result in delay in appropriate diagnosis and treatment of appendicitis. So an inflamed appendix in a sub-hepatic caecum caused by caecal maldescent for example can mimic cholecystitis, the pain being localized in the right upper quadrant. Here, we present a case of perforated sub-hepatic appendicitis with peritonitis, requiring open ileocaecal resection. Review of the existing literature has demonstrated that this pathology is uncommon, yet not so rare as one might presume...
November 21, 2016: Pathology, Research and Practice
https://www.readbyqxmd.com/read/27906036/complicated-acute-appendicitis-presenting-as-a-rapidly-progressive-soft-tissue-infection-of-the-abdominal-wall-a-case-report
#5
Corinne Beerle, Hans Gelpke, Stefan Breitenstein, Ralph F Staerkle
BACKGROUND: We report a case of a rare complication of acute appendicitis with perforation through the abdominal wall. The case points out that an intraabdominal origin should be considered in patients presenting with rapidly spreading soft tissue infections of the trunk. CASE PRESENTATION: A 58-year-old European woman presented to our hospital with a 1-week history of severe abdominal pain accompanied by rapidly spreading erythema and emphysema of the lower abdomen...
December 1, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27894435/pediatric-appendicitis
#6
REVIEW
Rebecca M Rentea, Shawn D St Peter
Appendicitis is one of the most common surgical pathologies in children. It can present with right lower quadrant pain. Scoring systems in combination with selective imaging and surgical examination will diagnose most children with appendicitis. Clinical pathways should be used. Most surgical interventions for appendicitis are now almost exclusively laparoscopic, with trials demonstrating better outcomes for children who undergo index hospitalization appendectomies when perforated. Nonoperative management has a role in the treatment of both uncomplicated and complicated appendicitis...
February 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/27890780/a-clinical-score-to-predict-appendicitis-in-older-male-children
#7
Anupam B Kharbanda, Michael C Monuteaux, Richard G Bachur, Nanette C Dudley, Lalit Bajaj, Michelle D Stevenson, Charles G Macias, Manoj K Mittal, Jonathan E Bennett, Kelly Sinclair, Peter S Dayan
OBJECTIVE: To develop a clinical score to predict appendicitis among older, male children who present to the emergency department (ED) with suspected appendicitis. METHODS: Patients with suspected appendicitis were prospectively recruited at 9 pediatric EDs. A total 2,625 patients enrolled; a subset of 961 males, age 8-18 were analyzed in this secondary analysis. Outcomes determined by pathology, operative reports and follow-up calls. Clinical and laboratory predictors with < 10% missing data and Kappa > 0...
November 24, 2016: Academic Pediatrics
https://www.readbyqxmd.com/read/27884613/appendectomy-in-patients-with-human-immunodeficiency-virus-not-as-bad-as-we-once-thought
#8
Michael C Smith, Paul J Chung, Yohannes C Constable, Matthew R Boylan, Antonio E Alfonso, Gainosuke Sugiyama
BACKGROUND: The number of patients living with human immunodeficiency virus and acquired immunodeficiency syndrome is growing due to advances in antiretroviral therapy. Existing literature on appendectomy within this patient population has been limited by small sample sizes. Therefore, we used a large, multiyear, nationwide database to study this topic comprehensively. METHODS: Using the Nationwide Inpatient Sample, we identified 338,805 patients between 2005 and 2012 who underwent laparoscopic or open appendectomy for acute appendicitis...
November 21, 2016: Surgery
https://www.readbyqxmd.com/read/27884453/a-call-for-a-standardized-definition-of-perforated-appendicitis
#9
Andrew P Rogers, Tiffany J Zens, Charles M Leys, Peter F Nichol, Daniel J Ostlie
BACKGROUND: Abscess rates have been reported to be as low as 1% and as high as 50% following perforated appendicitis (PA). This range may be because of lack of universal definition for PA. An evidence-based definition (EBD) is crucial for accurate wound classification, risk-stratification, and subsequent process optimization. ACS NSQIP-Pediatric guidelines do not specify a definition of PA. We hypothesize that reported postoperative abscess rates underrepresent true incidence, as they may include low-risk cases in final calculations...
October 27, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27880929/a-complicated-case-of-amyand-s-hernia-involving-a-perforated-appendix-and-its-management-using-minimally-invasive-laparoscopic-surgery-a-case-report
#10
Wisam Al-Ramli, Yahya Khodear, Muyiwa Aremu, Abdel Basset El-Sayed
INTRODUCTION: Amyand's hernia is a rare condition of inguinal hernia in which the appendix is incarcerated within the hernia sac through the internal ring. Complications include acute appendicitis and perforated appendicitis, which are rare in incidence, accounting for about 0.1% of cases.(1) These complications prove a diagnostic challenge due to their vague clinical presentation and atypical laboratory and radiological findings. Until recently, open appendectomy was the mainstay of treatment...
November 10, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27873747/atypical-presentation-of-appendicitis
#11
Oliver Beaumont, Robert Miller, Richard Guy
A woman aged 64 years presented as an emergency with a mass in the right iliac fossa, clinically within the abdominal wall, but an otherwise soft abdomen. Systemically, she was quite well with normal vital signs. Blood tests revealed raised inflammatory markers, and an abdominal CT scan demonstrated a perforated appendix with associated large subcutaneous abscess. This represents a rare presentation of a common condition, demonstrating how appendicitis can still be a challenging problem for the clinician...
November 10, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27872360/the-heidelberg-appendicitis-score-predicts-perforated-appendicitis-in-children
#12
Michael Boettcher, Patrick Günther, Thomas Breil
Background In the future, surgical management of pediatric appendicitis might become limited to nonperforating appendicitis. Thus, it becomes increasingly important to differentiate advanced from simple appendicitis and to predict perforated appendicitis among a group of children with right-sided abdominal pain, which was the aim of this study. Methods An institutionally approved, single-center retrospective analysis of all patients with appendectomy from January 2009 to December 2010 was conducted. All diagnostic aspects were evaluated to identify predictors and differentiators of perforated appendicitis...
November 20, 2016: Clinical Pediatrics
https://www.readbyqxmd.com/read/27871681/postoperative-antibiotic-use-and-the-incidence-of-intra-abdominal-abscess-in-the-setting-of-suppurative-appendicitis-a-retrospective-analysis
#13
Esther Bae, Ahmed Dehal, Vanessa Franz, Michael Joannides, Nicholas Sakis, Joshua Scurlock, Patrick Nguyen, Farabi Hussain
BACKGROUND: Although guidelines exist for postoperative antibiotic use in acute appendicitis that is perforated, gangrenous, or simple/uncomplicated, there are less data about its use in suppurative appendicitis. Here, we targeted this subgroup of patients to determine whether postoperative antibiotic administration affects incidence of intra-abdominal abscess formation. METHODS: We retrospectively examined 1,192 patients who underwent laparoscopic appendectomy for acute appendicitis at Kaiser Permanente Fontana Hospital between August 2010 and August 2013...
December 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27863889/same-day-discharge-in-laparoscopic-acute-non-perforated-appendectomy
#14
Andrew Scott, Shant Shekherdimian, Joshua D Rouch, Greg D Sacks, Aaron J Dawes, Wendy Y Lui, Letitia Bridges, Tracy Heisler, Steven R Crain, Mang-King W Cheung, Armen Aboulian
BACKGROUND: Small studies done during the past decade have demonstrated same-day discharge after appendectomy as an option for non-perforated appendicitis. Here we have examined a large cohort to confirm that same-day discharge in acute non-perforated appendicitis is a safe option. STUDY DESIGN: This was a retrospective study of patients from 14 Southern California Region Kaiser Permanente medical centers. All patients older than 18 years of age with acute, non-perforated appendicitis who underwent a laparoscopic appendectomy between 2010 and 2014 were included...
November 15, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27863822/surgical-site-infection-reporting-more-than-meets-the-agar
#15
Luke R Putnam, Tiffany G Ostovar-Kermani, Andrea Le Blanc, Kathryn T Anderson, Galit Holzmann-Pazgal, Kevin P Lally, KuoJen Tsao
BACKGROUND/PURPOSE: Surgical site infection (SSI) rate in pediatric appendicitis is a commonly used hospital quality metric. We hypothesized that surveillance of organ-space SSI (OSI) using cultures alone would fail to capture many clinically-important events. METHODS: A prospective, multidisciplinary surveillance program recorded 30-day SSI and hospital length of stay (LOS) for patients <18years undergoing appendectomy for perforated appendicitis from 2012 to 2015...
October 28, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27863342/a-case-report-describing-diverticulosis-of-the-appendix-presenting-as-acute-appendicitis
#16
Sarah L Khan, Madhu Siddeswarappa, Mohammad Farrukh Khan
INTRODUCTION: Diverticulosis of the appendix (DA) is a rare clinical finding which is often confused with acute or chronic appendicitis and is usually only identified during or after appendectomy. The symptoms of DA can last for up to two weeks and laboratory studies tend to reflect a more chronic inflammation. Distinguishing the two entities is important as DA has a higher risk for perforation and may be associated with an underlying malignancy. PRESENTATION OF CASE: A 54--year old African--American male presented with three--days of right sided abdominal pain, nausea, and vomiting...
November 15, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27857807/transanal-protrusion-of-ventriculoperitoneal-shunt-via-appendicular-perforation-a-rare-case-report
#17
Shaam Bodeliwala, Atul Agrawal, Amit Mittal, Daljit Singh, B G Vageesh, Hukum Singh
Perforation of abdominal viscera and protrusion of the distal end of ventriculoperitoneal shunt (VPS) through natural orifice is well known but rare complication. We report a case of a transanal protrusion of distal end of VPS through appendix perforation without any symptomatology of prior appendicitis. To the best of our knowledge, no case of such kind has been reported in literature yet. The management plan of these patients should be looked in a different way because they may have underlying inflammation of the appendix and distal end of shunt removal should be done by proper surgical exploration followed by added appendicectomy...
July 2016: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/27849324/pre-operative-stool-analysis-for-intestinal-parasites-and-fecal-occult-blood-in-patients-with-acute-appendicitis
#18
Sinan Hatipoğlu, Uğur Lök, Umut Gülaçtı, Tuncay Çelik
BACKGROUND: Etiology of acute appendicitis (AA) rarely involves parasitic infections of gastrointestinal (GI) tract. Preoperative diagnosis of parasitic infections in appendix remains difficult, although parasites can sometimes be observed inside the lumen during histopathological examination. The aim of the present study was to prospectively screen prevalence and species of intestinal parasites and adherence of fecal occult blood (FOB) in patients admitted to emergency department (ED) with clinical symptoms of AA who underwent appendectomy...
September 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/27847377/underestimated-amoebic-appendicitis-among-hiv-1-infected-individuals-in-japan
#19
Taiichiro Kobayashi, Koji Watanabe, Hideaki Yano, Yukinori Murata, Toru Igari, Kumiko Nakada-Tsukui, Kenji Yagita, Tomoyoshi Nozaki, Mitsuo Kaku, Kunihisa Tsukada, Hiroyuki Gatanaga, Yoshimi Kikuchi, Shinichi Oka
Entamoeba histolytica is not a common causative agent of acute appendicitis. However, amoebic appendicitis could sometimes be severe and life-threatening, mainly due to lack of awareness. Also, its frequency, clinical features and pathogenesis remain unclear. The study subjects were HIV-1-infected individuals who presented with acute appendicitis and later underwent appendectomy at our hospital between 1996 and 2014. Formalin-fixed paraffin-embedded preserved appendix specimens were re-examined by Periodic acid-Schiff (PAS) staining and PCR to identify undiagnosed amoebic appendicitis...
November 9, 2016: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/27836098/misdiagnosing-adult-appendicitis-clinical-cost-and-socioeconomic-implications-of-negative-appendectomy
#20
Kyle Mock, Yang Lu, Scott Friedlander, Dennis Y Kim, Steven L Lee
BACKGROUND: The aim of this study was to evaluate the clinical, financial, and socioeconomic factors associated with negative appendectomy (NA). METHODS: Data were obtained from the California State Inpatient Database (2005 to 2011). Patients (≥18 years) who underwent nonincidental appendectomies (n = 180,958) were evaluated with multivariate regression analyses. RESULTS: NA rates decreased from 4.5% in 2005 to 2.8% in 2011 (P < .01)...
September 28, 2016: American Journal of Surgery
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