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Perforated appendicitis

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https://www.readbyqxmd.com/read/28650684/intentional-ingestion-of-elemental-mercury-requiring-multi-step-decontamination-and-prophylactic-appendectomy-a-case-report-and-treatment-proposal
#1
Andrea Michielan, Azzurra Schicchi, Roberto Cappuccio, Davide Lonati, Francesca Lamboglia, Alessandra Vitalba, Alessandro Caroli, Marta Crevani, Carlo A Locatelli, Giorgio Betetto
BACKGROUND: Ingestion of elemental mercury (Hg0) is considered non-toxic. After massive ingestion, local intestinal complications may develop: retention within appendix is quite frequent but treatment is debated. We describe a case of intentional ingestion of Hg0 requiring multi-step decontamination and prophylactic appendectomy. Case detail: A 19-year-old woman was admitted to ED for abdominal pain. History revealed ingestion of large amount of Hg0 as suicide attempt. To prevent absorption, facilitate elimination, and avoid complications a conservative approach was started...
June 26, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28647737/trends-in-the-management-of-acute-appendicitis-in-a-single-center-quality-register-cohort-of-5-614-patients
#2
Martin J A Dahlberg, Emil H A Pieniowski, Lennart Å S Boström
Acute appendicitis is one of the most common reasons for emergency surgery. At Stockholm South General Hospital, information on all patients - 15 years or older - undergoing surgery for acute appendicitis is included in a quality register. Data on surgical method, preoperative imaging, hospital stay, intraoperative findings, and 30-day complications were recorded for each patient. From January 2004 to December 2014, 5,614 consecutive patients were registered. The percentage of patients examined with preoperative imaging increased from 30% in 2004 to 93% in 2014...
June 24, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28640003/infections-associated-with-streptococcus-constellatus-in-children
#3
Howard Faden, Mustafa Mohmand
Streptococcus constellatus is a viridans Streptococcus belonging to the Anginosus group. It was associated with abscesses in 37 children, 80% of whom had acute appendicitis with perforation and abscess formation in 50%. None of the children was younger than 3 years of age.
June 20, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28635516/concentration-of-uhcl1-in-the-serum-of-children-with-acute-appendicitis-before-and-after-surgery-and-its-correlation-with-crp-and-prealbumin
#4
Ewa Matuszczak, Marzena Tylicka, Wojciech Dębek, Anna Tokarzewicz, Ewa Gorodkiewicz, Adam Hermanowicz
Ubiquitin-mediated protein degradation plays a crucial role in various cellular processes, including signal transduction, cell differentiation, and stress response. Ubiquitin C-terminal hydrolase 1 (UCHL1) is a unique deubiquitinating enzyme that has both hydrolase and ligase activities. The aim of this study was the determination of UCHL1 concentration in serum of children with appendicitis, before and after the surgery. MATERIAL AND METHODS: 42 children with acute appendicitis, who were managed at the Pediatric Surgery Department, between 2013 and 2014, were randomly included into the study (age 9 months up to 14 years, mean age 2...
February 27, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28629607/post-operative-management-of-perforated-appendicitis-can-clinical-pathways-improve-outcomes
#5
Robert R Gerard, Barrett A Kielhorn, Laurence E McCahill, Brent Petersen, Andrew J Mullard
BACKGROUND: We sought to decrease organ space infection (OSI) following appendectomy for perforated acute appendicitis (PAA) by minimizing variation in clinical management. OBJECTIVE: A postoperative treatment pathway was developed and four recommendations were implemented: 1) clear documentation of post-operative diagnosis, 2) patients with unknown perforation status to be treated as perforated pending definitive diagnosis, 3) antibiotic therapy to be continued post operatively for 4-7 days after SIRS resolution, and 4) judicious use of abdominal computed tomography (CT) scanning prior to post-operative day 5...
June 10, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28624044/predictors-of-a-histopathologic-diagnosis-of-complicated-appendicitis
#6
Jonathan B Imran, Tarik D Madni, Christian T Minshall, Ali A Mokdad, Madhu Subramanian, Audra T Clark, Herb A Phelan, Michael W Cripps
BACKGROUND: Despite its utilization, the intraoperative (IO) assessment of complicated appendicitis (CA) is subjective. The histopathologic (HP) diagnosis should be the gold standard in identifying patients with CA; however, it is not immediately available to guide postoperative management. The objective of this study was to identify predictors of an HP diagnosis of CA. MATERIALS AND METHODS: A retrospective review of all patients who underwent appendectomy at our institution from 2011-2013 was conducted...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28624043/composition-of-the-cellular-infiltrate-in-patients-with-simple-and-complex-appendicitis
#7
Ramon R Gorter, Emma C E Wassenaar, Onno J de Boer, Roel Bakx, Joris J T H Roelofs, Madeleine J Bunders, L W Ernst van Heurn, Hugo A Heij
BACKGROUND: It is now well established that there are two types of appendicitis: simple (nonperforating) and complex (perforating). This study evaluates differences in the composition of the immune cellular infiltrate in children with simple and complex appendicitis. MATERIALS AND METHODS: A total of 47 consecutive children undergoing appendectomy for acute appendicitis between January 2011 and December 2012 were included. Intraoperative criteria were used to identify patients with either simple or complex appendicitis and were confirmed histopathologically...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28607634/evaluation-of-the-diagnostic-value-of-serum-level-of-total-bilirubin-in-patients-with-suspected-acute-appendicitis
#8
Mohammad Reza Motie, Minoosadat Mousavi Nik, Malihe Gharaee
INTRODUCTION: Clinical diagnosis of acute appendicitis still remains a problem. Delays in diagnosis of acute appendicitis may cause perforation and septic peritonitis which result in increasing morbidity and mortality. The aim of this study was to determine the sensitivity, specificity and the diagnostic value of total serum bilirubin levels as a predictor of acute appendicitis. METHODS: In this cross-sectional study, patients who underwent appendectomy with the diagnosis of acute appendicitis from April 2012 to March 2013 at Emam Reza Hospital in Mashhad (Iran) were enrolled...
April 2017: Electronic Physician
https://www.readbyqxmd.com/read/28607552/procalcitonin-guided-antibiotics-after-surgery-for-peritonitis-a-randomized-controlled-study
#9
Juliette C Slieker, Steve Aellen, Philippe Eggimann, Valentine Guarnero, Markus Schäfer, Nicolas Demartines
BACKGROUND: Serum procalcitonin (PCT) is a useful biomarker to tailor the duration of antibiotics in respiratory infections. The objective of this study was to determine whether PCT levels could tailor postoperative antibiotic therapy in patients operated for peritonitis. METHOD: Patients with peritonitis were randomized postoperatively. The control group received antibiotics for a defined duration according to institutional guidelines. In the study group, antibiotics were stopped based on serum PCT levels...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28602871/outcomes-of-antibiotic-therapy-for-uncomplicated-appendicitis-in-pregnancy
#10
Jeong Il Joo, Hyoung-Chul Park, Min Jeong Kim, Bong Hwa Lee
OBJECTIVE: The aim of the present study is to determine the feasibility and safety of antibiotics for uncomplicated simple appendicitis in pregnancy. METHOD: Ours was a 6-year prospective observational study conducted on 20 pregnant women in whom uncomplicated simple appendicitis (appendiceal diameter ≤ 11 mm and without any signs of appendicoliths, perforation, or abscess) was radiologically verified and managed with a 4-day course of antibiotics. Treatment failure rate, defined as the need for an appendectomy during hospitalization and recurrence in the follow-up period (median 25 months), and maternal or fetal complications during the pregnancy were evaluated...
June 8, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28599958/the-meteorological-influence-on-seasonal-alterations-in-the-course-of-acute-appendicitis
#11
Alexander Reinisch, Jan Heil, Guido Woeste, Wolf Bechstein, Juliane Liese
BACKGROUND: Several diseases, including acute appendicitis (AA), have been known to undergo seasonal variations. Changes in the incidence and course of AA are attributed to seasonal weather differences, but this connection remains unproven. METHODS: In this retrospective, single-center analysis, we analyzed daily meteorological data over an 8-year period. A connection of day-by-day meteorological data with 680 consecutive appendectomies was performed. Patients' characteristics, intraoperative findings, and outcome parameters were analyzed...
May 10, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28598452/risk-factors-for-complications-in-acute-appendicitis-among-paediatric-population
#12
R Poudel, T R Bhandari
INTRODUCTION: Appendicitis is one of the most common causes of acute abdomen in children. Patients who are diagnosed early and undergo an appendectomy before perforation have a good outcome. However, it is difficult to diagnose in young children because its clinical manifestations may be atypical. The aim of this study was to determine the risk factors for complications in acute appendicitis in paediatric population. METHODS: We performed a cross sectional study on children (age ≤18 years) who underwent appendectomy for suspected appendicitis from January 2014 to December 2015...
January 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/28585600/perforation-of-meckel-s-diverticulum-with-a-foreign-body-mimicking-acute-appendicitis-a-rare-complication
#13
Amaar Aamery, Ruqaiya Al-Shehhi, Kamran Malik, Abdullah Al-Harthy
Meckel's diverticulum mimicking acute appendicitis is a very rare condition encountered in practice. MD is asymptomatic in most of cases and only about 4 to16% of cases develop complications. Perforation of MD by a foreign body is even rarer being only reported in few cases in the literature. The surgical management might be wedge resection or segmental resection and primary anastomoses depending on the intra operative findings. We report a case with foreign body impaction in MD with perforation mimicking acute appendicitis...
June 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28578700/a-rare-presentation-of-an-acute-abdomen-an-ileal-diverticular-perforation
#14
Basuru Uvindu Thilakawardana, Sanjay De Mel, Vasitha Abeysuriya, Janaki Hewavisenthi, Chandima De Mel, Lal Chandrasena, Visula Abeysuriya
BACKGROUND: This case report highlights the value of prompt intervention of diagnostic laparoscopy in a patient suspects of having an acute abdomen due to an intestinal perforation, where there is a limitation of performing Contrast Enhanced Computed Tomography of abdomen. A previously healthy young adult presenting with an acute abdomen due to a spontaneous ileal perforation, without any associated risk factors is a rare clinical entity in a developing country. Therefore, entertaining an early diagnosis will possibly prevent a fatal consequence...
June 2, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28578474/differentiating-perforated-from-non-perforated-appendicitis-on-contrast-enhanced-magnetic-resonance-imaging
#15
Daniel G Rosenbaum, Gulce Askin, Debra M Beneck, Arzu Kovanlikaya
BACKGROUND: The role of magnetic resonance imaging (MRI) in pediatric appendicitis is increasing; MRI findings predictive of appendiceal perforation have not been specifically evaluated. OBJECTIVE: To assess the performance of MRI in differentiating perforated from non-perforated appendicitis. MATERIALS AND METHODS: A retrospective review of pediatric patients undergoing contrast-enhanced MRI and subsequent appendectomy was performed, with surgicopathological confirmation of perforation...
June 3, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28562252/time-from-emergency-department-evaluation-to-operation-and-appendiceal-perforation
#16
Michelle D Stevenson, Peter S Dayan, Nanette C Dudley, Lalit Bajaj, Charles G Macias, Richard G Bachur, Kelly Sinclair, Jonathan Bennett, Manoj K Mittal, Macarius M Donneyong, Anupam B Kharbanda
BACKGROUND AND OBJECTIVES: In patients with appendicitis, the risk of perforation increases with time from onset of symptoms. We sought to determine if time from emergency department (ED) physician evaluation until operative intervention is independently associated with appendiceal perforation (AP) in children. METHODS: We conducted a planned secondary analysis of children aged 3 to 18 years with appendicitis enrolled in a prospective, multicenter, cross-sectional study of patients with abdominal pain (<96 hours)...
May 24, 2017: Pediatrics
https://www.readbyqxmd.com/read/28554816/a-pre-operative-clinical-scoring-system-to-distinguish-perforation-risk-with-pediatric-appendicitis
#17
William Bonadio, Syeda Shahid, Lior Vardi, Carly Buckingham, Allison Kornblatt, Chloe Free, Peter Homel
IMPORTANCE: Appendicitis is a common, potentially serious pediatric disease. An important factor in determining management strategy [whether/when to perform appendectomy, duration of antibiotic therapy/hospitalization, etc.] and predicting outcome is distinguishing whether perforation is present. OBJECTIVE: The objective was to determine efficacy of commonly assessed pre-operative variables in stratifying perforation risk in children with appendicitis. DESIGN: A retrospective analysis of consecutive cases was performed...
May 22, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28552813/the-established-acute-surgical-unit-a-reduction-in-nighttime-appendicectomy-without-increased-morbidity
#18
Matthew G R Allaway, Guy D Eslick, Grace T Y Kwok, Michael R Cox
INTRODUCTION: Nighttime surgery for non-life threatening disease has been associated with poorer outcomes, but delaying surgery for acute appendicitis may also be detrimental. The aim was to assess the effect of the Acute Surgical Unit [ASU] model on nighttime surgery rates and outcomes for patients undergoing appendicectomy. METHOD: A retrospective review of medical records of patients having an appendicectomy. Primary outcomes were nighttime surgery rate, time from presentation to surgery, perforation rate, complication rate and length of stay...
May 24, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28531869/a-rare-case-of-subacute-appendicitis-actinomycosis-as-the-final-pathology-reports-a-case-report-and-literature-review
#19
G A Gómez-Torres, O S Ortega-Gárcia, E G Gutierrez-López, C A Carballido-Murguía, J A Flores-Rios, C R López-Lizarraga, C A Bautista López, C F Ploneda-Valencia
INTRODUCTION: Acute appendicitis is the most common indication for an emergency abdominal surgery in the world, with a lifetime incidence of around 10%. Actinomycetes are the etiology of appendicitis in only 0.02%-0.06%, having as the final pathology report a chronic inflammatory response; less than 10% of the cases are diagnosed before surgery. Here, we present the case of a subacute appendicitis secondary to actinomycosis. CASE REPORT: A 39-year-old male presented with a twelve-day evolution of intermittent abdominal pain in the right lower quadrant, treated at the beginning with ciprofloxacin and urinary analgesic...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28514306/unusual-case-of-rapid-growing-intraabdominal-abscess-caused-by-stenotrophomonas-maltophilia-after-laparoscopic-appendectomy-due-to-perforated-appendicitis-a-case-report
#20
Dae Ro Lim, Jung Cheol Kuk, Taehyung Kim, Eung Jin Shin
INTRODUCTION: An intraabdominal abscess due to Stenotrophomonas maltophilia (S maltophilia) infection is a very rare clinical manifestation. S maltophilia is a glucose nonfermentative, aerobic, gram-negative, mobile, and biofilm-forming bacterium. It is an opportunistic pathogen and uncommon cause of infection. Respiratory tract infections (pneumonia) and bloodstream infections (bacteremia) are the most common clinical manifestations of S maltophilia infection. CONCLUSIONS: This case report describes an unusual case of a rapidly growing, extremely large intraabdominal abscess (within 1 week during antibiotic therapy), which was detected 2 weeks after a laparoscopic appendectomy was performed for perforated appendicitis and was caused by multidrug-resistant S maltophilia infection...
May 2017: Medicine (Baltimore)
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