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Perforated appendicitis

J E Slotta, U Kopsch, M Ghadimi, O Kollmar
BACKGROUND: Acute appendicitis is a common disease which requires immediate surgical treatment of the focus of inflammation. So far there are no reliable data on how much time can pass between hospitalization, indications for surgery and initiating surgery without an increased risk of morbidity and mortality for the patient. OBJECTIVE: The aim of this study was to investigate how much time can lapse between admission and initiation of surgery for acute appendicitis while still providing patient safety and no increase in complication rates...
October 21, 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Murat Özgür Kılıç, Cem Emir Güldoğan, İlhan Balamir, Mesut Tez
BACKGROUND: The early prediction of gangrenous/perforated appendicitis is of great importance for the surgical planning, further treatments, and predicting the course of disease. Ischemia-modified albumin (IMA) was previously reported as a biomarker of various ischemia-based diseases. Our aim is to determine the predictive value of serum IMA in the severity of acute appendicitis. METHODS: Sixty-two patients who underwent urgent appendectomy were included in the study...
October 7, 2016: American Journal of Emergency Medicine
Joey Chan Yiing Beh, Anandswaroop Srinivas Uppaluri, Beatrice Fang Ju Koh, Peng-Chung Cheow
Ingested foreign bodies tend to pass through the gastrointestinal tract without incidence, and vast majority of cases do not need intervention. Rarely, these foreign bodies drop into the appendix and not likely to re-enter the normal digestive tract. We describe a case of a 72-year-old male patient who presented with right iliac fossa pain of 3-day duration. Clinical examination suggested classic acute appendicitis. Blood test results revealed leukocytosis. Computed tomography of the abdomen and pelvis showed evidence of acute appendicitis and a linear hyperdensity (foreign body) perforating the appendix...
July 2016: Journal of Radiology Case Reports
James A Meltzer, Sergey Kunkov, Jennifer H Chao, Ee Tein Tay, Jerry P George, David Borukhov, Stephen Alerhand, Prince A Harrison, Jeffrey Hom, Ellen F Crain
OBJECTIVE: The aim of this study was to assess whether increased time from emergency department (ED) triage to appendectomy is associated with a greater risk of children developing appendiceal perforation. METHODS: We performed a multicenter retrospective cohort study of children younger than 18 years hospitalized with appendicitis. To avoid enrolling patients who had perforated prior to ED arrival, we included only children who had a computed tomography (CT) scan demonstrating nonperforated appendicitis...
September 30, 2016: Pediatric Emergency Care
Francisco Schlottmann, Romina Reino, Emmanuel E Sadava, Ana Campos Arbulú, Nicolás A Rotholtz
INTRODUCTION: Complicated appendicitis (CA) may be a risk factor for postoperative intra-abdominal abscess formation (IAA). In addition, several publications have shown an increased risk of postoperative collection after laparoscopic appendectomy. Most surgeons prefer to place a drain to collect contaminated abdominal fluid to prevent consequent abscess formation. We aimed to evaluate the utility of placing an intra-abdominal drain in laparoscopic appendectomy for complicated acute appendicitis...
October 12, 2016: International Journal of Surgery
G Cocorullo, N Falco, R Tutino, T Fontana, G Scerrino, G Salamone, L Licari, G Gulotta
AIM: To evaluate the role of laparoscopy in the treatment of surgical emergency in old population. PATIENTS AND METHODS: Over-70 years-old patients submitted to emergency abdominal surgery from January 2013 to December 2014 were collected and grouped according to admission diagnoses. These accounted small bowel obstruction, colonic acute disease, appendicitis, ventral hernia, gastro-duodenal perforation, biliary disease. In each group it was analyzed the operation time (OT), the morbidity rate and the mortality rate comparing open and laparoscopic management using T-test and Chi-square test...
May 2016: Il Giornale di Chirurgia
Hideki Katagiri, Alan Kawarai Lefor, Tadao Kubota, Ken Mizokami
AIM: To review clinical experience with barium appendicitis at a single institution. METHODS: A retrospective review of patients admitted with a diagnosis of acute appendicitis, from January 1, 2013 to December 31, 2015 was performed. Age, gender, computed tomography (CT) scan findings if available, past history of barium studies, pathology, and the presence of perforation or the development of complications were reviewed. If the CT scan revealed high density material in the appendix, the maximum CT scan radiodensity of the material is measured in Hounsfield units (HU)...
September 27, 2016: World Journal of Gastrointestinal Surgery
Leonard Ndayizeye, Christian Ngarambe, Blair Smart, Robert Riviello, Jean Paul Majyambere, Jennifer Rickard
BACKGROUND: Few studies discuss causes and outcomes of peritonitis in low-income settings. This study describes epidemiology of patients with peritonitis at a Rwandan referral hospital. Identification of risk factors associated with mortality and unplanned reoperation could improve management of peritonitis. METHODS: Data were collected on demographics, clinical presentation, operative findings, and outcomes for all patients with peritonitis. Multivariate regression analysis identified factors associated with in-hospital mortality and unplanned reoperation...
October 3, 2016: Surgery
John W Scott, Joaquim M Havens, Lindsey L Wolf, Cheryl K Zogg, John A Rose, Ali Salim, Adil H Haider
BACKGROUND: The Affordable Care Act has the potential to significantly affect access to care for previously uninsured patients in need of emergency general surgical care. Our objective was to determine the relationship between insurance status and disease complexity at presentation among a national sample of emergency general surgical patients. METHODS: Data from the National Emergency Department Sample from 2006-2009 were queried to identify all patients aged 18-64 years old admitted through the emergency department with a primary diagnosis of appendicitis, diverticulitis, inguinal hernia, or bowel obstruction...
October 3, 2016: Surgery
Yuki Imaoka, Toshiyuki Itamoto, Yuji Takakura, Takahisa Suzuki, Satoshi Ikeda, Takashi Urushihara
BACKGROUND: Our previous retrospective study revealed the three preoperative predictors of complicated appendicitis (perforated or gangrenous appendicitis), which are body temperature ≥37.4 °C, C-reactive protein ≥4.7 mg/dl, and fluid collection surrounding the appendix on computed tomography. We reported here an additional prospective study to verify our ability to predict complicated appendicitis using the three preoperative predictors and thus facilitate better informed decisions regarding emergency surgery during night or holiday shifts...
2016: World Journal of Emergency Surgery: WJES
J Lemale, S Boudjemaa, B Parmentier, H Ducou Le Pointe, A Coulomb, L Dainese
INTRODUCTION: Meckel's diverticulum is a common malformation in children, usually asymptomatic, with complications in only 20% of cases. Exceptionally, a tumor can develop in Meckel's diverticulum in children, particularly Burkitt's lymphoma; in adults it can develop into a gastrointestinal stromal tumor, a leiomyosarcoma, or a neuroendocrine tumor such as a carcinoid tumor. The diagnosis of inflammatory pseudotumor following an insidious perforation is rare. OBSERVATION: We report the case of a 14-month-old boy who presented with fever, asthenia, food refusal, and digestive complaints such as vomiting and tender abdomen suggesting appendicitis...
September 27, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Keisuke Jimbo, Masahiro Takeda, Eri Miyata, Hiroshi Murakami, Reiko Kyodo, Hideki Orikasa, Geoffrey J Lane, Toshiaki Shimizu, Atsuyuki Yamataka
PURPOSE: The purpose of this study was to examine whether acute non-perforated appendicitis (ANPA) can be safely triaged by a pediatrician for conservative management (CM) using gray-scale ultrasonography with power Doppler (GSPD). METHOD: Seventy five cases of ANPA assessed by a pediatrician with GSPD (2013-2015) were reviewed. GSPD grading for ANPA was: I: slightly irregular wall/normal blood flow; II: irregular wall/increased blood flow; III: irregular wall/decreased blood flow; and IV: absence of wall/blood flow...
September 15, 2016: Journal of Pediatric Surgery
E Stranzinger, C Scherer, W Pabst, F Schuster, C Flück
No abstract text is available yet for this article.
September 2016: Ultrasound Int Open
Yujiro Tanaka, Hiroo Uchida, Hiroshi Kawashima, Michimasa Fujiogi, Keisuke Suzuki, Shinya Takazawa, Kyoichi Deie, Hizuru Amano, Tadashi Iwanaka
BACKGROUND: Although nonoperative treatment (non-OPT) for complicated appendicitis is performed widely, the long-term outcomes and merits of interval appendectomy (IA) need to be evaluated. METHODS: Between April 2007 and December 2013, all appendicitis patients with well-circumscribed abscess or phlegmon were required to select either laparoscopic surgery (OPT) or non-OPT with optional IA on admission. Optional IA was planned at ≥3months after non-OPT. For non-OPT, intravenous injection of antibiotics was continued until the serum C-reactive protein concentration decreased to <0...
September 15, 2016: Journal of Pediatric Surgery
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
Sefa Ozyazici, Faruk Karateke, Umit Turan, Adnan Kuvvetli, Huseyin Kilavuz, Burak Karakaya, Pınar Ozaltun, Murat Alısık, Ozcan Erel
Aim. To investigate the role of a novel oxidative stress marker, thiol/disulphide homeostasis, in patients diagnosed with acute appendicitis (AA). Methods. In this study, seventy-one (43 male and 28 female) patients diagnosed with AA and 71 (30 male and 41 female) healthy volunteers were included. Age, gender, body mass index (BMI), haemoglobin (Hb), white blood cell (WBC), c-reactive protein (CRP), and thiol/disulphide homeostasis parameters (native thiol, total thiol, disulphide, disulphide/native thiol, native thiol/total thiol, and disulphide/total thiol ratios) were compared between the groups...
2016: Mediators of Inflammation
Sali Priyanka Akhilesh, Yadav Kamal Sunder, Pande Prasad, George Mary Asha, Agarwal Mohan, Mehta Hitesh
Appendiceal mucormycosis is a rare life-threatening infection seen in immunocompromised patients. It is usually seen in chemotherapy induced neutropenia in patients with hematological malignancies. Clinically, the symptoms and signs may be masked due to ongoing corticosteroids. The condition may mimic bacterial appendicitis and the less serious condition, typhlitis. The disease demands prompt surgical debulking and aggressive antifungal treatment. However, surgery is delayed due to the poor performance status and severe neutropenia...
2016: Case Reports in Surgery
Laura N Medford-Davis, Rohan Shah, Danielle Kennedy, Emilie Becker
OBJECTIVES: The objective of this study was to determine characteristics associated with potentially preventable pediatric admissions as defined by the Agency for Healthcare Research and Quality. METHODS: The Texas Inpatient Public Use Data File, an administrative database of hospital admissions, identified 747 040 pediatric admissions ages 0 to 17 years to acute care facilities between 2005 and 2008. Potentially preventable admissions included 5 diagnoses: asthma, perforated appendicitis, diabetes, gastroenteritis, and urinary tract infection...
October 2016: Hospital Pediatrics
Christina Feng, Seema Anandalwar, Feroze Sidhwa, Charity Glass, Mahima Karki, David Zurakowski, Shawn J Rangel
PURPOSE: The purpose of the study was to explore the relationship between the degree of peritoneal contamination and postoperative resource utilization in children with complicated appendicitis. METHODS: Intraoperative findings were collected prospectively at a single children's hospital from 2012 to 2014. The degree of peritoneal contamination was categorized as either "localized" (confined to the right lower quadrant and pelvis) or "extensive" (extending to the liver)...
November 2016: Journal of Pediatric Surgery
Martin Salö, Nittaya Marungruang, Bodil Roth, Tiia Sundberg, Pernilla Stenström, Einar Arnbjörnsson, Frida Fåk, Bodil Ohlsson
BACKGROUND/AIM: The role of the microbiome has been widely discussed in the etiology of appendicitis. The primary aim was to evaluate the microbiome in the normal appendix and in appendicitis specifically divided into the three clinically and histopathologically defined grades of inflammation. Secondary aims were to examine whether there were any microbiome differences between proximal and distal appendices, and relate the microbiome with histopathological findings. METHODS: A prospective pilot study was conducted of children undergoing appendectomy for appendicitis...
September 9, 2016: International Journal of Colorectal Disease
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