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Appendectomy complications

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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/28644156/clinical-case-of-the-month-a-57-year-old-man-with-an-axillary-mass
#3
Palak Desai, Andrew Myers, Brian Boulmay, Fred A Lopez
A 57-year-old man presented to the surgical oncology clinic with a mildly tender mass under his right arm. Four years prior, the patient had a melanoma removed from his right shoulder along with an ipsilateral right axillary sentinel lymph sampling. Computed tomography (CT) scan was negative for metastatic disease at that time. The patient did not undergo completion axillary node dissection and was lost to follow-up. The patient was originally from Australia, did not tan but reported multiple sunburns before age 18...
May 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28637573/laparoscopic-appendectomy-protocol-expedites-management-of-uncomplicated-acute-appendicitis
#4
Alvaro M Bada, Joseph A Ibrahim, Karen Safcsak, Andrew C Gratzon, Chadwick P Smith, Michael L Cheatham
Bed availability remains a constant struggle for tertiary care centers resulting in the use of management protocols to streamline patient care and reduce length of stay (LOS). A standardized perioperative management protocol for uncomplicated acute appendicitis (UA) was implemented in April 2014 to decrease both CT scan usage and LOS. Patients who underwent laparoscopic appendectomy for UA from April 2012 to May 2013 (PRE group) and April 2014 to May 2015 (POST group) were compared retrospectively. There were no differences in patient demographics or clinical findings between the groups...
June 1, 2017: American Surgeon
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
#5
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/28635513/evaluation-of-platelet-indices-and-red-cell-distribution-width-as-new-biomarkers-for-the-diagnosis-of-acute-appendicitis
#6
Noha Boshnak, Mohamed Boshnaq, Hatem Elgohary
BACKGROUND: Debate around the value of laboratory tests in establishing the diagnosis of acute appendicitis (AA) still continues. This prospective study aimed to investigate the changes in mean platelet volume (MPV), platelet distribution width (PDW), and red cell distribution width (RDW) with the diagnosis of acute appendicitis. METHOD: 200 patients who underwent emergency appendectomy were included. According to postoperative histology, patients were divided into three groups: acute non-complicated, acute complicated appendicitis (positive appendicectomy groups), and negative appendectomy group...
February 16, 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
#7
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/28628705/time-to-appendectomy-and-risk-of-complicated-appendicitis-and-adverse-outcomes-in-children
#8
Stephanie K Serres, Danielle B Cameron, Charity C Glass, Dionne A Graham, David Zurakowski, Mahima Karki, Seema P Anandalwar, Shawn J Rangel
Importance: Management of appendicitis as an urgent rather than emergency procedure has become an increasingly common practice in children. Controversy remains as to whether this practice is associated with increased risk of complicated appendicitis and adverse events. Objective: To examine the association between time to appendectomy (TTA) and risk of complicated appendicitis and postoperative complications. Design, Setting, and Participants: In this retrospective cohort study using the Pediatric National Surgical Quality Improvement Program appendectomy pilot database, 2429 children younger than 18 years who underwent appendectomy within 24 hours of presentation at 23 children's hospitals from January 1, 2013, through December 31, 2014, were studied...
June 19, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28624044/predictors-of-a-histopathologic-diagnosis-of-complicated-appendicitis
#9
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/28623597/acute-appendicitis-still-a-surgical-disease-results-from-a-propensity-score-based-outcome-analysis-of-conservative-versus-surgical-management-from-a-prospective-database
#10
Niccolò Allievi, Asaf Harbi, Marco Ceresoli, Giulia Montori, Elia Poiasina, Federico Coccolini, Michele Pisano, Luca Ansaloni
OBJECTIVE: The aim of the present study was to compare the outcomes of conservative versus surgical treatment for acute appendicitis. BACKGROUND: Although acute appendicitis is a common disease, great debate exists regarding the appropriate management of patients. Conservative treatment has shown positive results in several RCTs, eliciting questions about indications to surgery, therapeutic appropriateness and ethical conduct. METHODS: Data were prospectively collected; a Propensity Score-based matching method was implemented in order to reduce bias arising from characteristics of the patients; a proportion of patients (69 in total) were excluded to obtain two comparable groups of study (1a)...
June 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28623596/impact-of-residency-training-level-on-the-surgical-quality-following-general-surgery-procedures
#11
Dominik Loiero, Maja Slankamenac, Pierre-Alain Clavien, Ksenija Slankamenac
OBJECTIVE: To investigate the safety of surgical performance by residents of different training level performing common general surgical procedures. METHODS: Data were consecutively collected from all patients undergoing general surgical procedures such as laparoscopic cholecystectomy, laparoscopic appendectomy, inguinal, femoral and umbilical hernia repair from 2005 to 2011 at the Department of Surgery of the University Hospital of Zurich, Switzerland. The operating surgeons were grouped into junior residents, senior residents and consultants...
June 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28618350/minimally-invasive-appendectomy-for-resection-of-appendiceal-mucocele-case-series-and-review-of-the-literature
#12
Sonia T Orcutt, Daniel A Anaya, Mokenge Malafa
INTRODUCTION: Appendiceal mucoceles encompass neoplastic and non-neoplastic causes of a distended Appendix filled with mucus. Appendectomy is recommended when an appendiceal mucocele is identified, incidentally or otherwise, in the event it is secondary to a malignancy. For an intact mucocele, it is critically important to avoid rupturing the mucocele during resection, as rupture of a neoplastic mucocele can result in pseudomyxoma peritonei, or mucin deposits in the peritoneum, which is associated with long-term morbidity and mortality...
May 29, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28614043/antibiotics-vs-appendectomy-for-acute-uncomplicated-appendicitis-in-adults-review-of-the-evidence-and-future-directions
#13
Jared M Huston, Lillian S Kao, Phillip K Chang, James M Sanders, Sara Buckman, Charles A Adams, Christine S Cocanour, Sarah E Parli, Julia Grabowski, Jose Diaz, Jeffrey M Tessier, Therese M Duane
BACKGROUND: Acute appendicitis is the most common abdominal surgical emergency in the United States, with a lifetime risk of 7%-8%. The treatment paradigm for complicated appendicitis has evolved over the past decade, and many cases now are managed by broad-spectrum antibiotics. We determined the role of non-operative and operative management in adult patients with uncomplicated appendicitis. METHODS: Several meta-analyses have attempted to clarify the debate. Arguably the most influential is the Appendicitis Acuta (APPAC) Trial...
July 2017: Surgical Infections
https://www.readbyqxmd.com/read/28607634/evaluation-of-the-diagnostic-value-of-serum-level-of-total-bilirubin-in-patients-with-suspected-acute-appendicitis
#14
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/28602871/outcomes-of-antibiotic-therapy-for-uncomplicated-appendicitis-in-pregnancy
#15
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
#16
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
#17
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/28597283/transumbilical-laparoscopic-assisted-appendectomy-in-children-is-it-worth-it
#18
Sara Hernandez-Martin, Lidia Ayuso, Ada Yessenia Molina, Javier Pison, Miguel Angel Martinez-Bermejo, Alberto Perez-Martinez
INTRODUCTION: Transumbilical laparoscopic-assisted appendectomy (TULAA) is the technique of choice for all types of appendicitis in our Department. It combines the advantages of laparoscopy (global vision and minimally invasion) and open surgery (lower cost). The objective was to assess the results of our TULAA series and compare them to the results of standard laparoscopic appendectomies (SLA) performed during the same period. METHODS: Retrospective review of total appendectomies performed since TULAA introduction (September 2003 to December 2015) with statistic analysis of the results...
June 8, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28588886/laparoscopic-versus-open-appendectomy-in-adults-and-children-a-meta-analysis-of-randomized-controlled-trials
#19
Liping Dai, Jian Shuai
OBJECTIVE: The aim of this study was to evaluate the differences of laparoscopic appendectomy (LA) versus open appendectomy (OA) in adults and children. METHODS: Randomized controlled trials (RCTs) comparing LA and OA in adults and children between January 1992-March 2016 were included in this study. A meta-analysis was performed to evaluate wound infection, intra-abdominal abscess, postoperative complications, reoperation rate, operation time, postoperative stay, and return to normal activity...
June 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28579585/a-case-of-liver-abscess-caused-by-appendicitis-which-was-considered-to-be-drained-from-hepatobronchial-fistula
#20
Shigeo Manabe, Takayuki Yasuoka, Yuki Endo, Fumitaka Usui, Taku Yamaguchi, Tatsuzo Matsuyama, Ikuhiro Hirata, Shuji Takahashi
A 52-year-old man was referred to our hospital complaining of right lower abdominal pain. He was diagnosed with appendicitis complicated with a liver abscess and underwent an appendectomy. After antibiotic treatment following surgery, the liver abscess penetrated the right lung, which was considered to be drained from a hepatobronchial fistula. Due to the effect of drainage, the liver abscess immediately improved and the patient was subsequently discharged.
2017: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
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