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appendicitis in children

M Fernández Castilla, A Salazar Villacorta, A Martín Nalda, J C Ferreres Piñas, A Coma Muñoz, G Guillén Burrieza
INTRODUCTION: Appendicular actinomycosis is a rare disease produced by cecal appendix invasion by Actinomyces gender bacteria after a predisposing cause that disrupts mucosal barrier, such as acute appendicitis. The highest frequency appears in adults; however, there are cases in paediatric age described in literature. The aim of this article is to introduce a case of appendicular actinomycosis in a child with atypical presentation and to review the literature. CLINICAL CASE: 10-year-old boy transferred to our hospital due to intraoperative finding at a different centre of a right flank tumor, without identification of cecal appendix...
April 20, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
M Fanjul, L Pérez, J Cerdá, M Zornoza, R Rojo, I Simal, M A García-Casillas, C Corona, D Peláez, E Molina, A Parente, S Rivas, J M Angulo, E De Tomás
BACKGROUND: Multiple approaches to the treatment of simple and complicated (gangrenous or perforated) appendicitis in children have been promoted. Our goal is to develop a new protocol for these patients that allows shorter hospital stays without increasing complications rates. METHODS: Prospective collected data of patients undergoing appendicitis treated according to the new protocol for a period of 7 months were reviewed. This protocol consists on antibiotic prophylaxis in all cases continued with triple antibiotic regimen in complicated appendicitis...
October 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Marcos Prada-Arias, José Luis Vázquez, Ángel Salgado-Barreira, Javier Gómez-Veiras, Margarita Montero-Sánchez, José Ramón Fernández-Lorenzo
AIM: The aim of this study was to assess the diagnostic accuracy of the biomarker fibrinogen (FB), along with the more traditional markers white blood cell count (WBC), absolute neutrophil count (ANC), and C-reactive protein (CRP), to discriminate appendicitis from nonspecific abdominal pain (NSAP) in children. METHODS: We prospectively evaluated all children aged 5 to 15 years admitted for suspected appendicitis at an academic pediatric emergency department during 2 years...
October 5, 2016: American Journal of Emergency Medicine
Chih-Cheng Luo, Kuang-Fu Cheng, Chen-Sheng Huang, Hung-Chieh Lo, Sheng-Mao Wu, Hung-Chang Huang, Wen-Kuei Chien, Ray-Jade Chen
BACKGROUND: In this study, we studied the therapeutic effectiveness of percutaneous drainage with antibiotics and the need for an interval appendectomy for treating appendiceal abscess in children with a research-oriented dataset released by the Bureau of National Health Insurance in Taiwan through the Collaboration Center for Health Information Application (CCHIA). METHODS: We identified 1225 patients under 18 years of age who had non-surgical treatment for an appendiceal abscess between 2007 and 2012 in a Taiwan CCHIA dataset...
October 18, 2016: BMC Surgery
Graham Cameron Thompson, Ellen Morrison, Marshall Ross, Helena Liu, Otto G Vanderkooi, Robin Eccles
OBJECTIVES: To determine the proportion of true-positive blood culture results in children presenting to the ED with suspected appendicitis. To describe the current practice of obtaining blood cultures in children with suspected appendicitis. METHODS: We performed a 2-year retrospective health record review of all children aged 2 through 17 years investigated for suspected appendicitis at a tertiary Pediatric Emergency Department. Subjects were identified by searching (a) institutional records for ICD-10-CA coding, (b) diagnostic imaging records of ultrasounds for appendicitis, and (c) surgical database records for nonincidental appendectomies...
October 17, 2016: Pediatric Emergency Care
James K Hamill, Jamie-Lee Rahiri, Gamage Gunaratna, Andrew G Hill
BACKGROUND: No enhanced recovery after surgery protocol has been published for laparoscopic appendectomy. This was a review of evidence-based interventions that could optimize recovery after appendectomy. METHODS: Interventions for the review Clinical pathway, fast-track or enhanced recovery protocols; needlescopic approach; single incision laparoscopic (SIL) approach; natural orifice transluminal endoscopic surgery (NOTES); regional nerve blocks; intraperitoneal local anaesthetic (IPLA); drains...
October 17, 2016: Surgical Endoscopy
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
R Guanà, L Lonati, S Garofalo, N Tommasoni, L Ferrero, A Cerrina, R Lemini, C Dallan, J Schleef
Introduction. Acute appendicitis is the most common surgical emergency in the pediatric population. The peak incidence occurs in the first decade of life, while it is uncommon to face appendicitis in children younger than 5 years of age. Laparoscopy is now demonstrated to be the optimal approach also to treat complicated appendicitis, but in very young children this standardized operation is not always easy to perform. Material and Methods. From January 2009 to December 2015 we operated on 525 acute appendicitis, with 120 patients less than 5 years of age...
2016: Surgery Research and Practice
Holly Depinet, Karen Copeland, Joseph Gogain, Halim Hennes, Norman A Paradis, Rebecca Andrews-Dickert, Cheryl W Vance, David S Huckins
BACKGROUND: The diagnosis of pediatric acute appendicitis can be difficult. Although scoring systems such as the Pediatric Appendicitis Score (PAS) are helpful, they lack adequate sensitivity and specificity as standalone diagnostics. When used for risk stratification, they often result in large percentages of moderate-risk patients requiring further diagnostic evaluation. METHODS: We applied a biomarker panel (the APPY1 Test) that has high sensitivity and negative predictive value (NPV) to patients with PAS in the moderate-risk range (3-7) and reclassified those patients with a negative result to the low-risk group...
August 10, 2016: American Journal of Emergency Medicine
Rebecca M Rentea, Shawn D St Peter, Charles L Snyder
Appendicitis is a common cause of abdominal pain in children. The diagnosis and treatment of the disease have undergone major changes in the past two decades, primarily as a result of the application of an evidence-based approach. Data from several randomized controlled trials, large database studies, and meta-analyses have fundamentally affected patient care. The best diagnostic approach is a standardized clinical pathway with a scoring system and selective imaging. Non-operative management of simple appendicitis is a reasonable option in selected cases, with the caveat that data in children remain limited...
October 14, 2016: Pediatric Surgery International
B Lembcke
Despite sophisticated physical examination and laboratory support, diagnosis of acute appendicitis remained challenging in clinical practice with a negative appendectomy rate of 15 - 30 %. As a remarkable clue and as early as 1986, ultrasonography (US) has been proven a reliable diagnostic method that is also explicitly helpful in difficult cases with atypical presentation and enables to rule out many differential diagnoses.Recent publications emphasized the role of multidetector computed tomography (CT) resulting in a significant reduction of false negative findings at operation...
October 2016: Zeitschrift Für Gastroenterologie
Jea Yeon Choi, Eell Ryoo, Jeong Hyun Jo, Tchah Hann, Seong Min Kim
PURPOSE: This study examined the risk factors of a delayed diagnosis of acute appendicitis in children undergoing an appendectomy. METHODS: This retrospective study involved children aged below 18 years, who underwent an appendectomy. After dividing them into a delayed diagnosis group and nondelayed diagnosis group according to the time interval between the initial hospital visit and final diagnosis, the risk factors of delayed diagnosis were identified using logistic regression analysis...
September 2016: Korean Journal of Pediatrics
Marija Kocic, Slavisa M Djuricic, Maja Djordjevic, Djordje Savic, Bozica Kecman, Adrijan Sarajlija
Almost any anatomical compartment may be involved in Gaucher disease (GD). Abdominal lymphadenopathy occurred during enzyme replacement therapy in more than a dozen children with GD so far. A fourteen-year-old boy from Serbia developed clinical signs of acute appendicitis six years after the onset of GD type 3 related abdominal lymphadenopathy. Ultrasound examination showed diffuse thickening of the intestinal wall in the ileocoecal region with periappendicular infiltration. An appendectomy was performed four months after conservative treatment with antibiotics...
September 30, 2016: Blood Cells, Molecules & Diseases
Alessandro Boscarelli, Simone Frediani, Silvia Ceccanti, Ilaria Falconi, Gabriele Masselli, Emanuele Casciani, Denis A Cozzi
In children, epiploic appendagitis has been seldom reported. We describe two children with clinical presentations mimicking appendicitis. A correct diagnosis was eventually achieved by magnetic resonance imaging (MRI) and confirmed at laparoscopy in the initial case. Our preliminary experience suggests that MRI is a valid and non-invasive alternative to computed tomography for characterization of unusual causes of pediatric abdominal pain in the acute hospital care setting.
September 20, 2016: Journal of Pediatric Surgery
Christine Keller, Nancy E Wang, Daniel L Imler, Shreyas S Vasanawala, Matias Bruzoni, James V Quinn
BACKGROUND: Ionizing radiation and cost make ultrasound (US), when available, the first imaging study for the diagnosis of suspected pediatric appendicitis. US is less sensitive and specific than computed tomography (CT) or magnetic resonance imaging (MRI) scans, which are often performed after nondiagnostic US. OBJECTIVES: We sought to determine predictors of nondiagnostic US in order to guide efficient ordering of imaging studies. METHODS: A prospective cohort study of consecutive patients 4 to 30 years of age with suspected appendicitis took place at an emergency department with access to 24/7 US, MRI, and CT capabilities...
September 27, 2016: Journal of Emergency Medicine
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
K Tinsley Anderson, Susan Greenfield, Luke R Putnam, Emma Hamilton, Akemi Kawaguchi, Mary T Austin, Lillian S Kao, Susan D John, Kevin P Lally, KuoJen Tsao
BACKGROUND: A pediatric computed tomography (CT) radiation dose reduction program was implemented throughout our children's associated hospital system in 2010. We hypothesized that the CT dose received for evaluation of appendicitis in children would be significantly higher among the 40 referral, nonmember hospitals (NMH) than the 9 member hospitals (MH). METHODS: Preoperative CTs of pediatric (<18years) appendectomy patients between April 2012 and April 2015 were reviewed...
September 15, 2016: Journal of Pediatric Surgery
Thomas P Cundy, Roger Gent, Claire Frauenfelder, Laura Lukic, Rebecca J Linke, Day Way Goh
BACKGROUND: This study appraises the diagnostic quality of ultrasound for acute appendicitis in children and consequently challenges the perception of inferior accuracy and suitability compared to computed tomography (CT). METHODS: Radiologist reports for consecutive "query appendicitis" ultrasound studies were retrieved from a hospital database for the study period 2009-2014. Children who subsequently underwent appendicectomy were identified. Corresponding operative and histopathology findings were evaluated...
September 15, 2016: Journal of Pediatric Surgery
Cristina Oana Mărginean, Lorena Elena Meliţ, Horaţiu Moldovan, Vasile Valeriu Lupu, Maria Oana Mărginean
BACKGROUND: Lead is a toxic element of the environment which leads to major complications once it enters the blood stream, affecting multiple organs and systems of the body. METHODS: We present the case of a 16-year-old girl, diagnosed with lead poisoning after occupational exposure due to the fact that the girl was actively involved in the family's pottery business.History revealed that the girl participated in the process of pottery, her father was also diagnosed with lead poisoning 2 years before...
September 2016: Medicine (Baltimore)
Zhongbo Yang, Magda Esebua, Lester Layfield
Fifteen percent to 25% of appendices resected for a preoperative diagnosis of acute appendicitis have no neutrophilic infiltration, thus histologically "normal." The discrepancy between clinical presentation and the lack of definite morphologic changes is confounding. It has been indicated that mast cells may play a role in the pathogenesis of the appendicitis-like pain in patients with histologically negative appendices (HNAs). To investigate whether mast cell density (MCD) is increased in pediatric HNAs, we retrieved 50 appendectomy cases (30 HNA and 20 control, ages 2 days-18 years) in our institute in the last 10 years...
October 2016: Annals of Diagnostic Pathology
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