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appendicitis in children

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https://www.readbyqxmd.com/read/28306630/nonoperative-management-of-appendicitis-in-children
#1
Joseph J López, Katherine J Deans, Peter C Minneci
PURPOSE OF REVIEW: The aim of this review is to summarize the recent literature investigating nonoperative management of uncomplicated and complicated appendicitis and highlight recent data establishing its safety and efficacy. RECENT FINDINGS: Recent studies and clinical trials have demonstrated the efficacy of nonoperative treatment of both uncomplicated and complicated appendicitis, defined as perforated appendicitis with or without formed abscess or phlegmon...
March 16, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28302361/unexpected-findings-after-surgery-for-suspected-appendicitis-rarely-change-treatment-in-pediatric-patients-results-from-a-cohort-study
#2
Ramon R Gorter, Paul van Amstel, Johanna H van der Lee, Patick van der Voorn, Roel Bakx, Hugo A Heij
BACKGROUND: To determine if non-operative treatment is safe in children with acute appendicitis, we evaluated the incidence of unexpected findings after an appendectomy in children, and the influence they have on subsequent treatment. METHODS: A historical cohort study (January 2004-December 2014) was performed including children, aged 0-17 years, who underwent an appendectomy for the suspicion of acute appendicitis. Patients were divided based upon histopathological examination...
March 6, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28283724/radiation-dose-associated-with-ct-guided-drain-placement-for-pediatric-patients
#3
Cody J Schwartz, Ari J Isaacson, Lynn Ansley Fordham, Marija Ivanovic, J Bradford Taylor, Robert G Dixon
BACKGROUND: To date, there are limited radiation dose data on CT-guided procedures in pediatric patients. OBJECTIVE: Our goal was to quantify the radiation dose associated with pediatric CT-guided drain placement and follow-up drain evaluations in order to estimate effective dose. MATERIALS AND METHODS: We searched the electronic medical record and picture archiving and communication system (PACS) to identify all pediatric (<18 years old) CT-guided drain placements performed between January 2008 and December 2013 at our institution...
March 10, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28277414/implementation-of-an-electronic-clinical-decision-support-tool-for-pediatric-appendicitis-within-a-hospital-network
#4
Marissa A Hendrickson, Andrew R Wey, Philippe R Gaillard, Anupam B Kharbanda
OBJECTIVES: Computed tomography (CT) has been widely used in the evaluation of children with suspected appendicitis, but concerns about ionizing radiation have increased interest in ultrasound for these patients. We sought to assess the effectiveness of an appendicitis electronic clinical decision support (E-CDS) system in increasing ultrasound and decreasing CT use in children evaluated in emergency departments (EDs) for suspected appendicitis. METHODS: This was a preintervention and postintervention analysis of an E-CDS implemented into an electronic health record system shared by an academic, tertiary-care children's hospital and a community hospital...
March 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28261620/acute-nonspecific-mesenteric-lymphadenitis-more-than-no-need-for-surgery
#5
REVIEW
Rossana Helbling, Elisa Conficconi, Marina Wyttenbach, Cecilia Benetti, Giacomo D Simonetti, Mario G Bianchetti, Flurim Hamitaga, Sebastiano A G Lava, Emilio F Fossali, Gregorio P Milani
Acute nonspecific, or primary, mesenteric lymphadenitis is a self-limiting inflammatory condition affecting the mesenteric lymph nodes, whose presentation mimics appendicitis or intussusception. It typically occurs in children, adolescents, and young adults. White blood count and C-reactive protein are of limited usefulness in distinguishing between patients with and without mesenteric lymphadenitis. Ultrasonography, the mainstay of diagnosis, discloses 3 or more mesenteric lymph nodes with a short-axis diameter of 8 mm or more without any identifiable underlying inflammatory process...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28259382/regional-variation-in-rates-of-pediatric-perforated-appendicitis
#6
Samir Sarda, Heather L Short, Jason M Hockenberry, Ian McCarthy, Mehul V Raval
BACKGROUND: While trends in perforated appendicitis (PA) rates have been studied, regional variability in pediatric admissions for PA remains unknown. METHODS: A retrospective, cross-sectional analysis of the 2006-2012 Kids' Inpatient Database was conducted to examine variation in PA admission rates by region of the United States and insurance status. PA rates were calculated and reported as per 1000 admissions in accordance with national quality measure specifications...
February 21, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28258881/ultrasound-for-diagnosis-of-appendicitis-in-a-community-hospital-emergency-department-has-a-high-rate-of-nondiagnostic-studies
#7
Scott M Alter, Brian Walsh, Patrick J Lenehan, Richard D Shih
BACKGROUND: Radiation concerns are changing the way emergency physicians evaluate patients. This is especially prevalent in pediatrics, and exemplified by abdominal pain management. Large academic center-based studies suggest appendix ultrasound (U/S) is sensitive and specific for appendicitis, with low nondiagnostic rates. OBJECTIVES: We sought to determine the diagnostic rate of appendix U/S and incidence of follow-up computed tomography (CT) imaging for pediatric patients at a community hospital...
February 28, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28257658/acute-appendicitis-in-young-children-less-than-5%C3%A2-years-review-article
#8
REVIEW
Hamdi Hameed Almaramhy
Despite wide spread availability of sophisticated diagnostic imaging, acute appendicitis in pre-school children remains a diagnostic challenge. Most of these children present late, often with complications e.g. appendicular perforation, abscess formation and peritonitis and as result hospital stay is prolonged and is associated with increased morbidity and mortality.The purpose of this article is to review peculiar features of acute appendicitis in preschool children.
January 26, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28254405/early-appendectomy-shortens-antibiotic-course-and-hospital-stay-in-children-with-early-perforated-appendicitis
#9
Hsin-Yu Tsai, Hsun-Chin Chao, Wan-Ju Yu
BACKGROUND: The optimal management of perforated appendicitis in the pediatric population has been controversial. This study aimed to compare the therapeutic efficacy between conservative treatment (CS) and early appendectomy (EA) in pediatric perforated appendicitis, and to determine whether surgical intervention is an optimal treatment modality for early perforated appendicitis in children. METHODS: Patients treated between January 2012 and April 2014, aged 0-18 years, with an imaging-based diagnosis of perforated appendicitis were retrospectively reviewed...
February 1, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28248876/obturator-externus-abscess-in-a-9-year-old-child-a-case-report-and-literature-review
#10
Charlotte de Bodman, Dimitri Ceroni, Justine Dufour, Pierre-Alex Crisinel, Aline Bregou-Bourgeois, Pierre-Yves Zambelli
RATIONALE: Obturator pyomyositis is a rare condition in children. Diagnosis is often delayed because of its rarity, and the vagaries of its presentation cause it to be easily be missed. Physicians should therefore familiarize themselves with this condition and consider it as a possible differential diagnosis in patients presenting with an acutely painful hip. Inflammatory syndrome is also frequent among sufferers and the MRI is a very sensitive diagnostic tool for obturator pyomyositis...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28248759/current-approach-to-the-diagnosis-and-emergency-department-management-of-appendicitis-in-children
#11
(no author information available yet)
No abstract text is available yet for this article.
March 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28248758/current-approach-to-the-diagnosis-and-emergency-department-management-of-appendicitis-in-children
#12
Susan C Lipsett, Richard G Bachur
Concerns about radiation exposure have led to a decrease in the use of computed tomography in suspected appendicitis, with increased reliance on ultrasound. Children with suspected appendicitis should be risk stratified using a combination of clinical signs and symptoms, white blood cell count, and ultrasound in order to guide further evaluation and management. Magnetic resonance imaging is a promising imaging modality but remains costly. Ongoing research is evaluating the role of nonoperative management in children with confirmed appendicitis...
March 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28223114/imaging-utilization-for-the-diagnosis-of-appendicitis-in-stand-alone-children-s-hospitals%C3%A2-in%C3%A2-the-united-states-trends-and-costs
#13
Hansel J Otero, Lauren Crowder
OBJECTIVE: To describe the imaging utilization patterns for the diagnosis of appendicitis among children's hospitals in the United States over the last 10 years (2005-2014). METHODS: All patients with a primary discharge diagnosis of appendicitis included in a large administrative database of 45 pediatric institutions in the United States between 2005 and 2014 were selected. Demographics, imaging utilization, and costs were described. RESULTS: In all, 96,786 children with appendicitis (59% boys, 41% girls; mean age: 9...
February 10, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28214369/diagnostic-accuracy-of-history-physical-exam-laboratory-tests-and-point-of-care-ultrasound-for-pediatric-acute-appendicitis-in-the-emergency-department-a-systematic-review-and-meta-analysis
#14
Roshanak Benabbas, Mark Hanna, Jay Shah, Richard Sinert
BACKGROUND: Acute appendicitis (AA) is the most common surgical emergency in children. Accurate and timely diagnosis is crucial but challenging due to atypical presentations and the inherent difficulty of obtaining a reliable history and physical examination in younger children. OBJECTIVES: To determine the utility of history, physical exam, laboratory tests, Pediatric Appendicitis Score (PAS) and Emergency Department-Point-of-Care Ultrasound (ED-POCUS) in the diagnosis of AA in ED pediatric patients...
February 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28213607/efficacy-and-safety-of-nonoperative-treatment-for-acute-appendicitis-a-meta-analysis
#15
REVIEW
Roxani Georgiou, Simon Eaton, Michael P Stanton, Agostino Pierro, Nigel J Hall
CONTEXT: Nonoperative treatment (NOT) with antibiotics alone of acute uncomplicated appendicitis (AUA) in children has been proposed as an alternative to appendectomy. OBJECTIVE: To determine safety and efficacy of NOT based on current literature. DATA SOURCES: Three electronic databases. STUDY SELECTION: All articles reporting NOT for AUA in children. DATA EXTRACTION: Two reviewers independently verified study inclusion and extracted data...
February 17, 2017: Pediatrics
https://www.readbyqxmd.com/read/28210834/conservative-treatment-in-uncomplicated-acute-appendicitis-reassessment-of-practice-safety
#16
Zvi Steiner, Genady Buklan, Rodica Stackievicz, Michael Gutermacher, Ita Litmanovitz, Guy Golani, Shmuel Arnon
The success rate of conservative treatment for children with uncomplicated appendicitis was prospectively evaluated among 197 children. All who received intravenous antibiotics for 3-5 days, and if symptoms resolved, were discharged home on oral antibiotics for 5 days. Failure rate, symptoms, laboratory signs, and sonographic findings were evaluated for prognostic markers of treatment failure. Children were followed for 18 months. The success rate of conservative treatment was 87%, with shorter hospital stays compared to children who eventually needed surgery (72 [60-84] vs...
February 16, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28204893/gastrointestinal-system-manifestations-in-juvenile-systemic-lupus-erythematosus
#17
Hafize Emine Sönmez, Asuman Nur Karhan, Ezgi Deniz Batu, Yelda Bilginer, Ersin Gümüş, Hülya Demir, Aysel Yüce, Seza Özen
Systemic lupus erythematosus (SLE) is an autoimmune disease which may involve gastrointestinal system (GIS). The aim of this study was to present GIS manifestations of pediatric SLE patients. The medical files of 69 children with SLE followed between January 2011 and January 2016 were reviewed. All fulfilled the Systemic Lupus International Collaborating Clinics criteria. All patients (≤18 years of age) with GIS manifestations were included. GIS manifestations were observed in 19 (27.5%) out of 69 SLE patients and present at the time of SLE diagnosis in 13 (68...
February 16, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28185747/lack-of-utility-of-measuring-serum-bilirubin-concentration-in-distinguishing-perforation-status-of-pediatric-appendicitis
#18
William Bonadio, Santina Bruno, David Attaway, Logesh Dharmar, Derek Tam, Peter Homel
BACKGROUND: Pediatric appendicitis is a common, potentially serious condition. Determining perforation status is crucial to planning effective management. PURPOSE: Determine the efficacy of serum total bilirubin concentration [STBC] in distinguishing perforation status in children with appendicitis. METHODS: Retrospective review of 257 cases of appendicitis who received abdominal CT scan and measurement of STBC. RESULTS: There were 109 with perforation vs 148 without perforation...
January 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28177940/emergency-department-pain-management-in-children-with-appendicitis-in-a-bi-ethnic-population
#19
Ron Jacob, Baruch Krauss, Gal Twito, Ronit Leiba, Itai Shavit
OBJECTIVES: Our goal was to examine factors associated with the administration of ED analgesia (any analgesia, opioid analgesia) in patients with acute appendicitis in a tertiary children's hospital in Israel, and to examine ethnic differences. METHODS: A retrospective cohort study of children evaluated in the ED, who had ICD-9 diagnosis of acute appendicitis. Regression analysis was used to test the effect of multiple variables on the provision of analgesia. Medications were administered according to a nurse-driven pain protocol...
February 7, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28173947/cost-analysis-of-nonoperative-management-of-acute-appendicitis-in-children
#20
Martina Mudri, Kamary Coriolano, Andreana Bütter
PURPOSE: The purpose of this study was to determine if nonoperative management of acute appendicitis in children is more cost effective than appendectomy. METHODS: A retrospective review of children (6-17years) with acute appendicitis treated nonoperatively (NOM) from May 2012 to May 2015 was compared to similar patients treated with laparoscopic appendectomy (OM) (IRB#107535). Inclusion criteria included symptoms ≤48h, localized peritonitis, and ultrasound confirmation of acute appendicitis...
January 30, 2017: Journal of Pediatric Surgery
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