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appendicitis management

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https://www.readbyqxmd.com/read/28818844/conservative-treatment-versus-surgery-for-uncomplicated-appendicitis-in-children-a-systematic-review-and-meta-analysis
#1
Ulf Kessler, Selim Mosbahi, Benedict Walker, Eva M Hau, Michael Cotton, Barbara Peiry, Steffen Berger, Bernhard Egger
OBJECTIVES: To compare conservative treatment with index admission appendicectomy in children with acute uncomplicated appendicitis. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Medline, Embase and the Cochrane Library (CENTRAL) from 1950 to 18 February 2017. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Studies that assessed both appendicectomy and non-operative management of acute uncomplicated appendicitis in children of less than 18 years of age...
August 17, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28814624/outcomes-of-nonoperative-management-of-uncomplicated-appendicitis
#2
Richard G Bachur, Susan C Lipsett, Michael C Monuteaux
BACKGROUND AND OBJECTIVES: Nonoperative management (NOM) of uncomplicated pediatric appendicitis has promise but remains poorly studied. NOM may lead to an increase in resource utilization. Our objective was to investigate the trends in NOM for uncomplicated appendicitis and study the relevant clinical outcomes including subsequent appendectomy, complications, and resource utilization. METHODS: Retrospective analysis of administrative data from 45 US pediatric hospitals...
June 2, 2017: Pediatrics
https://www.readbyqxmd.com/read/28812175/a-prospective-non-randomized-controlled-multicenter-trial-comparing-appendectomy-and-conservative-treatment-for-patients-with-uncomplicated-acute-appendicitis-the-actuaa-study
#3
Mauro Podda, Fernando Serventi, Lorenzo Mortola, Stefano Marini, Danilo Sirigu, Michela Piga, Marcello Pisano, Massimiliano Coppola, Ferdinando Agresta, Francesco Virdis, Salomone Di Saverio, Nicola Cillara
PURPOSE: Acute appendicitis (AA) is among the most common causes of lower abdominal pain and admissions to the emergency department. Over the past 20 years, there has been a renewed interest in the conservative management of uncomplicated AA, and several studies demonstrated that an antibiotic-first strategy is a viable treatment option for uncomplicated AA. The aim of this prospective non-randomized controlled, multicenter trial is to compare antibiotic therapy and emergency appendectomy as treatment for patients with uncomplicated AA confirmed by US and/or CT or MRI scan...
August 15, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28807208/imaging-for-acute-appendicitis-at-nonpediatric-centers-exposes-children-to-excess-radiation
#4
Faidah Badru, Nicholas Piening, Alvin To, Perry Xu, Colleen Fitzpatrick, Kaveer Chatoorgoon, Gustavo Villalona, Jose Greenspon
BACKGROUND: Radiation exposure is the reason for the decreased utilization of computed tomography (CT) in pediatric centers (PCs). We sought to compare the radiation dose exposure of CT imaging performed at outside hospitals (OH) versus PC in pediatric patients with acute appendicitis (AA). MATERIAL AND METHODS: A retrospective review of all patients managed at our PC for AA from January 2011 to March 2016 was performed. Patients who had CT imaging for AA at OH were compared to those who underwent CT for appendicitis at our PC...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28806283/expanding-the-scope-of-quality-measurement-in-surgery-to-include-non-operative-care-results-from-the-acs-nsqip-emergency-general-surgery-pilot
#5
Michael W Wandling, Clifford Y Ko, Paul E Bankey, Chris Cribari, H Gill Cryer, Jose J Diaz, Therese M Duane, S Morad Hameed, Matthew M Hutter, Michael H Metzler, Justin L Regner, Patrick M Reilly, H David Reines, Jason L Sperry, Kristan L Staudenmayer, Garth H Utter, Marie L Crandall, Karl Y Bilimoria, Avery B Nathens
BACKGROUND: Patients managed non-operatively have been excluded from risk-adjusted benchmarking programs, including the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP). Consequently, optimal performance evaluation is not possible for specialties like emergency general surgery (EGS) where non-operative management is common. We developed a multi-institutional EGS clinical data registry within ACS NSQIP that includes patients managed non-operatively to evaluate variability in non-operative care across hospitals and identify gaps in performance assessment that occur when only operative cases are considered...
August 12, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28799135/appendiceal-duplication-a-comprehensive-review-of-published-cases-and-clinical-recommendations
#6
H Nageswaran, U Khan, F Hill, A Maw
BACKGROUND: Duplex appendix is very rare (incidence 0.004%) but has clinical relevance given the frequency of appendicectomies performed. Failure to recognise duplication can result in failure of treatment and medico-legal consequences. A review of published cases was undertaken to identify factors that may help in managing this rare condition. METHODS: All English and non-English publications were identified in PubMed, Embase and Cochrane databases. Patient demographics, intraoperative findings, anatomical details and histopathology were analysed...
August 10, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28761642/frequency-characteristics-and-outcomes-of-appendicular-neuroendocrine-tumors-a-cross-sectional-study-from-an-academic%C3%A2-tertiary-care-hospital
#7
Abdelrahman Abdelaal, Walid El Ansari, Issam Al-Bozom, Mahwish Khawar, Fakhar Shahid, Ammar Aleter, Mohammed Rasoul Abunuwar, Ayman El-Menyar
BACKGROUND: Appendicular neuroendocrine tumors (NET, Carcinoid tumors) of the appendix are rare and mostly diagnosed incidentally on the post-operative histopathological examination. NET are usually associated with good 5-year survival rates. We aimed to assess our experience for the diagnosis and management of NET over 11 years. METHOD: It is a retrospective chart review of all clinically suspected patients with acute appendicitis who underwent emergent appendectomy with intention to treat between January 2004-December 2014, and were clinically followed up until 2016...
September 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28759405/outcomes-of-nonoperative-management-of-uncomplicated-appendicitis
#8
Richard G Bachur, Susan C Lipsett, Michael C Monuteaux
BACKGROUND AND OBJECTIVES: Nonoperative management (NOM) of uncomplicated pediatric appendicitis has promise but remains poorly studied. NOM may lead to an increase in resource utilization. Our objective was to investigate the trends in NOM for uncomplicated appendicitis and study the relevant clinical outcomes including subsequent appendectomy, complications, and resource utilization. METHODS: Retrospective analysis of administrative data from 45 US pediatric hospitals...
July 2017: Pediatrics
https://www.readbyqxmd.com/read/28757875/acute-appendicitis-an-extracolonic-manifestation-of-clostridium-difficile-colitis
#9
Ali Ridha, Shoaib M Safiullah, Sarah Al-Abayechi, Amin Ur Rehman Nadeem
The current report is the case of a 30-year-old male patient who presented with symptomatology suggestive of appendicitis. However, careful history-taking and laboratory tests led to the diagnosis of Clostridium difficile colitis, resulting in successful nonsurgical management of this patient. Although both appendicitis and C. difficile colitis are common conditions, they are rarely diagnosed concurrently. This is reflected by paucity of literature describing this manifestation. Given this current presentation, the authors contend that the manifestation of extracolonic colitis within the appendix is possibly underdiagnosed or misdiagnosed as an acute appendicitis and thus potentially results in unnecessary surgical intervention...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28744697/prospective-validation-of-neutrophil-to-lymphocyte-ratio-as-a-diagnostic-and-management-adjunct-in-acute-appendicitis
#10
A Khan, M Riaz, Michael E Kelly, W Khan, R Waldron, K Barry, I Z Khan
BACKGROUND: No optimal biomarker exists that accurately diagnoses appendicitis or predicts severity, estimates post-operative complications or total length of hospital stay (LOS). AIM: To prospectively validate the utility of neutrophil-to-lymphocyte (NLR) ratio in predicting the severity of appendicitis, LOS, and 30-day complication rates. METHODS: Patients who were admitted with a provisional diagnosis of acute appendicitis over a period of 18 months (Oct 2014-April 2016) were included...
July 25, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28738931/management-of-appendicitis-with-the-implementation-of-an-acute-care-surgery-service-in-a-community-teaching-hospital
#11
Michael Farrell, Emily Murphy, Richard Caplan, Kevin Bradley, Matthew Rubino, Mark Cipolle
No abstract text is available yet for this article.
July 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28738237/a-case-report-of-unexpected-pathology-within-an-incarcerated-ventral-hernia
#12
Erica D Kane, Katharine R Bittner, Michelle Bennett, John R Romanelli, Neal E Seymour, Jacqueline J Wu
INTRODUCTION: Incidence of hernial appendicitis is 0.008%, most frequently within inguinal and femoral hernias. Up to 2.5% of appendectomy patients are found to have Crohn's disease. Elucidating the etiology of inflammation is essential for directing management. PRESENTATION OF CASE: A 51-year-old female with achondroplastic dwarfism, multiple cesarean sections, and subsequent massive incisional hernia, presented with ruptured appendicitis within her incarcerated hernia...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28730753/randomized-clinical-trial-of-appendicitis-inflammatory-response-score-based-management-of-patients-with-suspected-appendicitis
#13
M Andersson, B Kolodziej, R E Andersson
BACKGROUND: The role of imaging in the diagnosis of appendicitis is controversial. This prospective interventional study and nested randomized trial analysed the impact of implementing a risk stratification algorithm based on the Appendicitis Inflammatory Response (AIR) score, and compared routine imaging with selective imaging after clinical reassessment. METHOD: Patients presenting with suspicion of appendicitis between September 2009 and January 2012 from age 10 years were included at 21 emergency surgical centres and from age 5 years at three university paediatric centres...
July 21, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28711125/care-of-acute-gastrointestinal-conditions-in-the-observation-unit
#14
REVIEW
Jason J Ham, Edgar Ordonez, R Gentry Wilkerson
The Emergency Department Observation Unit (EDOU) provides a viable alternative to inpatient admission for the management of many acute gastrointestinal conditions with additional opportunities of reducing resource utilization and reducing radiation exposure. Using available evidence-based criteria to determine appropriate patient selection, evaluation, and treatment provides higher-quality medical care and improved patient satisfaction. Discussions of factors involved in creating an EDOU capable of caring for acute gastrointestinal conditions and clinical protocol examples of acute appendicitis, gastrointestinal hemorrhage, and acute pancreatitis provide a framework from which a successful EDOU can be built...
August 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28699771/comparative-effectiveness-of-surgery-versus-antibiotics-in-acute-appendicitis-a-systematic-review
#15
Stephanie D Talutis, Frederick Thurston Drake
AIM: To review outcomes of surgical and antibiotic management of acute appendicitis. METHODS: 11 prospective studies comparing surgical versus antibiotic management of acute appendicitis over a 21-year period were reviewed. RESULTS: Antibiotic management is successful in most cases of uncomplicated acute appendicitis. The need for crossover in management and recurrent appendicitis were low among all studies. For those patients who ultimately required surgery, no increased complications were observed...
July 12, 2017: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/28697844/preoperative-predictor-of-extensive-resection-for-acute-appendicitis
#16
Fumitaka Saida, Shokei Matsumoto, Mitsuhide Kitano
BACKGROUND: Appendectomy has been the preferred treatment of acute appendicitis. However, extensive resection (ER) such as an ileocecal resection is sometimes needed. We analyzed the predictive factors of ER. METHODS: This was a retrospective study of 927 patients with acute appendicitis in 7 years. The data collected, including demographic characteristics, laboratory tests, computed tomography (CT) findings and days from onset. RESULTS: ER was performed in 40 patients (4...
July 1, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28693849/impact-of-outpatient-management-following-appendectomy-for-acute-appendicitis-an-acs-nsqip-p-analysis
#17
Cristen N Litz, Laurie Stone, Roberta Alessi, Nebbie E Walford, Paul D Danielson, Nicole M Chandler
BACKGROUND: In 2012, a same-day discharge protocol following appendectomy for acute appendicitis was initiated. Our objective was to determine the success of the protocol by reviewing the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) outcomes following protocol development. METHODS: The 2015 NSQIP-P Participant Use Data File was queried to identify patients with acute appendicitis who underwent appendectomy. Outcomes were compared to institutional outcomes...
June 30, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28688590/contemporary-management-of-appendicitis-in-children
#18
REVIEW
Rebecca M Rentea, Shawn D St Peter
No abstract text is available yet for this article.
August 2017: Advances in Pediatrics
https://www.readbyqxmd.com/read/28685263/scoring-system-for-differentiating-perforated-and-non-perforated-pediatric-appendicitis
#19
Einat Blumfield, Daniel Yang, Joshua Grossman
OBJECTIVES: Appendicitis is the most common indication for emergency pediatric surgery and its most significant complication is perforation. Perforated appendicitis (PA) may be managed conservatively, whereas non-perforated appendicitis (NP) is managed surgically. Recent studies have shown that ultrasound (US) is effective for differentiating between PA and NP, and does not expose pediatric patients to ionizing radiation. The purpose of this study is to enhance the accuracy of differentiation with a novel scoring system based on clinical, laboratory, and US findings...
July 7, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28678997/outcomes-and-costs-of-managing-appendicitis-at-safety-net-hospitals
#20
Roy P Won, Scott Friedlander, Steven L Lee
Importance: Safety-net hospitals serve vulnerable populations with limited resources. Although complex, elective operations performed at safety-net hospitals have been associated with inferior outcomes and higher costs, it is unclear whether a similar association has been seen with common emergency general surgery performed at safety-net hospitals. Objective: To evaluate the association of safety-net burden with the outcomes of appendectomy. Design, Setting, and Participants: A retrospective review was conducted of all nonfederally funded hospitals in the California state inpatient database that performed appendectomies from January 1, 2005, to December 31, 2011...
July 5, 2017: JAMA Surgery
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