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appendicitis management

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https://www.readbyqxmd.com/read/29457363/conventional-laparoscopic-appendectomy-versus-double-incision-three-port-laparoscopic-appendectomy-a-1-year-randomized-controlled-trial
#1
Vishwanath M Pattanshetti, Kanyadhara L Krishna
INTRODUCTION: Management of appendicitis has evolved dramatically in the last 120 years, from McBurney's large incision to minimally invasive laparoscopic appendectomy to hardly noticeable incisions with SILS. As a bridge between conventional laparoscopic surgery and SILS, double-incision laparoscopic surgery further minimizes the invasiveness of laparoscopic surgery by reducing the number of incisions. This study aimed to establish the efficacy of double-incision, three-port laparoscopic appendectomy (DILA) as an alternative to conventional three-port laparoscopic appendectomy...
February 19, 2018: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29455120/amyand-s-hernia-with-acute-gangrenous-appendicitis-and-cecal-perforation-a-case-report-and-review-of-the-literature
#2
William Kromka, Aline S Rau, Charles J Fox
INTRODUCTION: An Amyand's hernia is a heterogeneous clinical condition defined by the presence of the vermiform appendix within an inguinal hernia sac, which may or may not contain other abdominal contents or pathologic inflammatory changes. Herein we present an exceptionally rare case of an Amyand's hernia containing acute appendicitis and a perforated cecum. PRESENTATION OF CASE: A 46-year-old male with a right inguinal hernia of 2-3 year duration presented to our Emergency Department complaining of acute onset abdominal and groin pain...
February 14, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29431586/drain-failure-in-intra-abdominal-abscesses-associated-with-appendicitis
#3
Christopher B Horn, Adrian A Coleoglou Centeno, Jarot J Guerra, John E Mazuski, Grant V Bochicchio, Isaiah R Turnbull
BACKGROUND: Previous studies have suggested that percutaneous drainage and interval appendectomy is an effective treatment for appendicitis with associated abscess. Few studies to date have analyzed risk factors for failed drain management. We hypothesized that older patients with more co-morbidities would be at higher risk for failing conservative treatment. METHODS: The 2010-2014 editions of the National Inpatient Sample (NIS) were queried for patients with diagnoses of peri-appendiceal abscesses...
February 12, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29423825/non-operative-treatment-of-appendicitis-public-perception-and-decision-making
#4
Emer P O'Connell, Annmarie White, Paul Cromwell, Emma Carroll, Waqar Khan, Ronan Waldron, Iqbal Z Khan, Kevin Barry
BACKGROUND: Appendectomy has for many years been the accepted treatment of appendicitis. In recent years, non-operative management of appendicitis (NOTA) has been reported as an effective treatment option. AIMS: We aimed to assess the perspectives of public hospital attendees regarding the diagnosis and treatment options for appendicitis. METHODS: We conducted a cross-sectional survey of outpatients over a 10-week period (December 2016-March 2017)...
February 8, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29420399/appendiceal-endometriosis-and-ectopic-pregnancy-occurring-simultaneously
#5
Anat Chemerinski, Daniel Lubin, Sevelle Holder, Divya Shah
BACKGROUND: In the setting of a known ectopic pregnancy, severe abdominal pain with clinical concern for rupture is an indication for emergency surgery. In rare cases, appendiceal pathology may occur simultaneously. CASE: A woman with a known ectopic pregnancy presented to the emergency department with a clinical picture consistent with its rupture. At the time of surgery, an appendectomy also was performed owing to concern for concurrent appendicitis; histopathologic examination revealed appendiceal endometriosis...
February 5, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29413211/gastrointestinal-traumatic-injuries-gastrointestinal-perforation
#6
REVIEW
Maria A Revell, Marcia A Pugh, Melanie McGhee
The abdomen is a big place even in a small person. Gastrointestinal trauma can result in injury to the stomach, small bowel, colon, or rectum. Traumatic causes include blunt or penetrating trauma, such as gunshot wounds, stabbings, motor vehicle collisions, and crush injuries. Nontraumatic causes include appendicitis, Crohn disease, cancer, diverticulitis, ulcerative colitis, blockage of the bowel, and chemotherapy. The mechanism of injury will affect both the nature and severity of any resulting injuries. Treatment must address the critical and emergent nature of these injuries as well as issues that affect all trauma situations, which include management of hemodynamic instability...
March 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29404704/a-visual-decision-support-tool-for-appendectomy-care
#7
Edward Clarkson, Jason Zutty, Mehul V Raval
Appendectomy is the most common abdominal surgical procedure performed in children in the United States. In order to assist care providers in creating treatment plans for the postoperative management of pediatric appendicitis, we have developed a predictive statistical model of outcomes on which we have built a prototype decision aid application. The model, trained on 3724 anonymized care records and evaluated on a separate set of 2205 cases from a tertiary care center, achieves 97.0% specificity, 25.1% true sensitivity, and 58...
February 5, 2018: Journal of Medical Systems
https://www.readbyqxmd.com/read/29397242/a-rare-case-of-acute-right-sided-colonic-diverticulitis-presenting-as-pancreatitis
#8
Maria de Lourdes Ladino Sturchler, Evan A Rusoja, Arun Nagdev, Barry C Simon
BACKGROUND: This case report highlights the clinical presentation, radiologic findings, and medical management of a case of right colonic diverticulitis (RCD) with concomitant pancreatitis, a rare and easily missed entity in the emergency department (ED) of Western hemisphere countries. In our report, we present and discuss a case of RCD that led to pancreatitis in a female Asian patient. We review the epidemiology, diagnosis, and management of this disorder, and also discuss some complications associated with RCD...
January 31, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29395151/outcome-of-initially-nonoperative-treatment-for-acute-simple-appendicitis-in-children
#9
Ramon R Gorter, Johanna H van der Lee, Florence A C J Heijsters, Huibert A Cense, Roel Bakx, C M Frank Kneepkens, Marc H Wijnen, Alida F W van der Steeg, Klaas H In't Hof, Martin Offringa, Hugo A Heij
PURPOSE: To compare the outcome of initially nonoperative treatment with immediate appendectomy for simple appendicitis in children. METHODS: Between September 2012 and June 2014 children aged 7-17 years with a radiologically confirmed simple appendicitis were invited to participate in a multicentre prospective cohort study in which they were treated with an initially nonoperative treatment strategy; nonparticipants underwent immediate appendectomy. In October 2015, their rates of complications and subsequent appendectomies, and health-related quality of life (HRQOL) were assessed...
December 24, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29391281/appendicitis-grade-operative-duration-and-hospital-cost
#10
Courtney M Collins, Daniel L Davenport, Cynthia L Talley, Andrew C Bernard
BACKGROUND: The American Association for the Surgery of Trauma (AAST) established a grading system for appendicitis to allow prediction of risk and outcome, to assist in quality improvement and resource management, and to provide a framework for research. Grading is determined in clinical, imaging, operative, and pathologic categories but has not been completely validated. Our aim was to validate appendicitis grade with respect to duration of symptoms, operative duration and hospital costs...
January 29, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29391104/management-and-outcomes-of-appendectomy-during-pregnancy
#11
Roy P Won, Scott Friedlander, Steven L Lee
Acute appendicitis is a common nonobstetric indication for surgical intervention during pregnancy with serious potential complications for the mother and fetus. The aim of this study was to evaluate the presentation, management practices, outcomes, and costs of appendectomy during pregnancy. We did a retrospective analysis of 62,118 nonincidental appendectomies performed in women (age 15-45 years) identified from the California State Inpatient Database (2005-2011). Primary outcomes included diagnosis or type of appendicitis, use of laparoscopy, morbidity, length of stay, and cost...
October 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29390302/gastrointestinal-perforation-secondary-to-accidental-ingestion-of-toothpicks-a-series-case-report
#12
Zifeng Yang, Deqing Wu, Dailan Xiong, Yong Li
RATIONALE: Toothpicks are widely used as a tooth cleaning tool after meals in China. Most of the Chinese toothpicks are made of wood or bamboo with a hard texture and sharp ends. This characteristic has proven to be potentially dangerous when toothpicks are accidentally ingested, as they can cause damage and perforation of the digestive tract and other subsequent complications. PATIENT CONCERNS: The main clinical complaints of 5 patients in this study were mainly acute or chronic abdominal pain, duration from 2 days to 2 months, 1 case with vomiting, 1 case with fever...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29373647/eggerthella-lenta-bloodstream-infections-are-associated-with-increased-mortality-following-empiric-piperacillin-tazobactam-tzp-monotherapy-a-population-based-cohort-study
#13
Alejandra Ugarte-Torres, Mark R Gillrie, Thomas P Griener, Deirdre L Church
Background: Eggerthella lenta is a non-sporulating anaerobic gram-positive bacilli associated with polymicrobial intra-abdominal infections. Recently, E. lenta has been recognized as an important cause of anaerobic blood-stream infections (BSI) associated with high mortality. E. lenta has been reported to have high minimal inhibitory concentrations (MICs) to piperacillin-tazobactam (TZP), a broad-spectrum antibiotic with anaerobic coverage commonly used in multiple centers for empiric treatment of abdominal sepsis...
January 24, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29370892/laparoscopic-one-port-appendectomy-evaluation-in-pediatric-surgery
#14
A Binet, K Braïk, F Lengelle, M Laffon, H Lardy, S Amar
BACKGROUND: Appendectomy is a well-established surgical procedure in pediatric surgery used in the management of acute appendicitis. With the continuous advancement in the field of minimal invasive surgery, the recent focus is on single incision laparoscopic (SIL) surgery. SILA also goes further in order to decrease pain, improve recovery and enhance patient satisfaction. However, this approach is still not a well-established technique and not widely practiced, especially in pediatric surgery...
December 27, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29370051/a-protocol-for-non-operative-management-of-uncomplicated-appendicitis
#15
Tyler J Loftus, Camille G Dessaigne, Chasen A Croft, R Stephen Smith, Philip A Efron, Frederick A Moore, Scott C Brakenridge, Alicia M Mohr, Janeen R Jordan
BACKGROUND: We developed a protocol to identify candidates for non-operative management (NOM) of uncomplicated appendicitis. Our objective was to evaluate protocol efficacy with the null hypothesis that clinical outcomes, hospital readmission rates, and hospital charges would be unchanged after protocol implementation. METHODS: We performed a single-center 4-year propensity score matched retrospective cohort analysis of 406 patients with acute uncomplicated appendicitis...
February 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29365029/association-of-the-affordable-care-act-medicaid-expansion-with-access-to-and-quality-of-care-for-surgical-conditions
#16
Andrew P Loehrer, David C Chang, John W Scott, Matthew M Hutter, Virendra I Patel, Jeffrey E Lee, Benjamin D Sommers
Importance: Lack of insurance coverage has been associated with delays in seeking care, more complicated diseases at the time of diagnosis, and decreased likelihood of receiving optimal surgical care. The Patient Protection and Affordable Care Act's (ACA) Medicaid expansion has increased coverage among millions of low-income Americans, but its effect on care for common surgical conditions remains unknown. Objective: To evaluate the association of the ACA's Medicaid expansion with access to timely and recommended care for common and serious surgical conditions...
January 24, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29346264/sonography-of-the-cecum-gateway-to-the-right-lower-quadrant
#17
R Brooke Jeffrey, Andrew L Wentland, Eric W Olcott
Sonography of the cecum has come of age largely as a consequence of the successful evolution of appendiceal sonography as a useful tool in the evaluation of patients with right lower-quadrant pain. At some medical centers, graded-compression sonography (GCS) has become the initial imaging study of choice in the assessment of these individuals. The cecum serves as a helpful anatomic landmark for localization of the appendix in these examinations-providing a sonographic starting point in the search for the appendix...
January 17, 2018: Ultrasound Quarterly
https://www.readbyqxmd.com/read/29344678/conservative-antibiotic-treatment-for-acute-uncomplicated-appendicitis-is-feasible
#18
Zvi Steiner, Genady Buklan, Michael Gutermacher, Ita Litmanovitz, Tal Landa, Shmuel Arnon
PURPOSE: Appendectomy versus conservative antibiotic treatment (CAT) for children with acute uncomplicated appendicitis (AUA) remains unresolved, with concerns regarding the practicality of CAT. We analyzed our center's experience with CAT for AUA, using a protocol with strict inclusion, exclusion and treatment criteria. METHODS: Non-randomized, prospective cohort study included all children admitted betwee 2014 and 2016, with clinical and laboratory tests suspicious for AUA...
January 17, 2018: Pediatric Surgery International
https://www.readbyqxmd.com/read/29340826/single-port-laparoscopic-surgery-in-uncomplicated-acute-appendicitis-a-randomized-controlled-trial
#19
Byung Mo Kang, Sung Il Choi, Bum-Soo Kim, Suk-Hwan Lee
BACKGROUND: Single-port laparoscopic surgery (SPLS) is an alternative, minimally invasive surgical approach for managing appendicitis. The aim of this randomized trial was to evaluate the safety and efficacy of SPLS in uncomplicated appendicitis. METHODS: Between December 2009 and November 2010, 194 patients with radiologically diagnosed acute appendicitis were randomly allocated to undergo either SPLS or multiport laparoscopic surgery (MPLS). Patients with intraoperative findings of perforated appendicitis were excluded from the analysis...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29336754/predictors-and-outcomes-of-nondiagnostic-ultrasound-for-acute-appendicitis-in-children
#20
Richard Sola, Blair A Wormer, William E Anderson, Thomas M Schmelzer, Graham H Cosper
Ultrasound assessments of children with possible acute appendicitis (AA) are often nondiagnostic. We aimed to identify the predictors of nondiagnostic ultrasound and to investigate the outcomes. A retrospective review was conducted on children aged 4 to 17 years evaluated in 2013 for AA with ultrasound at a tertiary hospital pediatric emergency department. Demographics, clinical data, and outcomes were analyzed. Of 528 children, 194 (36.7%) had diagnostic ultrasounds and 334 (63.3%) had nondiagnostic ultrasounds...
December 1, 2017: American Surgeon
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