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appendicitis management

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https://www.readbyqxmd.com/read/27925670/limited-abdominal-sonography-for-evaluation-of-children-with-right-lower-quadrant-pain
#1
Martha M Munden, Shannon Wai, Michael C DiStefano, Wei Zhang
OBJECTIVES: To determine whether a complete abdominal sonographic examination is necessary in the evaluation of children with right lower quadrant pain that is suspicious for appendicitis in the emergency department and whether performing a limited, more-focused study would miss clinically important disease. METHODS: With Institutional Review Board approval, a retrospective study was performed of 704 patients, from ages 5-19 years, presenting to the emergency department with right lower quadrant pain that was suspicious for appendicitis who underwent a complete abdominal sonographic examination...
November 30, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27916376/factors-predictive-of-complicated-appendicitis-in-children
#2
Xuan-Binh D Pham, Veronica F Sullins, Dennis Y Kim, Blake Range, Amy H Kaji, Christian M de Virgilio, Steven L Lee
BACKGROUND: The ability to predict whether a child has complicated appendicitis at initial presentation may influence clinical management. However, whether complicated appendicitis is associated with prehospital or inhospital factors is not clear. We also investigate whether hyponatremia may be a novel prehospital factor associated with complicated appendicitis. MATERIALS AND METHODS: A retrospective review of all pediatric patients (≤12 y) with appendicitis treated with appendectomy from 2000 to 2013 was performed...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27908462/a-rare-case-of-perforated-sub-hepatic-appendicitis-a-challenging-differential-diagnosis-of-acute-abdomen-based-on-the-combination-of-appendicitis-and-maldescent-of-the-caecum
#3
Costanza Chiapponi, Olof Jannasch, Manuela Petersen, Wiebke Lessel, Christiane Bruns, Frank Meyer
Unusual locations of the appendix vermiformis can result in delay in appropriate diagnosis and treatment of appendicitis. So an inflamed appendix in a sub-hepatic caecum caused by caecal maldescent for example can mimic cholecystitis, the pain being localized in the right upper quadrant. Here, we present a case of perforated sub-hepatic appendicitis with peritonitis, requiring open ileocaecal resection. Review of the existing literature has demonstrated that this pathology is uncommon, yet not so rare as one might presume...
November 21, 2016: Pathology, Research and Practice
https://www.readbyqxmd.com/read/27899166/pain-management-of-acute-appendicitis-in-canadian-pediatric-emergency-departments
#4
Andrea L Robb, Samina Ali, Naveen Poonai, Graham C Thompson
OBJECTIVES: Children with suspected appendicitis are at risk for suboptimal pain management. We sought to describe pain management patterns for suspected appendicitis across Canadian pediatric emergency departments (PEDs). METHODS: A retrospective medical record review was undertaken at 12 Canadian PEDs. Children ages 3 to 17 years who were admitted to the hospital in February or October 2010 with suspected appendicitis were included. Patients were excluded if partially assessed or treated at another hospital...
November 30, 2016: CJEM
https://www.readbyqxmd.com/read/27896326/preoperative-diagnosis-of-amyand-s-hernia-by-ultrasound-and-computed-tomography
#5
Husam Vehbi, Cagri Agirgun, Ferda Agirgun, Yuksel Dogan
Inguinal hernia is the most common seen groin hernias which mostly contain bowel. The incidence of vermiform appendix in an inguinal hernia is seen in 1% of all inguinal hernia. This is known as Amyand's hernia. Appendix within a hernia can be normal or complicated by appendicitis. Most of these cases are not diagnosed preoperatively and managed during surgery. Preoperative diagnosis of these cases is so rare. Very few cases have been reported so far. In our case, we diagnosed an inflamed appendix in a 49 years old female within right inguinal hernia by using ultrasound and confirmed it by CT scan...
June 2016: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27894435/pediatric-appendicitis
#6
REVIEW
Rebecca M Rentea, Shawn D St Peter
Appendicitis is one of the most common surgical pathologies in children. It can present with right lower quadrant pain. Scoring systems in combination with selective imaging and surgical examination will diagnose most children with appendicitis. Clinical pathways should be used. Most surgical interventions for appendicitis are now almost exclusively laparoscopic, with trials demonstrating better outcomes for children who undergo index hospitalization appendectomies when perforated. Nonoperative management has a role in the treatment of both uncomplicated and complicated appendicitis...
February 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/27890780/a-clinical-score-to-predict-appendicitis-in-older-male-children
#7
Anupam B Kharbanda, Michael C Monuteaux, Richard G Bachur, Nanette C Dudley, Lalit Bajaj, Michelle D Stevenson, Charles G Macias, Manoj K Mittal, Jonathan E Bennett, Kelly Sinclair, Peter S Dayan
OBJECTIVE: To develop a clinical score to predict appendicitis among older, male children who present to the emergency department (ED) with suspected appendicitis. METHODS: Patients with suspected appendicitis were prospectively recruited at 9 pediatric EDs. A total 2,625 patients enrolled; a subset of 961 males, age 8-18 were analyzed in this secondary analysis. Outcomes determined by pathology, operative reports and follow-up calls. Clinical and laboratory predictors with < 10% missing data and Kappa > 0...
November 24, 2016: Academic Pediatrics
https://www.readbyqxmd.com/read/27880929/a-complicated-case-of-amyand-s-hernia-involving-a-perforated-appendix-and-its-management-using-minimally-invasive-laparoscopic-surgery-a-case-report
#8
Wisam Al-Ramli, Yahya Khodear, Muyiwa Aremu, Abdel Basset El-Sayed
INTRODUCTION: Amyand's hernia is a rare condition of inguinal hernia in which the appendix is incarcerated within the hernia sac through the internal ring. Complications include acute appendicitis and perforated appendicitis, which are rare in incidence, accounting for about 0.1% of cases.(1) These complications prove a diagnostic challenge due to their vague clinical presentation and atypical laboratory and radiological findings. Until recently, open appendectomy was the mainstay of treatment...
November 10, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27873747/atypical-presentation-of-appendicitis
#9
Oliver Beaumont, Robert Miller, Richard Guy
A woman aged 64 years presented as an emergency with a mass in the right iliac fossa, clinically within the abdominal wall, but an otherwise soft abdomen. Systemically, she was quite well with normal vital signs. Blood tests revealed raised inflammatory markers, and an abdominal CT scan demonstrated a perforated appendix with associated large subcutaneous abscess. This represents a rare presentation of a common condition, demonstrating how appendicitis can still be a challenging problem for the clinician...
November 10, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27872360/the-heidelberg-appendicitis-score-predicts-perforated-appendicitis-in-children
#10
Michael Boettcher, Patrick Günther, Thomas Breil
Background In the future, surgical management of pediatric appendicitis might become limited to nonperforating appendicitis. Thus, it becomes increasingly important to differentiate advanced from simple appendicitis and to predict perforated appendicitis among a group of children with right-sided abdominal pain, which was the aim of this study. Methods An institutionally approved, single-center retrospective analysis of all patients with appendectomy from January 2009 to December 2010 was conducted. All diagnostic aspects were evaluated to identify predictors and differentiators of perforated appendicitis...
November 20, 2016: Clinical Pediatrics
https://www.readbyqxmd.com/read/27857807/transanal-protrusion-of-ventriculoperitoneal-shunt-via-appendicular-perforation-a-rare-case-report
#11
Shaam Bodeliwala, Atul Agrawal, Amit Mittal, Daljit Singh, B G Vageesh, Hukum Singh
Perforation of abdominal viscera and protrusion of the distal end of ventriculoperitoneal shunt (VPS) through natural orifice is well known but rare complication. We report a case of a transanal protrusion of distal end of VPS through appendix perforation without any symptomatology of prior appendicitis. To the best of our knowledge, no case of such kind has been reported in literature yet. The management plan of these patients should be looked in a different way because they may have underlying inflammation of the appendix and distal end of shunt removal should be done by proper surgical exploration followed by added appendicectomy...
July 2016: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/27836368/the-cost-effectiveness-of-nonoperative-management-versus-laparoscopic-appendectomy-for-the-treatment-of-acute-uncomplicated-appendicitis-in-children
#12
James X Wu, Greg D Sacks, Aaron J Dawes, Daniel DeUgarte, Steven L Lee
BACKGROUND: Several studies have demonstrated the safety and short-term success of nonoperative management in children with acute, uncomplicated appendicitis. Nonoperative management spares the patients and their family the upfront cost and discomfort of surgery, but also risks recurrent appendicitis. METHODS: Using decision-tree software, we evaluated the cost-effectiveness of nonoperative management versus routine laparoscopic appendectomy. Model variables were abstracted from a review of the literature, Healthcare Cost and Utilization Project, and Medicare Physician Fee schedule...
October 20, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27835997/adenocarcinoma-mimicking-appendicular-lump-a-diagnostic-dilemma-a-case-report
#13
Sanket Kalpande, Jayashri Pandya, Tushar Sharma
BACKGROUND: Primary appendiceal adenocarcinoma is a rare tumor, mucinous variety being common. This case is reported to highlight the unusual presentation and diagnostic difficulty of appendiceal adenocarcinoma. CASE PRESENTATION: Patient presented with acute appendicitis with ill-defined tender lump which responded to conservative management. CONCLUSIONS: High index of suspicion should be kept in mind for elderly patients presenting with appendicular lump...
November 11, 2016: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27823760/diagnosis-and-management-of-right-colonic-diverticular-disease-a-review
#14
Francesco Ferrara, Jesús Bollo, Letizia V Vanni, Eduardo M Targarona
The aim of this narrative review is to define the clinical-pathological characteristics and to clarify the management of right colonic diverticular disease. It is rare in Europe, USA and Australia and more common in Asia. In the recent years its incidence has increased in the West, with various distributions among populations. Many studies have reported that it is difficult to differentiate the presenting symptoms of this disease from those of appendicitis before surgery, because the signs and symptoms are similar, so misdiagnosis is not infrequent...
November 4, 2016: Cirugía Española
https://www.readbyqxmd.com/read/27816201/fast-track-pathway-for-perforated-appendicitis
#15
Richard Frazee, Stephen Abernathy, Matthew Davis, Travis Isbell, Justin Regner, Randall Smith
BACKGROUND: Perforated appendicitis is associated with an increased morbidity and length of stay. "Fast track" protocols have demonstrated success in shortening hospitalization without increasing morbidity for a variety of surgical processes. This study evaluates a fast track pathway for perforated appendicitis. METHODS: In 2013, a treatment pathway for perforated appendicitis was adopted by the Acute Care Surgery Service for patients having surgical management of perforated appendicitis...
October 20, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27807602/management-treatment-and-outcomes-of-acute-appendicitis-in-an-elderly-population-a-single-center-experience
#16
O Cohen-Arazi, K Dabour, M Bala, A Haran, G Almogy
INTRODUCTION: Only 5-10% of cases of acute appendicitis (AA) are diagnosed above the age of 60 years. Complicated AA is more common in the elderly, who also have more comorbidities. The goals of this study were to describe our experience with elderly patients and identify predictors of increased morbidity. MATERIAL AND METHODS: Patients ≥65 years who were treated for AA between 2006 and 2013 were selected. The control consisted of patients aged 20-45 years, who were randomly selected from a pool of 900 patients...
November 2, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27805996/increased-anatomic-severity-predicts-outcomes-validation-of-the-american-association-for-the-surgery-of-trauma-s-emergency-general-surgery-score-in-appendicitis
#17
Matthew Hernandez, Johnathan M Aho, Elizabeth B Habermann, Asad Choudhry, David Morris, Martin Zielinski
BACKGROUND: Determination and reporting of disease severity in emergency general surgery (EGS) lacks standardization. Recently, the American Association for the Surgery of Trauma (AAST) proposed an anatomic severity grading system. We aimed to validate this system in patients with appendicitis, and determine if cross sectional imaging correlates with disease severity at operation. METHODS: Patients 18 years or older undergoing treatment for acute appendicitis between 2013 and 2015 were identified...
October 31, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27799883/surgical-management-of-inflammatory-bowel-disease-in-china-a-systematic-review-of-two-decades
#18
Qiao Yu, Ren Mao, Lei Lian, Siew Chien Ng, Shenghong Zhang, Zhihui Chen, Yanyan Zhang, Yun Qiu, Baili Chen, Yao He, Zhirong Zeng, Shomron Ben-Horin, Xinming Song, Minhu Chen
BACKGROUND/AIMS: The past decades have seen increasing incidence and prevalence of inflammatory bowel disease (IBD) in China. This article aimed to summarize the current status and characteristics of surgical management for IBD in China. METHODS: We searched PubMed, Embase, and Chinese databases from January 1, 1990 to July 1, 2014 for all relevant studies on the surgical treatment IBD in China. Eligible studies with sufficient defined variables were further reviewed for primary and secondary outcome measures...
October 2016: Intestinal Research
https://www.readbyqxmd.com/read/27793458/nonoperative-management-of-appendicitis-in-adults-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#19
REVIEW
John M Findlay, Jihène El Kafsi, Clare Hammer, Jeffrey Gilmour, Richard S Gillies, Nicholas D Maynard
No abstract text is available yet for this article.
December 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27788918/comparison-of-outcomes-of-patients-with-acute-appendicitis-between-an-acute-care-surgery-model-and-traditional-call-coverage-model-in-the-same-community
#20
Shaina Schaetzel, Rachel Dirks, James Davis
BACKGROUND: This study compared outcomes, patient flow, and cost between an acute care surgery (ACS) and traditional call model (TRAD) for acute appendicitis in the same community and time period. METHODS: Patients who underwent appendectomy from 7/1/2012 to 6/30/2014 were retrospectively reviewed. An ACS and TRAD were compared. Demographic data, outcomes, cost, and time intervals were compared. RESULTS: Of the 945 patients reviewed, the ACS group had more perforated appendicitis on preoperative computed tomography scan (9% vs 3%, P < ...
October 3, 2016: American Journal of Surgery
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