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appendicitis management

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https://www.readbyqxmd.com/read/29217323/noninvasive-monitoring-of-physiologic-compromise-in-acute-appendicitis-new-insight-into-an-old-disease
#1
Young Mee Choi, David Leopold, Kristen Campbell, Jane Mulligan, Greg Z Grudic, Steven L Moulton
INTRODUCTION: Physiologic compromise in children with acute appendicitis has heretofore been difficult to measure. We hypothesized that the Compensatory Reserve Index (CRI), a novel adjunctive cardiovascular status indicator, would be low for children presenting with acute appendicitis in proportion to their physiological compromise, and that CRI would rise with fluid resuscitation and surgical management of their disease. METHODS: Ninety-four children diagnosed with acute appendicitis were monitored with a CipherOx CRI™ M1 pulse oximeter (Flashback Technologies Inc...
November 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29207775/axial-torsion-of-meckel-s-diverticulum-a-rare-case-report
#2
Sandesh Vithal Parab, Pramod Govindrao Salve, Aruna Dahiphale, Rupesh Thakare, Amit Aiwale
Meckel's Diverticulum (MD) is the most common congenital anomaly of gastrointestinal tract, occurring in 2% of the population. It is a true diverticulum and histologically all four intestinal layers are present within MD. There are various complications related to a Meckel's diverticulum, including haemorrhage, intestinal obstruction, inflammation and perforation. Axial torsion followed by gangrene of MD is the rarest of the complications that have been reported. The exact mechanism for torsion is unclear. Preoperative diagnosis of torsion of MD is difficult and often confused with appendicitis as pain is usually localized to right lower quadrant...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29205688/integration-of-radiological-findings-and-a-clinical-score-in-pediatric-appendicitis
#3
Derya Aydin, Caner Turan, Ali Yurtseven, Petek Bayindir, Bade Toker, Zafer Dokumcu, Murat Sezak, Eylem Ulas Saz
BACKGROUND: The efficacy of ultrasonography (US) and abdominal X-ray in combination with PAS is complicated in the diagnosis of acute appendicitis. Abdominal X-ray is as useful as US with clinical assessment when evaluated by experienced pediatric radiologist in acute appendicitis. We aimed to determine the value of US and abdominal X-ray for appendicitis in children when combined with clinical assessment based on the Pediatric Appendicitis Score (PAS). We also aimed to establish a practical pathway for acute appendicitis in childhood...
December 5, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/29198605/incidence-demographics-and-outcomes-of-nonoperative-management-of-appendicitis-in-the-united-states
#4
Christopher B Horn, Dajun Tian, Grant V Bochicchio, Isaiah R Turnbull
BACKGROUND: Appendicitis is the most common intraabdominal surgical emergency in the United States, with over 250,000 cases each year. Several recent studies have evaluated the efficacy of nonoperative management of appendicitis. We measured changes in the treatment of appendicitis in the United States from 1998 to 2014 and evaluated outcomes in the contemporary cohort of appendicitis cases from 2010 to 2014. METHODS: The National Inpatient Sample was queried for cases with a principal diagnosis of appendicitis...
December 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29190038/closure-methods-of-the-appendix-stump-for-complications-during-laparoscopic-appendectomy
#5
REVIEW
Gurdeep S Mannu, Maria K Sudul, Joao H Bettencourt-Silva, Elspeth Cumber, Fangfang Li, Allan B Clark, Yoon K Loke
BACKGROUND: Laparoscopic appendectomy is amongst the most common general surgical procedures performed in the developed world. Arguably, the most critical part of this procedure is effective closure of the appendix stump to prevent catastrophic intra-abdominal complications from a faecal leak into the abdominal cavity. A variety of methods to close the appendix stump are used worldwide; these can be broadly divided into traditional ligatures (such as intracorporeal or extracorporeal ligatures or Roeder loops) and mechanical devices (such as stapling devices, clips, or electrothermal devices)...
November 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29180172/early-appendectomy-reduces-costs-in-children-with-perforated-appendicitis
#6
Joseph T Church, Edwin J Klein, Benjamin D Carr, Steven W Bruch
BACKGROUND: Perforated appendicitis can be managed with early appendectomy, or nonoperative management followed by interval appendectomy. We aimed to identify the strategy with the lowest health care utilization and cost. METHODS: We retrospectively reviewed the medical records of all children ≤18 years old with perforated appendicitis admitted to a single institution between January 2009 and March 2016. After excluding immunosuppressed patients and transfers from outside hospitals, we grouped the remaining patients by early or interval appendectomy...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29179594/ultrabilitation-beyond-recovery-oriented-rehabilitation
#7
Stephen A Buetow, Pablo Martínez-Martín, Brendan McCormack
PURPOSE: Current rehabilitation models emphasize therapy that attempts to return to "normal" the lives of persons who are disabled. An opportunity is available to scrutinize whether this recovery orientation of rehabilitation is necessarily optimal. METHOD: This conceptual article uses reasoning, informed by experience and a nonsystematic review of literature across diverse disciplines. RESULTS: For some persons with disability, optimizing recovery might be unwanted or insufficient...
November 28, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29160493/neonatal-appendicitis-a-survival-case-study
#8
Izabela Linha Secco, Taine Costa, Etiene Letícia Leone de Moraes, Márcia Helena de Souza Freire, Mitzy Tannia Reichembach Danski, Regina Paula Guimarães Vieira Cavalcante
OBJECTIVE: To report a case of neonatal appendicitis in a children's hospital in southern Brazil, demonstrating the impact on neonatal survival. METHOD: Case study with data collection from medical records, approved by the Institution and Ethics Committee for Research with Human Beings. RESULTS: The clinical picture is initially characterized by food intolerance, evolving to hypoactivity, alteration of vital signs and septicemia due to intestinal perforation...
November 2017: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/29157691/nonoperative-management-of-appendicitis-a-paradigm-shift-answers-to-the-july-2017-journal-club-questions
#9
Callie M Thompson, Wesley H Self, Tyler W Barrett
No abstract text is available yet for this article.
December 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29155250/surgical-management-of-acute-appendicitis-in-adults-a-review-of-current-techniques
#10
REVIEW
Maximilian Sohn, Ayman Agha, Stefan Bremer, Kai S Lehmann, Marcus Bormann, Alfred Hochrein
Acute appendicitis is one of the most frequent disorders in abdominal surgery. Therefore, appendectomy is a matter of significant interest in that field. Yet, four different techniques are available: open appendectomy, (conventional) laparoscopic appendectomy, single port laparoscopic appendectomy and NOTES-appendectomy with its different variations. To evaluate the current state of the art in appendectomy a bibliographic search was conducted. All prospectively randomized trials and national register cohort studies published between 1/2010 and 5/2016 were included into the analysis...
November 18, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29148199/five-lessons-in-uncomplicated-appendicitis-can-we-remove-the-surgery
#11
Andrew Read, Jane Xu, Susan Adams, Jonathan Karpelowsky
Appendicectomy has remained the treatment of choice for appendicitis for over a century and is the most commonly performed emergency operation in children. However, emerging evidence suggests that appendicectomy may not always be necessary in uncomplicated appendicitis, with early paediatric trials demonstrating that antibiotic-only therapy can be safe and effective. Further rigorously designed and appropriately powered studies are necessarily to establish the place of non-operative management of uncomplicated appendicitis in the future...
November 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29146647/initial-non-operative-management-of-uncomplicated-appendicitis-in-children-a-protocol-for-a-multicentre-randomised-controlled-trial-apac-trial
#12
Max Knaapen, Johanna H van der Lee, Roel Bakx, Sarah-May L The, Ernst W E van Heurn, Hugo A Heij, Ramon R Gorter
INTRODUCTION: Based on epidemiological, immunological and pathology data, the idea that appendicitis is not necessarily a progressive disease is gaining ground. Two types are distinguished: simple and complicated appendicitis. Non-operative treatment (NOT) of children with simple appendicitis has been investigated in several small studies. So far, it is deemed safe. However, its effectiveness and effect on quality of life (QoL) have yet to be established in an adequately powered randomised trial...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29146455/successful-nonoperative-management-of-uncomplicated-appendicitis-predictors-and-outcomes
#13
Tyler J Loftus, Scott C Brakenridge, Chasen A Croft, R Stephen Smith, Philip A Efron, Frederick A Moore, Alicia M Mohr, Janeen R Jordan
BACKGROUND: Our objective was to identify predictors of successful nonoperative management (NOM) of uncomplicated appendicitis. We hypothesized that the absence of diabetes, absence of an appendicolith, short duration of symptoms, absence of systemic inflammation, and low modified Alvarado score would predict successful NOM. METHODS: We performed a retrospective cohort analysis of 81 consecutive patients who underwent NOM of uncomplicated appendicitis. Successful NOM was defined as resolution of appendicitis with antibiotics alone and no recurrent appendicitis within 180 days...
November 13, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29134308/appendicitis-rural-patient-status-is-associated-with-increased-duration-of-prehospital-symptoms-and-worse-outcomes-in-high-and-low-middle-income-countries
#14
Matthew C Hernandez, Eric Finnesgaard, Johnathon M Aho, Victor Y Kong, John L Bruce, Stephanie F Polites, Grant L Laing, Damian L Clarke, Martin D Zielinski
INTRODUCTION: Appendicitis is a significant economic and healthcare burden in low-, middle-, and high-income countries. We aimed to determine whether urban and rural patient status would affect outcomes in appendicitis in a combined population regardless of country of economic status. We hypothesize that patients from rural areas and both high- and low-middle-income countries would have disproportionate outcomes and duration of symptoms compared to their urban counterparts. METHODS: Adults (≥18 years) with appendicitis during 2010-2016 in South Africa and USA were reviewed using multi-institutional data...
November 13, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29131764/nongynecologic-findings-seen-at-pelvic-us
#15
Akram M Shaaban, Maryam Rezvani, Jeffrey D Olpin, Anne M Kennedy, Ayman H Gaballah, Bryan R Foster, Christine O Menias, Khaled M Elsayes
Ultrasonography (US) is frequently the first imaging modality used to examine women with symptoms involving the pelvis. It is widely available and involves no exposure to ionizing radiation. Images can be acquired with a transabdominal, endovaginal, or translabial approach, and the use of video clips and three-dimensional reconstructions can be helpful. US is excellent for assessment of the uterus, ovaries, and adnexa. Occasionally, nongynecologic pelvic diseases arising from the gastrointestinal, genitourinary, and musculoskeletal systems and the pelvic peritoneal and extraperitoneal spaces may be detected and can be a source of diagnostic dilemma...
November 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29127919/a-case-report-of-a-de-garengeot-hernia-in-a-nonagenarian-veteran
#16
Luis R Taveras, Sergio Huerta
INTRODUCTION: A hernia containing the vermiform appendix [de Garengeot hernia (DGH)] is an exceedingly rare event. Appendicitis occurring in this setting if further unusual. Most cases of DGH are made during inguinal exploration. In the present report, we discuss a patient who underwent an operation which revealed a DGH with appendicitis. PRESENTATION OF A CASE: A 94-year-old man with a past medical history significant for hypertension and Parkinson's disease was admitted to the hospital for the management of an event of CHF exacerbation...
November 3, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29123444/imaging-findings-of-the-unusual-presentations-associations-and-clinical-mimics-of-acute-appendicitis
#17
REVIEW
Mustafa Kemal Demir, Yildiray Savas, Yavuz Furuncuoglu, Tarik Cevher, Serdar Demiral, Babek Tabandeh, Melisa Aslan
There are many kinds of unusual presentations or associations and clinical mimics of acute appendicitis, and definitive diagnosis requires knowledge of the imaging findings in some cases. The unusual presentations and associations of acute appendicitis included in this study are perforated appendicitis, acute appendicitis occurring in hernias, acute appendicitis with cystic endosalpingiosis, intussusception of appendix, and acute appendicitis with pregnancy. We also present uncommon gastrointestinal, urinary and gynecologic clinical mimics of acute appendicitis including anomalous congenital band, duplication cysts, giant Meckel's diverticulitis, inflammatory fibroid polyp, renal artery thrombosis, spontaneous urinary extravasation and OHVIRA syndrome...
October 2017: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/29103787/a-prospective-same-day-discharge-protocol-for-pediatric-appendicitis-adding-value-to-a-common-surgical-condition
#18
Yangyang R Yu, Carolyn M Smith, Kimberly K Ceyanes, Bindi J Naik-Mathuria, Sohail R Shah, Adam M Vogel, Kathleen E Carberry, Jed G Nuchtern, Monica E Lopez
PURPOSE: Standardized clinical pathways for simple appendicitis decrease length of stay and result in cost savings. We performed a prospective cohort study to assess a same day discharge (SDD) protocol for children with simple appendicitis. METHODS: All children undergoing laparoscopic appendectomy for simple appendicitis after protocol implementation (February 2016 to January 2017) were assessed. Length of stay (LOS), 30-day resource utilization (ED visits and hospital readmissions), patient satisfaction, and hospital accounting costs for SDD were compared to non-SDD patients...
October 9, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29103784/expanding-the-inclusion-criteria-for-nonoperative-management-of-uncomplicated-appendicitis-outcomes-and-cost
#19
Steven L Lee, Lara Spence, Kyle Mock, James X Wu, Huan Yan, Daniel A DeUgarte
BACKGROUND: Carefully selected children with early appendicitis may be managed nonoperatively. However, it is unknown whether nonoperative management (NOM) is applicable to all patients with uncomplicated appendicitis. The purpose of this study was to evaluate the outcomes of NOM of uncomplicated appendicitis with expanded inclusion criteria. METHODS: A prospective, nonrandomized patient-preference study comparing NOM versus laparoscopic appendectomy (LA) was performed in children with radiographic/clinical evidence of uncomplicated appendicitis...
October 9, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29101666/laparoscopic-appendectomy-vs-antibiotic-therapy-for-acute-appendicitis-a-propensity-score-matched-analysis-from-a-multicenter-cohort-study
#20
Gaetano Poillucci, Lorenzo Mortola, Mauro Podda, Salomone Di Saverio, Laura Casula, Chiara Gerardi, Nicola Cillara, Luigi Presenti
Acute appendicitis (AA) is among the most common causes of acute lower abdominal pain leading patients to the emergency department. Significant debate remains on whether AA should be operated or not. A propensity score-matched analysis was performed in seven Italian Hospitals, with the aim to assess safety and feasibility both nonoperative management with antibiotics (AT) and surgical therapy with appendectomy (ST) for patients with AA. Data regarding all patients discharged from the participating centers with a diagnosis of appendicitis from January 1st, 2014 to December 31st, 2014 were collected retrospectively...
December 2017: Updates in Surgery
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