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appendicitis, timing of treatment

J E Slotta, U Kopsch, M Ghadimi, O Kollmar
BACKGROUND: Acute appendicitis is a common disease which requires immediate surgical treatment of the focus of inflammation. So far there are no reliable data on how much time can pass between hospitalization, indications for surgery and initiating surgery without an increased risk of morbidity and mortality for the patient. OBJECTIVE: The aim of this study was to investigate how much time can lapse between admission and initiation of surgery for acute appendicitis while still providing patient safety and no increase in complication rates...
October 21, 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Julian C Harnoss, Isabelle Zelienka, Pascal Probst, Kathrin Grummich, Catharina Müller-Lantzsch, Jonathan M Harnoss, Alexis Ulrich, Markus W Büchler, Markus K Diener
OBJECTIVE: The aim was to investigate available evidence regarding effectiveness and safety of surgical versus conservative treatment of acute appendicitis. SUMMARY OF BACKGROUND DATA: There is ongoing debate on the merits of surgical and conservative treatment for acute appendicitis. METHODS: A systematic literature search (Cochrane Library, Medline, Embase) and hand search of retrieved reference lists up to January 2016 was conducted to identify randomized and nonrandomized studies...
October 17, 2016: Annals of Surgery
Andrea Zanichelli, Hilary J Longhurst, Marcus Maurer, Laurence Bouillet, Werner Aberer, Vincent Fabien, Irmgard Andresen, Teresa Caballero
BACKGROUND: Hereditary angioedema due to C1 inhibitor deficiency (C1-INH-HAE) causes swelling in the skin and upper airways and pain in the abdomen because of mucosal swelling. C1-INH-HAE is frequently misdiagnosed, leading to delays in diagnosis, inadequate treatment, and unnecessary procedures. OBJECTIVE: To evaluate the history of misdiagnosis in patients participating in the Icatibant Outcome Survey (IOS). METHODS: The IOS is an observational study in which safety and effectiveness of icatibant have been evaluated since 2009...
October 2016: Annals of Allergy, Asthma & Immunology
G Cocorullo, N Falco, R Tutino, T Fontana, G Scerrino, G Salamone, L Licari, G Gulotta
AIM: To evaluate the role of laparoscopy in the treatment of surgical emergency in old population. PATIENTS AND METHODS: Over-70 years-old patients submitted to emergency abdominal surgery from January 2013 to December 2014 were collected and grouped according to admission diagnoses. These accounted small bowel obstruction, colonic acute disease, appendicitis, ventral hernia, gastro-duodenal perforation, biliary disease. In each group it was analyzed the operation time (OT), the morbidity rate and the mortality rate comparing open and laparoscopic management using T-test and Chi-square test...
May 2016: Il Giornale di Chirurgia
Leonie T van Hulsteijn, J Sven D Mieog, Maarten H T Zwartbol, Jos W S Merkus, Cees van Nieuwkoop
BACKGROUND: Several infectious processes of intra-abdominal origin may atypically present as skin or soft tissue infections or abscess in the thigh. CASE REPORT: We describe the case of a 73-year-old woman who presented to the emergency department with the clinical picture of a skin infection of the right leg. The patient's condition deteriorated during medical treatment with intravenous antibiotics. Subsequent radiologic imaging revealed that the complaints were caused by a bulging retroperitoneal appendicular abscess along the iliopsoas muscle, although the patient experienced no abdominal symptoms...
September 19, 2016: Journal of Emergency Medicine
K Menclová, E Traboulsi, A Nikov, L Hána, M Rousek, M Ryska
INTRODUCTION: Acute appendicitis is the most common cause of intra-abdominal emergency surgery worldwide. The approach to its treatment keeps changing. The number of acute appendectomies has been decreasing. Many patients are treated conservatively with success. Our study compares conservative and surgical treatment of acute appendicitis, including its complications in our department. METHODS: We retrospectively analyzed the group of 117 patients hospitalized with the clinical diagnosis of acute appendicitis...
2016: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
H A Heij, M J van Lieburg
Non-surgical treatment of acute phlegmonous appendicitis has been receiving increasing attention in recent years, representing a reversal of policy. The appendectomy came into vogue at the beginning of the 20th century. It is true that prompt surgical intervention in all patients with appendicitis or an indication thereof almost guarantees success, but it gradually came to be forgotten that this intervention was not always necessary. In this article we will document the historical development of this disease and its treatment, and return to the original reports made by pathologist Reginald Fitz and the internist William Osler to show that their opinion was not black and white...
2016: Nederlands Tijdschrift Voor Geneeskunde
Adriani Nikolakopoulou, Dimitris Mavridis, Matthias Egger, Georgia Salanti
Pairwise and network meta-analysis (NMA) are traditionally used retrospectively to assess existing evidence. However, the current evidence often undergoes several updates as new studies become available. In each update recommendations about the conclusiveness of the evidence and the need of future studies need to be made. In the context of prospective meta-analysis future studies are planned as part of the accumulation of the evidence. In this setting, multiple testing issues need to be taken into account when the meta-analysis results are interpreted...
September 1, 2016: Statistical Methods in Medical Research
Antonio Biondi, Carla Di Stefano, Francesco Ferrara, Angelo Bellia, Marco Vacante, Luigi Piazza
BACKGROUND: Appendectomy is the most common surgical procedure performed in emergency surgery. Because of lack of consensus about the most appropriate technique, appendectomy is still being performed by both open (OA) and laparoscopic (LA) methods. In this retrospective analysis, we aimed to compare the laparoscopic approach and the conventional technique in the treatment of acute appendicitis. METHODS: Retrospectively collected data from 593 consecutive patients with acute appendicitis were studied...
2016: World Journal of Emergency Surgery: WJES
Oğuzhan Özdemir, Yavuz Metin, Nurgül Orhan Metin, Ali Küpeli, Süleyman Kalcan, Filiz Taşçı
OBJECTIVE: We aimed to search the contribution of diffusion-weighted imaging (DWI) in follow-up of patients with acute appendicitis associated inflammatory appendiceal mass (IAM). DWI was used as a monitoring imaging method to assess the response of medical treatment. MATERIALS AND METHODS: 19 patients (mean age, 37+-13.1; age range, 19-69; M/F: 10/9), presented with clinical, laboratory and computed tomography (CT) findings suggestive of IAM were enrolled prospectively in this study...
2016: European Journal of Radiology Open
Jyotindu Debnath, Vivek Sharma, R Ravikumar, Rajesh Kumar, Samar Chatterjee, Santhanan Sampath, Vijay Chandran, Vinay Maurya, Mukul Bhatia
Acute appendicitis (AA) is a common surgical emergency. Accurate and timely diagnosis of AA is essential for successful outcome. Imaging plays an important role in the diagnosis, exclusion of AA as well as diagnosing alternative clinical conditions which can closely simulate AA. A correct alterative diagnosis may obviate the need of unnecessary appendectomy or may even change the treatment regime altogether. This pictorial essay illustrates various clinical conditions which mimicked AA clinically during our day to day practice...
July 2016: Medical Journal, Armed Forces India
Charlotte M H Moriarty, Robert J Baker
General medical conditions are an important part of the differential diagnosis in athletes presenting with pain or injury. A psoas abscess is a collection of pus in the iliopsoas muscle compartment and is a rare cause of hip, low back, or groin pain. Psoas abscesses may have significant morbidity and mortality, as 20% progress to septic shock. Presenting symptoms are generally nonspecific and the onset may be subacute. Clinical presentation may have features suggestive of other diagnoses, including septic hip arthritis, iliopsoas bursitis, and retrocecal appendicitis...
August 19, 2016: Sports Health
Mahdi Alemrajabi, Saeed Safari, Adnan Tizmaghz, Fatemeh Alemrajabi, Ghazaal Shabestanipour
INTRODUCTION: The mainstay of treatment for perforated peptic ulcer is Omental patch closure. With the advent of laparoscopic surgery, this approach is being used for the treatment of perforated peptic ulcer. The aim of this study was to evaluate the outcome of laparoscopy in Firoozgar general hospital over a period of 18 months. The outcome of the laparoscopic approach and the associated morbidity and mortality, operation time, conversion rate and hospital stay were assessed. METHODS: A prospective analysis of 29 consecutive patients (mean age 37...
June 2016: Electronic Physician
Byung Hee Kang, Kyung Chul Yoon, Sung Woo Jung, Gyeo Ra Lee, Hyung Soon Lee
PURPOSE: This study aimed to compare clinical outcomes for single-incision laparoscopic appendectomy (SILA) and conventional laparoscopic appendectomy (CLA) for the treatment of acute appendicitis and to assess the feasibility of performing SILA in a small hospital with limited surgical instruments and staff experience. METHODS: Retrospective record review identified 133 patients who underwent laparoscopic appendectomy from December 2013 to April 2015. Patients were categorized according to the type of appendectomy performed (SILA or CLA)...
August 2016: Annals of Surgical Treatment and Research
Jesper Frølund Laustsen, Ole Steen Bjerring, Øyvind Johannessen, Niels Qvist
INTRODUCTION: The diagnosis and treatment of acute appendicitis during pregnancy is still debated. While laparoscopic appendectomy in general has become the gold standard, this procedure has not generally been implemented for pregnant women. METHODS: We retrospectively reviewed the patient charts of all patients who underwent appendectomy during pregnancy in the period from 2000 to 2012. Open appendectomy (OA) was performed in 25 cases and laparoscopic (LA) in 19...
August 2016: Danish Medical Journal
Samantha Mc Kenzie Stancu, Bogdan Aurelian Popescu, Mircea Beuran
Meckel's Diverticulum is the most common congenital malformation of the gastrointestinal tract with a prevalence of 2 % in the general population, being twice as common and symptomatic in males. Not seldom is the diagnosis made incidentally, upon laparotomy for other intra-abdominal conditions, namely acute appendicitis. Simple Diverticulectomy is the surgical treatment of choice. We present the case of S.M., a 38 year-old male who was admitted to the Surgery Department of the Bucharest Clinical Emergency Hospital for sudden onset of initially periumbilical pain, which later migrated and localized in the right iliac fossa (RIF) accompanied by vomiting after the onset of pain, approximately 24 hours prior to admission...
May 2016: Chirurgia
Salomone Di Saverio, Arianna Birindelli, Micheal D Kelly, Fausto Catena, Dieter G Weber, Massimo Sartelli, Michael Sugrue, Mark De Moya, Carlos Augusto Gomes, Aneel Bhangu, Ferdinando Agresta, Ernest E Moore, Kjetil Soreide, Ewen Griffiths, Steve De Castro, Jeffry Kashuk, Yoram Kluger, Ari Leppaniemi, Luca Ansaloni, Manne Andersson, Federico Coccolini, Raul Coimbra, Kurinchi S Gurusamy, Fabio Cesare Campanile, Walter Biffl, Osvaldo Chiara, Fred Moore, Andrew B Peitzman, Gustavo P Fraga, David Costa, Ronald V Maier, Sandro Rizoli, Zsolt J Balogh, Cino Bendinelli, Roberto Cirocchi, Valeria Tonini, Alice Piccinini, Gregorio Tugnoli, Elio Jovine, Roberto Persiani, Antonio Biondi, Thomas Scalea, Philip Stahel, Rao Ivatury, George Velmahos, Roland Andersson
Acute appendicitis (AA) is among the most common cause of acute abdominal pain. Diagnosis of AA is challenging; a variable combination of clinical signs and symptoms has been used together with laboratory findings in several scoring systems proposed for suggesting the probability of AA and the possible subsequent management pathway. The role of imaging in the diagnosis of AA is still debated, with variable use of US, CT and MRI in different settings worldwide. Up to date, comprehensive clinical guidelines for diagnosis and management of AA have never been issued...
2016: World Journal of Emergency Surgery: WJES
Bianca Alanis-Rivera, Luis Abraham Zúñiga-Vázquez, María Carmen Silva-Escamilla
BACKGROUND: Recent studies considered hyperbilirubinemia as a marker to identify the presence of perforated appendix. The aim of the study is to verify that the presence of hyperbilirubinemia is a useful marker to identify the presence of perforated appendix before surgery, and thereby, provide early treatment to avoid progression of the disease and its complications. METHODS: This is a retrospective study, which identified 225 patients, who met the inclusion and exclusion criteria, from January 2012 to October 2014 at the IMSS General Hospital 29, taking into account laboratory results and postoperative, performing a univariate, bivariate and multivariate analysis...
September 2016: Revista Médica del Instituto Mexicano del Seguro Social
Yingchao Li, Chen Mi, Weizhi Li, Junjun She
BACKGROUND: Acute appendicitis is the most common abdominal emergency, but the diagnosis of appendicitis remains a challenge. Endoscopic retrograde appendicitis therapy (ERAT) is a new and minimally invasive procedure for the diagnosis and treatment of acute appendicitis. AIM: To investigate the diagnostic value of ERAT for acute appendicitis by the combination of colonoscopy and endoscopic retrograde appendicography (ERA). METHODS: Twenty-one patients with the diagnosis of suspected uncomplicated acute appendicitis who underwent ERAT between November 2014 and January 2015 were included in this study...
July 13, 2016: Digestive Diseases and Sciences
Grace Zee Mak, Deborah S Loeff
Acute appendicitis is the most common cause of emergent surgery in children. Historically, surgical dogma dictated emergent appendectomy due to concern for impending perforation. Recently, however, there has been a paradigm shift in both the understanding of its pathophysiology as well as its treatment to more nonoperative management. No longer is it considered a spectrum from uncomplicated appendicitis inevitably progressing to complicated appendicitis over time. Rather, uncomplicated and complicated appendicitis are now considered two distinct pathophysiologic entities...
July 1, 2016: Pediatric Annals
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