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acute appendicitis classification

Tomoya Ikeda, Junichiro Yamauchi, Kento Miyazaki, Sho Yasuta, Shota Fujita, Mamoru Satoh, Keiichi Shirasaki, Shin Kobayashi, Takashi Ajiki, Katsuo Tsuchihara, Noriko Kondo, Shuichi Ishiyama
A 52-year-old patient presented with epigastric pain.An enhanced CT scan showed a strongly enhanced appendix with abscess formation.Appendectomy was performed under the diagnosis of acute appendicitis with perityphlitic abscess.The stump of the appendix was white and hard, suggesting malignant transformation.Intraoperative frozen sectional examination indicated goblet cell carcinoid(GCC)of the appendix.Thereafter, we performed ileocecal resection with lymphadenectomy (D3).The final pathological diagnosis was GCC, pSS, pN1, Stage III a by the Japanese classification of colorectal carcinoma...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Sofie Tind, Niels Qvist
BACKGROUND: The classification of acute appendicitis (AA) into various grades is not consistent, partly because it is not clear whether the perioperative or the histological findings should be the foundation of the classification. When comparing results from the literature on the frequency and treatment of AA it is important that the classifications are consistent. Furthermore, in the clinical settings, incorrect classification might lead to over diagnosing and a prolonged antibiotic treatment...
January 2017: World Journal of Surgery
Katherine W Gonzalez, Brian G Dalton, Brendan Kurtz, Michael C Keirsey, Tolulope A Oyetunji, Shawn D St Peter
BACKGROUND: Wound classification has catapulted to the forefront of surgical literature and quality care discussions. However, it has not been validated in laparoscopy or children. We analyzed pediatric infection rates based on wound classification and reviewed the most common noninfectious complications which could be a more appropriate measure for quality assessment. METHODS: We performed a retrospective review of 800 patients from 2011 to 2014 undergoing common procedures at a tertiary pediatric hospital...
November 2016: Journal of Pediatric Surgery
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
Matthew P Kronman, Assaf P Oron, Rachael K Ross, Adam L Hersh, Jason G Newland, Adam Goldin, Shawn J Rangel, Scott J Weissman, Danielle M Zerr, Jeffrey S Gerber
BACKGROUND AND OBJECTIVES: Appendicitis guidelines recommend either narrower- or extended-spectrum antibiotics for treatment of complicated appendicitis. The goal of this study was to compare the effectiveness of extended-spectrum versus narrower-spectrum antibiotics for children with appendicitis. METHODS: We performed a retrospective cohort study of children aged 3 to 18 years discharged between 2011 and 2013 from 23 freestanding children's hospitals with an appendicitis diagnosis and appendectomy performed...
July 2016: Pediatrics
Eduardo Sotelo-Anaya, Martha Patricia Sánchez-Muñoz, César Felipe Ploneda-Valencia, Liliana Faviola de la Cerda-Trujillo, Oscar Varela-Muñoz, Carlos Gutiérrez-Chávez, Carlos Rene López-Lizarraga
INTRODUCTION: México is the second place in overweight and obese adults. Acute appendicitis (AA), is the most common indication for an emergency surgery around the world, with an estimated lifetime incidence of 7-14%. Laparoscopic appendectomy (LA) has been described as a safe and good surgery approach for this group of patients. Nevertheless, in México, there is not any evidence supporting these outcomes in our population. METHODS: All the patients that came to the ER from July to December 2014 with age >16-year, body mass index (BMI) > 25 kg/m(2) (overweight) and, BMI >30 kg/m(2) (obese) were included in the study...
August 2016: International Journal of Surgery
David Metcalfe, Olubode Olufajo, Arturo J Rios-Diaz, Adil Haider, Joaquim M Havens, Stephanie Nitzschke, Zara Cooper, Ali Salim
BACKGROUND: Designated trauma centers improve outcomes for severely injured patients. However, major trauma workload can disrupt other care pathways and some patient groups may compete ineffectively for resources with higher priority trauma cases. This study tested the hypothesis that treatment at a higher-level trauma center is an independent predictor for worse outcome after appendectomy. METHODS: An observational study was undertaken using an all-payer longitudinal data set (California State Inpatient Database 2007-2011)...
May 15, 2016: Journal of Surgical Research
Tolulope A Oyetunji, Dani O Gonzalez, Katherine W Gonzalez, Benedict C Nwomeh, Shawn D St Peter
PURPOSE: Surgical wound classification has emerged as a measure of surgical quality of care, but scant data exist in the era of minimally invasive procedures, especially in children. The aim of this study is to examine the surgical site infection (SSI) rate by wound classification during common pediatric surgical procedures. METHODS: A retrospective analysis of the 2013 Pediatric-National Surgical Quality Improvement Program (Peds-NSQIP) dataset was conducted. Patients undergoing pyloromyotomy, cholecystectomy, ostomy reversal, and appendectomy were included...
June 2016: Journal of Pediatric Surgery
Suzanne M Beecher, John Hogan, Donal Peter O''Leary, Ray McLaughlin
BACKGROUND: It remains difficult to distinguish between complicated appendicitis (CAP) and uncomplicated appendicitis (UAP). There is a paucity of studies utilizing inflammatory markers to stratify the severity of acute appendicitis. This study aimed to evaluate and demonstrate the potential clinical utility of inflammatory markers as adjuncts in distinguishing CAP and UAP. METHODS: A comparative observational study was performed. Patients diagnosed with acute appendicitis were categorized as (a) complicated (necrosis, perforation, abscess) and (b) uncomplicated (inflamed, edematous)...
2016: Digestive Surgery
Thomas L Sutton, Etienne E Pracht, David J Ciesla
BACKGROUND: Acute appendicitis (AA) is often studied as a surrogate for acute care surgery. Previous studies have shown differences in outcomes based on insurance status, but associated costs to health care systems are in need of further study. The purpose of the present study was to investigate how treatment, outcomes, and health care resource utilization differ between the uninsured and commercially insured in the setting of AA. METHODS: Patients with AA were identified by International Classification of Diseases, ninth edition, codes using the Agency for Health Care Administration Florida Hospital inpatient discharge data sets for 2002-2011...
March 2016: Journal of Surgical Research
Shu-Yuan Xiao
Most epithelial neoplasms of the vermiform appendix are of mucinous type and can be stratified into 3 main diagnostic categories: (1) adenoma, (2) mucinous neoplasms of uncertain malignant potential or low-grade mucinous neoplasm, and (3) adenocarcinoma. Clinically, appendiceal mucinous adenomas and adenocarcinomas may present as right lower abdominal pain mimicking acute appendicitis, a mass, or pseudomyxoma peritonei. Nomenclature currently in use to describe and diagnose mucinous tumors of the appendix, particularly those of low morphologic grade, varies among surgical pathologists and centers, resulting in different histologic and clinical features being attributed to these entities in the literature...
June 2010: Surgical Pathology Clinics
Go Ohba, Seiichi Hirobe, Koji Komori
Introduction We have succeeded in classifying the severity of appendicitis by evaluating the structure of the submucosal layer and blood flow in the appendix wall with ultrasonography (US). Here, we propose a new preoperative classification system to guide treatment strategy. Materials and Methods Between February 2005 and December 2011, a total of 440 acute appendicitis cases were diagnosed, and 407 met inclusion criteria for this study. US and Doppler findings were used to classify cases as Grade I, IIa, IIb, III, or appendiceal mass...
December 2016: European Journal of Pediatric Surgery
Carlos Augusto Gomes, Massimo Sartelli, Salomone Di Saverio, Luca Ansaloni, Fausto Catena, Federico Coccolini, Kenji Inaba, Demetrios Demetriades, Felipe Couto Gomes, Camila Couto Gomes
Advances in the technology and improved access to imaging modalities such as Computed Tomography and laparoscopy have changed the contemporary diagnostic and management of acute appendicitis. Complicated appendicitis (phlegmon, abscess and/ or diffuse peritonitis), is now reliably distinguished from uncomplicated cases. Therefore, a new comprehensive grading system for acute appendicitis is necessary. The goal is review and update the laparoscopic grading system of acute appendicitis and to provide a new standardized classification system to allow more uniform patient stratification...
2015: World Journal of Emergency Surgery: WJES
Feng-Qin Qi, Bo Zhang
OBJECTIVE: To investigate the significance of C-reactive protein (CRP) in the discrimination of acute appendicitis pathology and its guiding role in the timing of surgery. METHODS: 307 patients in our hospital from July 2012 to December 2013 were selected, who received appendectomy and simultaneous detections of WBC, neutrophil percentage and CRP; and Logistic regression analysis and Roc analysis of these indicators were conducted; Roc curve was drawn. RESULTS: Logistic regression analysis showed that the proportion of neutrophils and CRP were the risk factors to determine gangrenous appendicitis, but the box chart and Roc curves showed that C-reactive protein was superior to neutrophil classification in determining gangrenous appendicitis (areas under the curve were 0...
2015: International Journal of Clinical and Experimental Medicine
Animesh A Singla, Joshua Rajaratnam, Apresh A Singla, Stephanie Wiltshire, Charlotte Kwik, Michelle Smigelski, Mathew J Morgan
INTRODUCTION: Acute appendicitis in the setting of midgut malrotation is uncommon. Midgut malrotation commonly presents within the first month of life. A minority remain asymptomatic and may present with concomitant abdominal pathology making diagnosis difficult. PRESENTATION OF CASE: This paper reports a rare case of a 73-year-old male diagnosed with acute appendicitis and asymptomatic MM .The patient underwent a laparoscopic appendectomy, but had an unplanned return to theatre for washout of post-operative intra-abdominal haematoma...
2015: International Journal of Surgery Case Reports
Aneel Bhangu, Kjetil Søreide, Salomone Di Saverio, Jeanette Hansson Assarsson, Frederick Thurston Drake
Acute appendicitis is one of the most common abdominal emergencies worldwide. The cause remains poorly understood, with few advances in the past few decades. To obtain a confident preoperative diagnosis is still a challenge, since the possibility of appendicitis must be entertained in any patient presenting with an acute abdomen. Although biomarkers and imaging are valuable adjuncts to history and examination, their limitations mean that clinical assessment is still the mainstay of diagnosis. A clinical classification is used to stratify management based on simple (non-perforated) and complex (gangrenous or perforated) inflammation, although many patients remain with an equivocal diagnosis, which is one of the most challenging dilemmas...
September 26, 2015: Lancet
Adrien Randazzo, Anne Kornreich, Bénédicte Lissoir
INTRODUCTION: Clostridium species is a group of anaerobic bacteria constituting the colonic microflora of the intestinal tract. Since molecular methodologies based on 16 rRNA have been established for the classification and the recognition of bacterial species, more than 150 species of Clostridium have been described. Most are considered harmless saprophytes; however, these bacteria may be involved in a wide variety of infections and may be a common cause of enteritis and enterotoxemias in humans...
October 2015: Anaerobe
Phil Hider, Leona Wilson, John Rose, Thomas G Weiser, Russell Gruen, Stephen W Bickler
BACKGROUND: Surgery is a crucial component of health systems, yet its contribution has been difficult to define. We linked national hospital service utilization with national epidemiologic data to describe the use of surgical procedures in the management of a broad spectrum of conditions. METHODS: We compiled International Classification of Diseases-10-Australian Modification codes from the New Zealand National Minimum Dataset, 2008-2011. Using primary cause of admission, we aggregated hospitalizations into 119 disease states and 22 disease subcategories of the World Health Organization Global Health Estimate (GHE)...
July 2015: Surgery
Lütfi Soylu, Oğuz Uğur Aydın, Sezai Aydın, Necdet Özçay
Appendicitis and endometriosis are commonly encountered surgical problems. Endometrial involvement of the appendix is rare and very few cases have been reported in the literature. True diagnosis of appendix invagination is highly difficult due to variable symptoms. Noting the findings which are in favour of invagination in patients diagnosed with acute appendicitis is of great significance in order to be prepared for changing surgical attempts. This case describes a 34 year old female patient diagnosed with infertility who was operated on for acute appendicitis...
2014: Ulusal Cerrahi Dergisi
Luke R Putnam, Shauna M Levy, Galit Holzmann-Pazgal, Kevin P Lally, Kao Lillian S, KuoJen Tsao
BACKGROUND/PURPOSE: Surgical wound class (SWC) is used to risk-stratify surgical site infections (SSI) for quality reporting. We previously demonstrated only 8% agreement between hospital-based SWC and diagnosis-based SWC for acute appendicitis. We hypothesized that education and process-based interventions would improve hospital-based SWC reporting and the validity of SSI risk stratification. METHODS: Patients (<18 years old) who underwent appendectomies for acute appendicitis between January 2011 and December 2013 were included...
June 2015: Journal of Pediatric Surgery
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