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acute appendicitis classification

Nicholas Yock Teck Soh, Nan Zun Teo, Carrie Jen Hsi Tan, Shivani Rajaraman, Marianne Tsang, Calvin Jian Ming Ong, Ramesh Wijaya
BACKGROUND: It is unclear if location of disease matters in perforated diverticulitis. Management guidelines for perforated diverticulitis currently do not make a distinction between right perforated diverticulitis (RPD) and left perforated diverticulitis (LPD). We aim to compare disease presentation and management outcomes between RPD and LPD. METHODS: This was a 10-year retrospective comparative cohort study of 99 patients with acute perforated diverticulitis between 2004 and 2013 in a single institution...
March 12, 2018: International Journal of Colorectal Disease
Katherine J Baxter, Hannah T M H Nguyen, Mark L Wulkan, Mehul V Raval
Importance: The pediatric perforated appendix rate is a quality metric measured by the Agency for Healthcare Research and Quality (AHRQ) that reflects access to care. The association of health care utilization prior to presentation with appendicitis is unknown. Objective: To determine whether increased health care utilization prior to presentation with appendicitis is associated with lower perforated appendicitis rates in children. Design, Setting, and Participants: Retrospective cohort study of privately insured children drawn from large employer and insurance company administrative data found in the Truven MarketScan national insurance claims database...
January 31, 2018: JAMA Surgery
Mengjie Yu, Tianxin Xiang, Xiaoping Wu, Shouhua Zhang, Wenlong Yang, Yu Zhang, Qiang Chen, Shuilin Sun, Baogang Xie
BACKGROUND: The discovery of new metabolic markers may be helpful for early diagnosis of acute pediatric appendicitis (APA). However, no studies have been reported regarding identification of potential metabolic markers for the APA diagnosis by metabonomics. METHODS: Serum samples of APA (n=32), non-appendicitis inflammation (NAI, n=32) and healthy children (HS, n=65) were analyzed by the 1H NMR-based metabonomics. A logistic regression model was established to screen the most efficient markers combinations for classification...
January 8, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
Kim El Hentour, Ingrid Millet, Emmanuelle Pages-Bouic, Fernanda Curros-Doyon, Nicolas Molinari, Patrice Taourel
PURPOSE: To construct a decision tree based on CT findings to differentiate acute pelvic inflammatory disease (PID) from acute appendicitis (AA) in women with lower abdominal pain and inflammatory syndrome. MATERIALS AND METHODS: This retrospective study was approved by our institutional review board and informed consent was waived. Contrast-enhanced CT studies of 109 women with acute PID and 218 age-matched women with AA were retrospectively and independently reviewed by two radiologists to identify CT findings predictive of PID or AA...
February 2018: European Radiology
Jinbeom Cho, Dosang Lee, Kiyoung Sung, Jongmin Baek, Junhyun Lee
PURPOSE: The postoperative treatment after appendectomy is usually decided on the basis of the surgeons' intraoperative findings. Comparatively, the pathologic diagnosis of appendicitis is confirmed several days after the surgery; therefore, it usually does not affect the postoperative treatment strategy. The aim of this study was to investigate the discrepancies between the surgical and pathologic diagnoses of appendicitis and to identify their clinical implication. METHODS: A retrospective observational study was performed in 1,817 patients who underwent 3-port laparoscopic appendectomy for the final diagnosis of appendicitis...
July 2017: Annals of Surgical Treatment and Research
Garth H Utter, Kevin M Schuster, Preston R Miller, Nathan T Mowery, Suresh K Agarwal, Robert J Winchell, Marie L Crandall
No abstract text is available yet for this article.
November 2017: Journal of Trauma and Acute Care Surgery
Cristen N Litz, Jessica B Asuncion, Paul D Danielson, Nicole M Chandler
PURPOSE: Antibiotic administration within one hour prior to incision is a common quality metric; however, antibiotics are typically started at the time of diagnosis in pediatric patients with acute appendicitis. The purpose was to determine if antibiotic administration within one hour prior to incision reduces the incidence of surgical site infections (SSI) in pediatric patients with acute appendicitis started on parenteral antibiotics upon diagnosis. METHODS: A retrospective review was performed of 478 patients aged 0-18years who underwent appendectomy for acute appendicitis from 7/2013 to 4/2015...
May 11, 2017: Journal of Pediatric Surgery
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
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