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appendiceal abscess

Frederico José Ribeiro Teixeira, Sérgio Dias do Couto Netto, Eduardo Hiroshi Akaishi, Edivaldo Massazo Utiyama, Carlos Augusto Metidieri Menegozzo, Marcelo Cristiano Rocha
INTRODUCTION: Acute appendicitis is significantly common. Despite the increased use of computed tomography, the number of perforated cases has been stable in the past three decades. Between 2% and 6% of patients with acute appendicitis present appendiceal mass, often described as inflammatory phlegmon or abscess. Malignant tumors are confirmed by pathological analysis in 0.9-1.4% of all appendectomies performed to treat acute appendicitis. However, recent series demonstrate an elevated incidence of malignancies, ranging from 5...
2017: World Journal of Emergency Surgery: WJES
Maria Leonarda Altieri, Guglielmo Niccolò Piozzi, Pierluigi Salvatori, Maurizio Mirra, Gaetano Piccolo, Natale Olivari
INTRODUCTION: Appendiceal diverticulitis is a rare pathology that mimics acute appendicitis. Appendiceal diverticula are classified into congenital and acquired with difference in incidence and pathogenesis. Appendiceal diverticulitis is often overlooked because of mildness of symptomatology with increasing risk of complications, such as perforation. Appendiceal diverticula are often associated to higher risk of neoplasm especially carcinoid tumors and mucinous adenomas. PRESENTATION OF CASE: A 40-year-old caucasic male presented into Emergency Room with right lower quadrant pain associated with vomit, abdominal tenderness, fever and moderate leukocytosis (11...
February 20, 2017: International Journal of Surgery Case Reports
Emin Kose, Abdullah Sisik, Mustafa Hasbahceci
Amyand's hernia is defined as protrusion of the vermiform appendix in an inguinal hernia sac. It is a rare entity with variable clinical presentation from normal vermiform appendix to abscess formation due to perforation of acute appendicitis. Although surgical treatment includes appendectomy and hernia repair, appendectomy in the absence of an inflamed appendix and use of a mesh in cases of appendectomy remain to be controversial. The aim of this study was to review the experience of mesh inguinal hernia repair plus appendectomy performed for Amyand's hernia with noninflamed appendices...
2017: Surgery Research and Practice
Cameron E Gaskill, Vlad V Simianu, Jonathan Carnell, Daniel S Hippe, Puneet Bhargava, David R Flum, Giana H Davidson
PURPOSE: Urgent appendectomy has long been the standard of care for acute appendicitis. Six randomized trials have demonstrated that antibiotics can safely treat appendicitis, but approximately 1 in 4 of these patients eventually requires appendectomy. Overall treatment success may be limited by complex disease including perforation. Patients׳ success on antibiotic therapy may depend on preoperative identification of complex disease on imaging. However, the effectiveness of computed tomography (CT) in differentiating complex disease including perforated from nonperforated appendicitis remains to be determined...
December 7, 2016: Current Problems in Diagnostic Radiology
Paul Anthony Karam, Amy Hiuser, David Magnuson, Federico Gian Filippo Seifarth
Transumbilical laparoscopic assisted appendectomy combines laparoscopic single port dissection with open appendectomy after exteriorization of the appendix through the port site. Compared to the conventional three-port approach, this technique provides an alternative with excellent cosmetic outcome. We developed a safe and effective technique to perform an intracorporeal single port appendectomy, using the same laparoscope employed in the extracorporeal procedure. Retrospective review of 71 consecutively performed intracorporeal single port appendectomies and 30 conventional three-port appendectomies in children 6 to 17 years of age...
December 20, 2016: La Pediatria Medica e Chirurgica: Medical and Surgical Pediatrics
Byeong Geon Jeon, Hyuk Jung Kim, Kuk Hyun Jung, Sang Wook Kim, Jin Soo Park, Ki Ho Kim, Il Dong Kim, Sang-Jeon Lee
INTRODUCTION: To our knowledge, this study is the first to identify the predictive factors and outcomes of prolonged operative time associated with laparoscopic appendectomy. We aimed to identify preoperative factors that influence operation time and to determine how operative time affects laparoscopic appendectomy outcomes. METHODS: The medical records of 3049 patients who had undergone laparoscopic appendectomy between January 2008 and December 2014 were retrospectively reviewed...
December 2016: International Journal of Surgery
Chih-Cheng Luo, Kuang-Fu Cheng, Chen-Sheng Huang, Hung-Chieh Lo, Sheng-Mao Wu, Hung-Chang Huang, Wen-Kuei Chien, Ray-Jade Chen
BACKGROUND: In this study, we studied the therapeutic effectiveness of percutaneous drainage with antibiotics and the need for an interval appendectomy for treating appendiceal abscess in children with a research-oriented dataset released by the Bureau of National Health Insurance in Taiwan through the Collaboration Center for Health Information Application (CCHIA). METHODS: We identified 1225 patients under 18 years of age who had non-surgical treatment for an appendiceal abscess between 2007 and 2012 in a Taiwan CCHIA dataset...
October 18, 2016: BMC Surgery
Piriyankan Ananthavarathan, Kamlesh Patel, Catherine Doran, Nigel Suggett
INTRODUCTION: Atraumatic splenic rupture is a rare surgical emergency that is often attributed to neoplastic or infectious causes. Rarely, it has been identified to also occur in the setting of an acute severe sepsis and in cases of pelvic or splenic abscess formation post-appendicectomy. However, to our knowledge, the co-presentation of acute appendiceal abscess and splenic rupture has not been previously described. PRESENTATION OF CASE: We present the case of a 67-year old male with decompensating haemorrhagic shock secondary to atraumatic splenic rupture on a background of an inadequately treated complicated appendicitis originally managed as diverticulitis with antibiotics in the community...
April 13, 2016: International Journal of Surgery Case Reports
Caroline E Reinke, Lawrence E Tabone, Philip Fong, Jin S Yoo, Chan W Park
BACKGROUND AND OBJECTIVES: Laparoscopic appendectomy remains one of the most common emergency general surgical procedures in the United States. In an era of increasing focus on costs in medical care, we sought to evaluate the use of polymeric clips to secure the appendiceal base during laparoscopic appendectomy. METHODS: We performed a prospective cohort study of patients undergoing laparoscopic appendectomy from April 2013 through September 2014 at a single academic teaching institution...
July 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Martin Salö, Emil Järbur, Mette Hambraeus, Bodil Ohlsson, Pernilla Stenström, Einar Arnbjörnsson
BACKGROUND: The aim of the study was to describe the technique of two-trocar laparoscopic appendectomy and compare the outcome between two- and three-trocar techniques in children. METHODS: All children who underwent laparoscopic surgery for suspected appendicitis from 2006 to 2014 in a center for pediatric surgery were included in the study. Converted surgeries and patients with appendiceal abscess or concomitant intestinal obstruction were excluded. A total of 259 children underwent appendectomy with either two (35 %) or three (65 %) laparoscopic trocars according to the surgeons' preference and intraoperative judgment...
August 4, 2016: BMC Surgery
Hiroyuki A Watanabe, Taketoshi Fujimoto, Yo Kato, Mayumi Sasaki, Toshikazu Ikusue
A man in his early thirties presented to our clinic with right lower abdominal pain. Computed tomography (CT) and ultrasonography (US) revealed a swollen appendix and an appendicolith. Abscess formation was not observed but ongoing appendiceal rupture was not ruled out. Three months after successful conservative therapy, the lumen of the apical portion was kept dilated and laparoscopic interval appendectomy was performed. No tumorous findings were observed macroscopically. However, histology revealed many tiny nests infiltrating the submucosa, muscular layer, and subserosa at the root of the appendix...
August 2016: Clinical Journal of Gastroenterology
Christopher Soll, Paloma Wyss, Hans Gelpke, Dimitri Aristotle Raptis, Stefan Breitenstein
PURPOSE: Polymeric clips (hem-o-lok ligation system) are a novel alternative for securing the base of the appendix during laparoscopic appendectomy. There is a lack of systematic evaluation of polymeric clips to close the appendiceal stump with regard to postoperative intra-abdominal abscesses. The aim of this study was to compare the hem-o-lok ligation system with conventional devices. METHODS: The outcome of 813 consecutive patients, operated between 2009 and 2013 receiving laparoscopic appendectomy either with hem-o-look or endoloop for acute appendicitis, was analysed...
August 2016: Langenbeck's Archives of Surgery
David Mills, Bazak Sharon, Kari Schneider
Tubo-ovarian abscess (TOA) in non-sexually active female adolescents is a rare presentation to the pediatric emergency department. In the following case, bilateral TOA secondary to Streptococcus constellatus was diagnosed in a 13-year-old virginal female. The patient was seen 4 months before presentation for interventional radiology-guided drainage and antibiotic treatment for an intra-abdominal abscess due to suspected appendiceal rupture. Exploratory laparotomy on the most recent presentation demonstrated an appendix with inflammation and serositis on pathology report, a concern for chronic appendicitis with microperforation and subsequent bacterial translocation of the bilateral ovaries...
June 2, 2016: Pediatric Emergency Care
P Horvath, J Lange, R Bachmann, F Struller, A Königsrainer, M Zdichavsky
BACKGROUND: Laparoscopic appendectomy is now the treatment of choice in uncomplicated appendicitis. To date its importance in the treatment of complicated appendicitis is not clearly defined. METHODS: From January 2005 to June 2013 a total of 1762 patients underwent appendectomy for the suspected diagnosis of appendicitis at our institution. Of these patients 1516 suffered from complicated appendicitis and were enrolled. In total 926 (61 %) underwent open appendectomy (OA) and 590 (39 %) underwent laparoscopic appendectomy (LA)...
January 2017: Surgical Endoscopy
Mazhar Khalil, Peter Rhee, Tahereh Orouji Jokar, Narong Kulvatunyou, Terence O'Keeffe, Andrew Tang, Ahmed Hassan, Lynn Gries, Rifat Latifi, Bellal Joseph
BACKGROUND: Emerging literature in acute appendicitis favors the nonoperative management of acute appendicitis. However, the actual use of this practice on a national level is not assessed. The aim of this study was to assess the changing trends in nonoperative management of acute appendicitis and its effects on patient outcomes. METHODS: We did an 8-year (2004-2011) retrospective analysis of the National Inpatient Sample database. We included all inpatients with the diagnosis of acute appendicitis...
June 2016: Journal of Trauma and Acute Care Surgery
Ghaleb Darwazeh, Steven C Cunningham, Gopal C Kowdley
Patients with appendiceal abscess or phlegmon have been traditionally managed with antibiotics and radiologically guided drainage of the abscess. Many studies have questioned the need for interval appendectomy. A systematic review of the nonsurgical treatment of patients with an appendiceal abscess or phlegmon was undertaken. The rate of recurrence after nonsurgical management, morbidity and length of hospital stay was measured. PubMed and Cochrane databases were queried to identify 21 studies reporting the morbidity of nonsurgical treatment of appendiceal phlegmon or abscess, and five studies reporting the morbidity of performing interval appendectomy...
January 2016: American Surgeon
Nurith Hiller, Tal Fux, Anna Finkelstein, Haggi Mezeh, Natalia Simanovsky
To investigate which clinical, laboratory, and CT findings potentially facilitate the differential diagnosis between tubo-ovarian abscess (TOA) and periappendicular abscess (PAA), we retrospectively reviewed abdominal CT examinations and medical records for all women who presented to our medical center with unilateral right pelvic abscess formation who underwent CT evaluation from 2004-2014. A wide spectrum of clinical data and imaging findings were recorded. CT diagnoses were made in consensus by two experienced body radiologists blinded to the final diagnosis...
April 2016: Emergency Radiology
Mohammad Reza Vahdad, Matthias Nissen, Alexander Semaan, Tobias Klein, Emanuel Palade, Thomas Boemers, Hamid Reza Foroutan, Ralf-Bodo Troebs, Grigore Cernaianu
PURPOSE: To evaluate the outcome of laparoendoscopic single-site (LESS-A) through one transumbilical port vs. 3-port laparoscopic (3TA) appendectomy in children. METHODS: We reviewed the records of 309 children (65 LESS-A, 244 3TA) operated on between 2008 and 2012. One hundered forty-nine patients had acute catarrhalis (CA), 133 phlegmonous (PLA), and 27 perforated appendicitis (PA). We compared the duration of operation (DO) the incidence of abdominal abscesses (AA) and wound infections (WI), as well as the degree of appendiceal inflammation (DI) among surgeons with and without board certification...
January 2016: Archives of Iranian Medicine
David C Levin, David Eschelman, Laurence Parker, Vijay M Rao
PURPOSE: To compare recent trends in the use of percutaneous and surgical approaches to treating abdominal abscesses in a large population. METHODS: The nationwide Medicare Physician/Supplier Procedure Summary Master Files for 2001 through 2013 were searched. Current Procedural Terminology-4 codes were selected for the four types of abdominal abscesses that had distinct codes for both open surgical and percutaneous drainage-appendiceal, peritoneal, subphrenic, and liver...
December 2015: Journal of the American College of Radiology: JACR
Tae Hyung Kim, Byung Sun Cho, Jae Hag Jung, Moon Soo Lee, Je Ho Jang, Chang Nam Kim
PURPOSE: Recently, randomized controlled trials have reported that conservative therapy can be a treatment option in patients with noncomplicated appendicitis. However, preoperative diagnosis of noncomplicated appendicitis is difficult. In this study, we determined predictive factors to distinguish patients with noncomplicated appendicitis from those with complicated appendicitis. METHODS: A total of 351 patients who underwent surgical treatment for acute appendicitis from January 2011 to December 2012 were included in this study...
October 2015: Annals of Coloproctology
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