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Acute Appendicitis

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5 papers 0 to 25 followers
Robert R Gerard, Barrett A Kielhorn, Brent Petersen, Andrew J Mullard, Laurence E McCahill
BACKGROUND: We sought to decrease organ space infection (OSI) following appendectomy for perforated acute appendicitis (PAA) by minimizing variation in clinical management. OBJECTIVE: A postoperative treatment pathway was developed and four recommendations were implemented: 1) clear documentation of post-operative diagnosis, 2) patients with unknown perforation status to be treated as perforated pending definitive diagnosis, 3) antibiotic therapy to be continued post operatively for 4-7 days after SIRS resolution, and 4) judicious use of abdominal computed tomography (CT) scanning prior to post-operative day 5...
June 10, 2017: American Journal of Surgery
Te-Lu Yap, Yong Chen, Wilson Wei Xin Low, Caroline Choo Phaik Ong, Shireen Anne Nah, Anette S Jacobsen, Liang Shen, Yee Low
AIM: The aim of this study was to develop a new Children's Appendicitis Score (CAS) by combining 3 inflammatory markers and a set of predictors for suspected appendicitis in children. METHODS: 374 children aged 4-16years with suspicion of appendicitis were prospectively enrolled for the derivation cohort. Demographic characteristics, clinical features, laboratory, and histology data were collected. The outcome measure was the histological presence or absence of appendicitis...
December 2015: Journal of Pediatric Surgery
Dario Tartaglia, Andrea Bertolucci, Christian Galatioto, Matteo Palmeri, Gregorio Di Franco, Rita Fantacci, Niccolò Furbetta, Massimo Chiarugi
BACKGROUND: Optimal management of macroscopically normal appendix encountered during laparoscopy for acute abdominal pain is still unclear. METHODS: 164 acute abdominal pain cases in which laparoscopy showed a normal appendix were reviewed. No other intra-peritoneal acute disease was present in 50 patients (Group 1) whereas a miscellanea of intra-peritoneal conditions was identified in the other 114 (Group 2). All the patients underwent appendectomy with specimen examination...
April 2016: International Journal of Surgery
Stephanie F Polites, Mohamed I Mohamed, Elizabeth B Habermann, James L Homme, Jana L Anderson, Christopher R Moir, Michael B Ishitani, Abdalla E Zarroug
BACKGROUND: A diagnostic algorithm for appendicitis in children was created to reduce computed tomography (CT) use owing to the risk of cancer from radiation exposure and cost of CT. This study evaluates the impact of the algorithm on CT use and diagnostic accuracy of appendicitis. METHODS: Patients ≤18 years who underwent appendectomy for suspected appendicitis after presenting to the emergency department for 2 years before and 3 years after algorithm implementation were identified...
August 2014: Surgery
V Sallinen, E A Akl, J J You, A Agarwal, S Shoucair, P O Vandvik, T Agoritsas, D Heels-Ansdell, G H Guyatt, K A O Tikkinen
BACKGROUND: For more than a century, appendicectomy has been the treatment of choice for appendicitis. Recent trials have challenged this view. This study assessed the benefits and harms of antibiotic therapy compared with appendicectomy in patients with non-perforated appendicitis. METHODS: A comprehensive search was conducted for randomized trials comparing antibiotic therapy with appendicectomy in patients with non-perforated appendicitis. Key outcomes were analysed using random-effects meta-analysis, and the quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach...
May 2016: British Journal of Surgery
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