Appendicitis Research Papers - Academia.edu (original) (raw)

Background: The Coronavirus Disease 2019 (COVID-19) pandemic has impacted volume, management strategies and patient outcomes of acute appendicitis. The aim of this systematic review and meta-analysis was to evaluate whether the COVID-19 pandemic resulted in higher incidence of complicated appendicitis in children presenting with acute appendicitis compared to the pre-COVID-19 period. The secondary aim was to investigate the proportion of the patients treated by non-operative management (NOM). Methods: A systematic search of four scientific databases was performed. The search terms used were (coronavirus OR SARS-CoV-2 OR COVID-19 OR novel coronavirus) AND (appendicitis). The inclusion criteria were all patients aged <18 years and diagnosed with acute appendicitis during the COVID-19 and pre-COVID-19 periods. The proportion of children presenting with complicated appendicitis and the proportion of children managed by NOM was compared between the two groups. The Downs and Black scal...

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- Incidence Geometry, Medicine, Diagnostics, Appendicitis
- by Antonia Lynch
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- Pancreatitis, Causality, Pregnancy, Humans
- by Dr Ketan Vagholkar
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- Surgery, Treatment Outcome, Medicine, Humans

Background and aims Acute appendicitis (AA) is among the most common causes of acute abdominal pain. Diagnosis of AA is still challenging and some controversies on its management are still present among different settings and practice patterns worldwide. In July 2015, the World Society of Emergency Surgery (WSES) organized in Jerusalem the first consensus conference on the diagnosis and treatment of AA in adult patients with the intention of producing evidence-based guidelines. An updated consensus conference took place in Nijemegen in June 2019 and the guidelines have now been updated in order to provide evidence-based statements and recommendations in keeping with varying clinical practice: use of clinical scores and imaging in diagnosing AA, indications and timing for surgery, use of non-operative management and antibiotics, laparoscopy and surgical techniques, intra-operative scoring, and peri-operative antibiotic therapy. Methods This executive manuscript summarizes the WSES gu...

- by Goran Augustin
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- Evidence Based Medicine, Evidence Based Practice, Health Care, Adolescent

BACKGROUND: Appendicitis remains an intriguing disease entity, and there are severe unresolved postulations in the mind of clinicians worldwide. The primary concern is the likelihood of progression to perforation and the potential implications in contemporary African settings. A systematic review study has not been carried out for appendicitis research in Africa. AIM: To examine the literature critically and to present an update on current controversies on acute appendicitis with some particular emphasis on contemporary African settings. METHOD: A review of publications obtained from Medline search, medical libraries, and Google. RESULTS: Twenty-four audits were included in the quantitative analysis. Some were excluded from the subgroup analyses. Negative appendicectomies occurred at a rate of 18 % (488/3 862). Women were more likely to have a negative appendicectomy than men (32% versus 12%, p < 0.02). The perforation rate for appendicectomy patients was 28% (880/3 480), and the mortality rate was 3% (522/3 454). The current global research efforts are focused on the role of 'antibiotics' in the treatment and genetics of acute appendicitis CONCLUSION: Appendicitis remains a significant health challenge in Africa due to the attendant high incidence of perforations and complications. The current trend suggests that a nonsurgical, antibiotic approach in the treatment of uncomplicated appendicitis may be beneficial but remains 'controversial' with very low acceptance in Africa. This article reviews the current 'state of the art' in the evaluation and management of appendicitis that is leading to stratified care for patients, mainly in contemporary African settings.

- by Bamidele Johnson Alegbeleye
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- Pathophysiology, TRENDS, Appendicitis, Appendicectomy

Objectives:-
To emphasize on the problem of delay in the diagnosis and management of paediatric appendicitis .
Methods:- Retrospective study carried out in two Medical Teaching Hospitals , during the period Sept.2003June 2012.
Results:-
The total number of patients were 886. The male : female ratio was 4.5: l. Age ranged between 4-12 years. There were 654-78.8% patients in group -l and 232-26.2 % patients in group -2.There were 193-83.2 % patients in group-2 had medical delay (MD). There were 33- 14.2% had hospital delay (HD) and 6—2.6 % patients had surgical delay (SD).The rate of advanced appendicitis in the first 24 hours was 4.9% , it reach 100% after 48 hours. The quality of primary doctor who first examined the patient and the advices given were assessed. The characteristics of both hospitals where the study was done were also assessed. The mean MD was 30.3 hours , the mean HD was 28.8 hours and the mean SD was 9.0 hours.
Conclusion:-
Diagnosis of appendicitis in children is not always easy. Early recognition of child complains , improving the quality of primary attended doctors and the hospitals dealing with paediatric appendicectomy are of major importance in decreasing the incidence of advanced appendicitis.

- by Dr.Ayman Elhosny
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- Children, Advanced, Appendicitis
- by J Tonet
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- Treatment Outcome, Electrocardiography, Humans, Placebo

- by Andrey Litvin
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- Evidence Based Medicine, Evidence Based Practice, Health Care, Adolescent
- by Boris Sakakushev
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- Evidence Based Medicine, Evidence Based Practice, Health Care, Adolescent

Appendix List of Primers. (XLSX 54 kb)

- by Timothy McCaffrey
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- Pharmacology, Biochemistry, Genetics, Marine Biology
- by Sarah Laditka
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- Program Evaluation, Asthma, Adolescent, Medicine

BACKGROUND: The first laparoscopic procedures were performed well for over thirty years in Europe. Mostly, these include appendectomy and cholecystectomy. However, in Nigeria and other developing countries, the practice commenced only recently and with encouraging results in many centers. Laparoscopic appendectomy (LA) in the low resource setting remains controversial. AIM: We audit the procedures; highlight the cost-saving technique, and the practical skills transfer model for laparoscopic appendectomy performed at Lagoon Hospitals in Lagos, Nigeria. METHODS: We review the hospital records per case of appendectomy done from January 2012 through December 2016 at the Lagoon Hospitals, Lagos - Nigeria. RESULTS: Two hundred and fifty-eight 258 patients were diagnosed with acute appendicitis (AA) within the study period. (Number - n=97; 37.6%) Patients had open appendectomy (OA). Then (n=16; 6.2%) patients that presented with clinical and radiological diagnosis of complicated AA eventually had an open laparotomy. Meanwhile, (n=145; 56.2%) cases had LA. In the laparoscopy group, (n=4; 1.6%) patients who had initial diagnostic laparoscopy revealed a normal appendix in addition to other operative findings that precluded appendectomy. Subsequently, an estimated (n=141; 54.6%) patients underwent LA, for which conversion to open laparotomy was inadvertently required in (n=2; 0.8%) of these cases. The median time for the LA procedure was higher than that observed for OA (49.5 vs. 34.5 min). Patients in the LA group had a shorter median postoperative stay (1.5 vs. 2.5 days). CONCLUSION: LA reduced the rate of unnecessary appendectomy, and postoperative hospital stays in our patients, potentially reducing crowding in our surgical wards. The complications were very similar to those seen in other facilities elsewhere. LA is safe, average cost, and gradually gaining acceptance among Surgeons in Nigeria. For effective training of qualified surgeons on site, short but repetitive hands-on training sessions has been advocated as appropriate. LA is achievable in resource-constrained settings

Background: Neutrophil to lymphocyte ratio (NLR) is one of the tools to differentiate complicated and uncomplicated acute appendicitis (AA) preoperatively. However there is a considerable difference in the cutoff values of NLR in different studies. This study aimed to establish a cutoff value of NLR to distinguish complicated AA from uncomplicated AA preoperatively at our center. Methods: This was a prospective observational study conducted over 2 years from January 2017 to December 2019 in the department of surgery, Chitwan Medical College Bharatpur. Patients with a provisional diagnosis of AA and undergoing appendectomy were included in the study. The difference in NLR between the two groups was compared by Mann-Whitney U-test. The predictive ability of NLR was estimated by the receiver operating characteristic (ROC) curve analysis. Results: One hundred eighty-eight patients were included in the study, 112 patients were males and 76 were females. Among them, 29.2% (n=55) were co...

- by anup shrestha
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- Medicine, Clinical Sciences, Acute Appendicitis, Neutrophil to lymphocyte ratio

De Garengeot hernia is defined as femoral hernia containing appendix. An acute appendicitis in a femoral hernia is a extremely unusual surgical finding and occurs in 0.08%-0.013% of all cases. We report the case of an elderly woman, who presented with a typical clinical image of incarcerated femoral hernia and underwent open surgery. An infrainguinal incision was performed and after the dissection of hernia sac, an acute appendicitis within femoral hernia was revealed. Subsequently, appendectomy and hernioplasty were performed. Acute appendicitis within femoral hernia should be included in differential diagnosis of patients presenting with clinical signs of an incarcerated femoral hernia and prompt surgical treatment is essential in order to avoid severe complications.

- by George Pappas-Gogos
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- Medicine, General Surgery, Clinical Sciences, Inguinal Hernia
- by Timothy McCaffrey
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- Genetics, Computational Biology, Biomarkers, Humans

Major surgical societies advised using non-operative management of appendicitis and suggested against laparoscopy during the COVID-19 pandemic. The hypothesis is that a significant reduction in the number of emergent appendectomies was observed during the pandemic, restricted to complex cases. The study aimed to analyse emergent surgical appendectomies during pandemic on a national basis and compare it to the same period of the previous year. This is a multicentre, retrospective, observational study investigating the outcomes of patients undergoing emergent appendectomy in March-April 2019 vs March-April 2020. The primary outcome was the number of appendectomies performed, classified according to the American Association for the Surgery of Trauma (AAST) score. Secondary outcomes were the type of surgical technique employed (laparoscopic vs open) and the complication rates. One thousand five hundred forty one patients with acute appendicitis underwent surgery during the two study periods. 1337 (86.8%) patients met the inclusion criteria: 546 (40.8%) patients underwent surgery for acute appendicitis in 2020 and 791 (59.2%) in 2019. According to AAST, patients with complicated appendicitis operated in 2019 were 30.3% vs 39.9% in 2020 (p = 0.001). We observed an increase in the number of post-operative complications in 2020 (15.9%) compared to 2019 (9.6%) (p < 0.001). The following determinants increased the likelihood of complication occurrence: undergoing surgery during 2020 (+ 67%), the increase of a unit in the AAST score (+ 26%), surgery performed > 24 h after admission (+ 58%), open surgery (+ 112%) and conversion to open surgery (+ 166%). In Italian hospitals, in March and April 2020, the number of appendectomies has drastically dropped. During the first pandemic wave, patients undergoing surgery were more frequently affected by more severe appendicitis than the previous year's timeframe and experienced a higher number of complications. Trial registration number and date: Research Registry ID 5789, May 7th, 2020.

- by Teresa Perra and +1
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- Surgery, General Surgery, Cirugia, Chirurgia

Objective: To evaluate the diagnostic accuracy of Alvarado score for the prediction of acute appendicitis. Study Design: Analytical study. Place and Duration of Study: This study was carried out in the Department of Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad, during the period from January 15, 2009 to July 15, 2010. Methodology: The study included all adult patients of either gender who presented with clinical findings suggestive of acute appendicitis, who were assigned Alvarado score of < 4 pre-operatively and subsequently underwent emergency appendicectomy with histological examination of the resected specimens. Based on the Alvarado score, the patients were stratified into two groups. i.e. Group I (with a score of > 7) and Group II (with a score of 5-7). Alvarado score was compared with the histopathology. The data was subjected to statistical analysis to measure the objective. Results: The overall sensitivity, specificity, positive predictive value a...

- by Syed jameel Shah
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- Medicine, Acute Appendicitis, Alvarado score, Appendicitis
- by Ferdinando Agresta
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- Treatment Outcome, Adolescent, Medicine, Italy

The acute appendicitis necessitates emergency abdominal surgery and in the past decade, sonography has gained acceptance for examining patients with acute abdominal pain. Sonographic imaging is dynamic, noninvasive, rapid, inexpensive and readily accessible. Manual analysis of sonographic image is a tedious process and consumes enormous time. The authors aim at design and development of an automatic system that would detect acute appendicitis by taking sonographic images as input. This paper describes the image mining system that automates the diagnosis of acute appendicitis with significant time reduction. The experimentation methods, results of the testing using real data are detailed in this paper. The data set of 21 patients’ sonographic images collected from a reputed hospital in India has been used as input. It is concluded that an algorithm integrating region based segmentation and euclidean distance method yields accurate results in diagnosing

- by Devi Thirupathi
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- Ultrasound, Euclidean Distance, Manhattan Distance, Appendicitis
- by Sarath Sistla and +1
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- Risk, Treatment Outcome, Adolescent, Prospective studies
- by Abdul-Wahed Meshikhes
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- Humans, Clinical Sciences, Time Factors, Appendectomy

Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis. The aim of this study is to describe the worldwide clinical and diagnostic work-up and management of AA in surgical departments. This prospective multicenter observational study was performed in 116 worldwide surgical departments from 44 countries over a 6-month period (April 1, 2016-September 30, 2016). All consecutive patients admitted to surgical departments with a clinical diagnosis of AA were included in the study. A total of 4282 patients were enrolled in the POSAW study, 1928 (45%) women and 2354 (55%) men, with a median age of 29 years. Nine hundred and seven (21.2%) patients underwent an abdominal CT scan, 1856 (43.3%) patients an US, and 285 (6.7%) patients both CT scan and US. A total of 4097 (95.7%...

- by ashraf abbas
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- Treatment Outcome, Medicine, Prospective studies, Humans
- by Mark Sagarin
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- Medicine, Humans, Female, Clinical Sciences

- by M. Zese
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- Surgery, General Surgery, Cirugia, Chirurgia
- by Mark Davenport
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- Gastroenterology, Neonatal Necrotizing Enterocolitis, Humans, Child
- by Sarah Weihmiller
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- Pediatrics, Forecasting, Medicine, Diarrhea

BACKGROUND: Appendiceal orifice inflammation (AOI) is a common ‘skip lesion’ in patients with ulcerative colitis (UC). However, other skip lesions are less well known.OBJECTIVE: To evaluate the atypical distribution of UC lesions, other than AOI, in terms of their frequency, pattern, risk factors and prognostic implications.METHODS: A retrospective analysis of colonoscopic findings and clinical course of 240 adult UC patients who were initially diagnosed at Asan Medical Center (Seoul, South Korea) was performed.RESULTS: Of 240 patients, 46 (19.2%) showed an atypical distribution of lesions at initial colonoscopy: eight (3.3%) had rectal sparing (segmental-type UC); and 38 (15.8%) had patchy/segmental skip lesions other than AOI. Skip lesions were detected more frequently in proximal segments of the colon than in distal segments (P=0.001). An atypical distribution was more common in patients with AOI (31.3%) than in those without AOI (10.6%; P<0.001). The clinical course of patien...

- by Suk-kyun Yang
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- Adolescent, Medicine, Inflammatory Bowel Disease, Humans

MATERIALS AND METHODS: Ninety-five consecutive patients underwent two unenhanced multidetector row CT examinations with 4 × 2.5-mm collimation, 120 kVp, and 30 and 100 effective mAs. Two radiologists independently read the images... more

- by Viviane de Maertelarr
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- Radiology, Nuclear medicine, Adolescent, Comparative Study

BACKGROUND Acute appendicitis is one of the commonest abdominal emergencies and appendectomy. is one of the commonest emergency procedures performed all over the world. The study was done with an objective to evaluate the different causative factors for delayed presentation of appendicitis. METHODS This cross-sectional study was carried out in the Surgical "C" unit, at Ayub Teaching Hospital, Abbottabad, Pakistan from 20th June 2013 to 19th June 2014. A total of 130 patients presented with appendicitis in OPDs or emergency department. Detailed history, general physical and systemic examination especially abdominal examination was done along with investigations. RESULTS It was found that 23.08% of complicated appendicitis presentation is due to missed diagnosis by physicians, 30.77% is due to missed diagnosis by non-doctors, 23.08% is due to conservative management at DHQ hospitals by surgeons, and 23.08% presented late because of self-medication at home. CONCLUSION All pat...

- by Salma Ghaffar
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- Pakistan, Medicine, Humans, Female

Classic symptoms of appendicitis include right lower quadrant pain on palpation, loss of appetite, nausea and vomiting. However, only about half of patients present with these characteristic symptoms. The remainder of patients must undergo some type of diagnostic study to verify or rule out appendicitis. This article describes the types of medical imaging that are used to evaluate possible appendicitis, including conventional abdominal radiography, ultrasound, computed tomography and nuclear medicine imaging.

- by Audrey Harris
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- Humans, Radiologic Technology, Differential Diagnosis, Diagnostic Imaging

HASTINGS CENTER REPORT 35 November-December 2009 patient��who, by this time, had been admitted to the hospital with signs of evolving sepsis. And when the CT was finally done eighteen hours after it had been requested by the attending... more

- by Anne Lyerly
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- Philosophy, Applied Ethics, Decision Making, Depression

Chronic abdominal Pain in children is a very common cause of hospital admission. Many of them are discharged without a diagnosis even after battery of investigations. Laparoscopy plays a significant role in diagnosis and management of many causes of acute and chronic abdominal pain. The purpose of this study was to determine the efficacy of laparoscopy as an efficient diagnostic and management tool in children with chronic abdominal pain. A descriptive, prospective case series was collected in the department of Paediatric surgery Mayo's Hospital Lahore, over the period of 5 years between Jan 2007-Dec 2013. The data of consecutive 50 patients, who were admitted in the department with the diagnosis of chronic abdominal pain, was recorded. All patients who had 2-3 admissions in hospital for last 2 months and failed to establish a definitive diagnosis after clinical examination and base line investigations underwent laparoscopy. The details of associated symptoms, finding of laparos...

- by Nabila Talat
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- Prospective studies, Humans, Child, Female
- by Robert mindelzun
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- Kidney diseases, Colic, Humans, Female
- by Torrey Laack
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- Medicine, Humans, Female, Male
- by Mustafa Selçuk
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- Polysaccharides, Adolescent, Humans, Child
- by susan bewley
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- Informed Consent, Adolescent, Family Practice, Emotions
- by Andrew J A Holland
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- Adolescent, Humans, Child, Female

The clinical presentation of cute appendicitis is rarely encountered in neonatology. When it does occur, it is thought to be due to prematurity or develops secondary to coexisting diseases. We present a case of appendicitis in a 10-day-old Middle-Eastern girl, who was born at term and who had no underlying conditions that are typically associated with neonatal appendicitis. This case highlights that certain causes and clinical signs are unreliable when coming to a working diagnosis of neonatal appendicitis, and that regardless of the cause, timely detection and management are necessary in achieving surgical success.

- by B.h. Ayoub
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- Humans, Female, Differential Diagnosis, Newborn Infant
- by Kirien Kjossev
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- Humans, Male, Adult, Appendectomy
- by Mónica Solar
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- Bioinformatics, English language, Cancer, Life Sciences
- by Lodewijk Cobben
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- Magnetic Resonance Imaging, Abdominal Imaging, Prospective studies, Humans
- by Michael Tunik
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- Humans, Female, Male, Clinical Sciences

- by Adamu Ahmed
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- Treatment Outcome, Prospective studies, Humans, Hospitalization
- by Katherine Virgo
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- Surgery, Survival Analysis, Adolescent, Humans
- by Robert Jeffrey
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- Adolescent, Prospective studies, Humans, Child

Objective: To evaluate the diagnostic accuracy of ultrasound in acute appendicitis in comparison with Alvarado score keeping histopathological correlation as gold standard. Study Design: Comparative cross-sectional study. Place and Duration of Study: Departments of Radiology, Surgery and Pathology of PIMS Hospital, Islamabad, from Jan 2018 to Oct 2018. Methodology: Patients that were Alvarado positive or either ultrasound positive were included in the study followed by appendectomy. Removed appendix was sent for histopathological examination. The results were entered in structured proformas. Results: Out of 200 patients, 117 (58.5%) were male patients while 83 (41.55%) were females. Mean age of the patients was 22.6 ± 3.1 year with range 9 to 55 years. Mean Alvarado score of patients was found to be 9.1 with maximum score 10 and minimum score of 7. Among ultrasound findings, 192 (96%) patients had appendix with diameter >6mm. Ninety two (46%) patients had free fluid, 186 (93%) pa...

- by Dr.Rehana Khadim
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- Radiology, Medicine, Acute Appendicitis, Appendicitis
- by Tuomo Rantanen
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- Adolescent, Medicine, Humans, Female

The aim of this randomized, double-blind clinical trial was to determine the effectiveness of systemic antibiotic application followed by either topical ionized solution (IS) or topical saline solution (placebo) as surgical site infection (SSI) prophylaxis in appendectomy for non-perforated appendicitis. Prophylactic antibiotic was administered pre-incision and either topical IS or placebo was applied pre-suturing to 529 patients, who were then monitored for 30 days. When topical IS was used, SSI relative risk was 0.739 (95% CI 0.537, 1.019) and the SSI prevention rate was 26.06% (CI −1.8%, 46.3%). The number needed to treat was 14.80 patients and the number needed to harm was 209 in order for SSI to be avoided. In conclusion, there was a trend for topical IS prophylaxis to reduce SSI frequency in patients undergoing appendectomy for non-perforated appendicitis, but the result was not statistically significant.

- by Valery Melnikov
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- Treatment Outcome, Adolescent, Medicine, Humans

- by Fatih Altintoprak
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- Treatment Outcome, Medicine, Prospective studies, Humans