Search results for "appendicitis"

Acute appendicitis: should the laparoscopic approach be proposed as the gold standard? Six-year experience in an Emergency Surgery Unit

2016

Acute appendicitis is common in an Emergency Surgery Unit. Although the laparoscopic approach is a method accepted for its treatment, no strong data are available for determining how many procedures must an experienced surgeon carry out for obtaining all the advantages of this technique and if this approach can become the gold standard in the activity of a general emergency unit with senior surgeons variously skilled on the basic laparoscopy. 142 patients that underwent appendectomy (90 laparoscopic, 52 conventional) for acute appendicitis were enrolled in this institutional retrospective cohort study. The surgeons were classified with a descriptor-based grading and divided in two groups re…

Predictive biomarkers for complicated acute appendicitis: A prospective Ecuadorian study.

2020

The aim of the study was to determine the usefulness of known biomarkers as pre-operative predictors of complicated acute appendicitis (CAA) and perforated appendicitis (PA).This was an observational, analytic, cross-sectional, and prospective study at Hospital Teodoro Maldonado Carbo (August 2016-December 2017). Evaluated biomarkers: white blood cells count, neutrophil percentage (N%), neutrophil-to-lymphocyte ratio, glucose, total bilirubin, C-reactive protein, and procalcitonin (PCT). The statistical analysis was performed by means of the area under the receiver operating characteristics (AUROC) curve estimation. Biomarkers' cutoff point was identified using Youden's index. Sensitivity, …

Changes of protein gene product 9.5 (PGP 9.5) immunoreactive nerves in inflamed appendix.

1995

The existence of chronic appendicitis is controversial. In this prospective study, we investigated possible changes in the innervation of the appendix under different pathological conditions and correlated histological findings with clinical observation. Thirty appendectomy specimens and 14 appendices obtained from organ donors or patients who underwent right hemicolectomy were immediately fixed in Bouin's solution and processed for immunocytochemistry using an antiserum directed against the panneuronal marker protein gene product 9.5 (PGP 9.5). The density of PGP 9.5 immunostaining was evaluated by digitized morphometry. Significant differences in the density of the PGP 9.5-immunoreactive …

Blood sulfur-amino acid concentration reflects an impairment of liver transsulfuration pathway in patients with acute abdominal inflammatory processes

2001

Whole-blood free amino acids were measured in a control group made up of eight healthy women fasted for 12 h and also in eight patients with acute pancreatitis, five patients with acute cholecystitis and seven patients with acute appendicitis. Blood was withdrawn immediately on admission to hospital and again 3 d later following a controlled peripheral parenteral nutrition diet; this is with the exception of the appendicitis group. L-CYSTATHIONINE AND l-methionine concentrations were significantly higher in pancreatitis and appendicitis patients when compared with controls. In the pancreatitis and cholecystitis patients, l-serine concentration was also significantly higher when compared wit…

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis.

2019

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (pro…

Computerized prediction of perforating appendicitis in children.

1989

Push-and-pull enteroscopy using a single-balloon technique for difficult colonoscopy.

2006

Background and study aims Several factors predict difficult or incomplete colonoscopy with a standard colonoscope, including female gender, low body mass index, extensive diverticulosis, and prior pelvic surgery. Patients and methods A push-and-pull enteroscopy device and a single-balloon technique was used in 14 patients (six men, eight women; mean age 62 +/- 15 years) after failure of ileocolonoscopy or endoscopic therapy using either a standard or a pediatric colonoscope. The original ileocolonoscopy had been performed to investigate colon polyps (n = 6), an obscure inflammatory process in the ileocecal region (n = 6), or iron deficiency anemia with a positive fecal occult stool test (n …

Der Einfluß des Operateurs auf die Behandlungsqualität bei akuter Appendicitis

1998

Die Behandlungsqualitat bei akuter Appendicitis wird von der Quote an Appendixperforationen, der Rate entfernter blander Appendices und der perioperativen Morbiditat bestimmt. Im Rahmen einer prospektiven Datenerfassung wurden zwischen 1. 4. 1993 und 30. 7. 1996 alle 271 unter dem Verdacht einer akuten Appendicitis operierten Patienten erfast. Die Rate einer perforierten Appendicitis betrug 3,7 %, bei 19,6 % der Patienten fand sich eine blande Appendix. Bezogen auf den fur die Indikationsstellung verantwortlichen Facharzt ergaben sich keine signifikanten Unterschiede in der Rate an Appendixperforationen, jedoch signifikante Unterschiede der Quote von Patienten mit blander Appendix (6,5–26 %…

Acute appendicitis in a patient with situs viscerum inversus totalis: Role of laparoscopic approach. A case report and brief literature review

2020

Highlights • Abdominal pain due to acute appendicitis in one of the most causes of access to Emergency Room requiring surgical consult and treatment. • The occurrence of anatomical anomalies should be considered especially when clinical and imaging features are misleading. In these cases laparoscopic surgery can be a safe tool in order to confirm uncertain diagnosis. • We report a case of acute appendicitis in a 23-year-old Caucasian men with situs viscerum inversus detected on radiological investigation. • Laparoscopic approach was used to confirm the diagnosis and to perform appendectomy. Trocars placement was tailored for this peculiar case. • Situs viscerum inversus and midgut malrotati…

Physiological parameters for Prognosis in Abdominal Sepsis (PIPAS) Study: a WSES observational study

2019

Timing and adequacy of peritoneal source control are the most important pillars in the management of patients with acute peritonitis. Therefore, early prognostic evaluation of acute peritonitis is paramount to assess the severity and establish a prompt and appropriate treatment. The objectives of this study were to identify clinical and laboratory predictors for in-hospital mortality in patients with acute peritonitis and to develop a warning score system, based on easily recognizable and assessable variables, globally accepted. Background Timing and adequacy of peritoneal source control are the most important pillars in the management of patients with acute peritonitis. Therefore, early pr…