The current management of acute uncomplicated appendicitis: should there be a change in paradigm? A systematic review of the literatures and analysis of treatment performance

Appendectomy has long been the mainstay of intervention for acute appendicitis, aiming at preventing perforation, peritonitis, abscess formation and recurrence. With better understanding of the disease process...
Source: World Journal of Emergency Surgery - Category: Emergency Medicine Authors: Tags: Review Source Type: research

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ConclusionsThe initial diagnosis and surgical management of such patients is challenging due to an atypical presentation. The surgical management of such patients is discussed with a brief review of the literature.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
This study is a prospective, multicenter, parallel-group, randomized (1:1), double-blinded, placebo-controlled, phase III non-inferiority study with blind evaluation of the primary efficacy criterion. The primary objective is to evaluate the impact of the absence of post-operative antibiotic therapy on the organ/space surgical site infection (SSI) rate in patients presenting with CAA (other than in cases of generalized peritonitis). Patients in the experimental group will receive at least one dose of preoperative and perioperative antibiotic therapy (2  g ceftriaxone by intravenous injection every 24 h up to ...
Source: Trials - Category: Research Source Type: clinical trials
AbstractBackgroundIntra-abdominal abscesses (IAA) may develop after laparoscopic appendectomies (LA) for acute appendicitis. The identification of risk factors for postoperative IAA could lead to a decrease in the readmission rate and surgery redoes after LA for acute appendicitis.Materials and methodsThe present study retrospectively analyzed patients undergone LA for acute appendicitis during the period 2001 –2017. Clinical, intraoperative, and postoperative outcomes were described. Comparison between groups was made via univariate and multivariate analyses.ResultsThe charts of 2076 patients undergone LA were revie...
Source: Updates in Surgery - Category: Surgery Source Type: research
The objective of this study is to compare laparoscopic (LA) and open appendectomy (OA) for the management of diffuse peritonitis caused by AA. This is a prospective multicenter cohort study, including 223 patients with diffuse peritonitis from perforated AA, enrolled in the Physiological parameters for Prognosis in Abdominal Sepsis (PIPAS) study from February to May 2018. Two groups were created: LA  = 78 patients, mean age 42.51 ± 22.14 years and OA = 145 patients, mean age 38.44 ± 20.95 years. LA was employed in 34.98% of cases. There was no ...
Source: Updates in Surgery - Category: Surgery Source Type: research
ConclusionOur case report illustrates the significance in identifying atypical features of appendicitis, broadening the differential of non-specific abdominal pain in pediatric patients, and depending on the clinical situation, ruling out other potential intra-abdominal infections even in the presence of a true urinary tract infection.
Source: International Journal of Emergency Medicine - Category: Emergency Medicine Source Type: research
This study aimed to determine the effects of interval appendectomy from the perspective of long-term follow-up.MethodsA retrospective review of patients with complicated appendicitis between 2010 and 2017 was performed. The medical records of 471 patients with initial non-operative therapy and 377 patients treated with emergency appendectomy who served as controls were reviewed. Propensity score matching was performed to adjust for any potential selection bias in the two strategies. A comparison of the clinical outcomes, including short- and long-term postoperative complications, was conducted in the 348 matched patients.R...
Source: European Journal of Trauma and Emergency Surgery - Category: Emergency Medicine Source Type: research
ConclusionAlthough rare, imperforate hymen with retrograde menstruation that causes dilatation of the vagina and uterus (i.e., hematocolpometra) is an important consideration in the differential diagnosis of abdominal pain in premenarchal females with abdominal pain. It is easily diagnosed by physical examination. However, if patient or parents refuse genital exam evaluation, imaging studies can greatly help with diagnosis. Ultrasound will show an echogenic fluid accumulation in the vagina that can extend to uterus.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
Conclusions: There is a relationship between the non-use of drains and collections and evisceration in post-operative patients with open appendectomy, by complicated acute appendicitis. PMID: 31448803 [PubMed - in process]
Source: Cirugia y Cirujanos - Category: Surgery Authors: Tags: Cir Cir Source Type: research
ConclusionsOur results demonstrate that urgent laparoscopic surgeries in the third trimester of pregnancy are feasible, and they can be safely performed with minimal risk for the patient and fetus. Larger prospective studies are required to validate these recommendations.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
Conclusions: The conversion rate to CLA was 15.9%. Serum C-reactive protein level and complicated appendicitis were strong predictive factors for conversion from SPLA in acute appendicitis. PMID: 31118987 [PubMed]
Source: Videosurgery and Other Miniinvasive Techniques - Category: Surgery Tags: Wideochir Inne Tech Maloinwazyjne Source Type: research
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