Acute appendicitis. Update of clinical scores.

Acute appendicitis. Update of clinical scores. Ann Ital Chir. 2019;90:231-237 Authors: Altomare M, Cimbanassi S, Chiara O, Salvi PF Abstract OBJECTIVES: Evaluate Alvarado Score's (AS) accuracy related with C-reactive protein (CRP). Evaluate the accuracy rate of ultrasonography (US). MATERIALS AND METHODS: We analyzed data on 290 patients admitted to Emergency Department (ED) of Sant'Andrea Hospital (Rome - Italy) presenting abdominal pain in lower quadrants between Jan2009-Apr2015. AS, laboratory tests, images and report from CT-scan and US were collected. Histological examination is considered as Gold Standard. We calculated Specificity(Sp), Sensitivity(Se), Accuracy(Ac), positive predictive value(PPV), and negative predictive value(NPV). We use Exact Fisher Test (EFT) for samples less than 50 units, and Chi square test (χ2). CRP were assessed as possible laboratory marker to be added to AS. RESULTS: Two hundred and forty patients (82%) were enrolled following the inclusion criteria. The variations obtained from the AS with C-reactive protein show no difference. CT-scan vs US results show a higher Sp for US despite CT (p= 0.0509 χ2=3.803. Se and NPV are higher in CT compared to the US (Se: p=0.000315 χ2= 12.88 NVP: p=0.015. We evaluated Ac of US and CT within the individual groups (low(L), Intermediate(I), High(H): L; 37 patients show no statistically significant difference (EFT=1; p>0.05). I: show superiority of CT-scan in Se and ...
Source: Annali Italiani di Chirurgia - Category: Surgery Tags: Ann Ital Chir Source Type: research

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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
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
ConclusionThe diagnosis of TBP had been complicated by the presence of CP in the reported case. The underlying CP not only preclude the diagnosis of TBP, but also produced symptoms that mimicked a condition requiring surgery.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
ConclusionAcute appendicitis may be caused by a variety of causes including ingested foreign bodies if impacted in its lumen. When the patient has signs of generalized peritonitis it is important to exclude bowel perforation. The surgery can be done by the open surgery or laparoscopically.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
ConclusionAcute appendicitis may be caused by a variety of causes including ingested foreign bodies if impacted in its lumen. When the patient has signs of generalized peritonitis it is important to exclude bowel perforation. The surgery can be done by the open surgery or laparoscopically. ‘
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
Authors: Soldo I, Radisic Biljak V, Bakula B, Bakula M, Simundic AM Abstract Introduction: The evaluation of patients with suspected appendicitis strives to identify all patients with presenting symptoms while minimizing negative appendectomy rate. The aim of the study was to identify the optimal combination of clinical and laboratory parameters that should facilitate the emergency department surgeon's definite decision. Materials and methods: The study group comprised 120 patients with suspicion of acute appendicitis (AA). In 60 patients the AA diagnosis was confirmed intraoperatively and by histological analy...
Source: Biochemia Medica - Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research
Abdominal pain is a challenging presentation in children. Examination findings and etiology vary greatly, spanning a vast spectrum from flatulence to frank peritonitis with septic shock. Here, we discuss a 10-year-old boy with 24 hours of progressively worsening lower abdominal pain, nausea, and subjective fevers. History and physical examination findings were consistent with appendicitis. However, physicians were surprised when the single-view abdominal radiograph showed an unanticipated, somewhat perplexing discovery.
Source: Pediatric Emergency Care - Category: Emergency Medicine Tags: Illustrative Cases Source Type: research
Rationale: Meckel's diverticulum (MD) is common congenital abnormality of gastrointestinal tract, only about 6.4% of patients become symptomatic. A smaller minority develop potential fatal complications such as hemorrhage, perforation, abscess, and bowel obstruction. Patient concerns: A 15-year-old boy with history of appendicitis was admitted due to worsening abdominal pain and nausea for 1 day. The physical examination showed the abdomen was soft, with the diffuse tenderness to palpation and voluntary guarding. Diagnosis: Abdominal computed tomography showed a probable MD in the distal ileum. Single photon emissi...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
ConclusionAcute appendicitis can mimic acute scrotum and surgeons must have a high index of suspicion of this complication for diagnosing. This unusual clinical presentation may be challenging and can delay the diagnosis leading to perforated peritonitis.ResumoIntroduçãoA apendicite aguda é a doença cirúrgica mais comum do abdome na prática clínica, afetando principalmente adultos jovens. Tem uma grande variedade de apresentações clínicas, devido à variação anatômica do apêndice cecal. Sua apresentação como ...
Source: Journal of Coloproctology - Category: Gastroenterology Source Type: research
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