Is Ischemia-Modified Albumin a Reliable Marker in Accurate Diagnosis of Appendicitis in Children?
AbstractBackgroundAcute appendicitis is one of the most common abdominal emergencies. Despite all improvements in diagnostic techniques, there are still ongoing problems as proper diagnosis, misdiagnosis and perforated appendicitis. The aim of this study is to demonstrate the clinical value of IMA in patients with appendicitis and to determine the accurate diagnosis of appendicitis in clinically suspected patients.MethodsPediatric patients with acute abdominal pain who had the Pediatric Appendicitis Score (PAS) ≥ 7 (n = 109) and a control group of 35 patients were included in this prospective case–control study. Patients were divided into two groups: patients with appendicitis (pathologically confirmed) (n = 78) and no appendicitis (n = 31). No appendicitis included observation patients and negative appendectomy. Serum samples were collected for routine laboratory parameters and IMA before surgery.ResultsPatients with appendicitis had significantly higher IMA levels than no appendicitis and control groups (p = 0.001 andp
Publication date: Available online 23 January 2020Source: Journal of Minimally Invasive GynecologyAuthor(s): Whitney Trotter Ross, Jordan M. Newell, Richard Zaino, Allen R. Kunselman, Gerald J. Harkins, Andrea S. BentonAbstractStudy ObjectiveTo evaluate the diagnosis of appendiceal endometriosis in coincidental appendectomy specimens using a standard versus modified histopathologic analysis.DesignProspective analysis of 300 consecutive patients undergoing coincidental appendectomy at time of a primary gynecologic procedure.SettingAcademic tertiary referral hospital in the Northeastern United States.PatientsWomen ages 22 to...
Acute appendicitis is a common condition emergency physician encounter during pediatric emergency visits. With a reported incidence of 1 in 50,000 appendectomies, stump appendicitis, an acute inflammation of the residual appendicular tissue, is a rare post-operative complication. The diagnosis of stump appendicitis is time-critical to prevent associated morbidities of abscess formation, perforation and sepsis. Another atypical presentation of appendicitis includes recurrent appendicitis, which is recognized as one or more previous episodes of similar clinical presentation as acute appendicitis, but symptoms subside within 24 to 48 h.
CONCLUSION: The strategy of repeating limited focused US followed by CT scan in cases that remain inconclusive has good diagnostic accuracy and reasonable NAR and decreases the number of CT scans. PMID: 31913249 [PubMed - as supplied by publisher]
ConclusionWith two primary, non-synchronous lesions, a thorough literature review suggests that during the patient's initial TAH-BSO, she could have additionally undergone an appendectomy. In doing so, this would provide accurate, complete staging and determine if the two neoplasms were truly primary in origin or metastatic. In addition, new genetic markers are being discovered, such as the Special AT-rich sequence-binding protein 2 (SATB2) marker, which has been found to be positive in those with a LAMN and negative in those with a primary mucinous ovarian carcinoma. By acquiring appropriate and complete staging we can be...
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.
Authors: Consalvo V, D'Auria F Abstract BACKGROUND: The laparoscopic appendectomy approach (LAA) for acute appendicitis has fewer intra- and post-operative complications, less pain, and smaller scars compared to the traditional open appendectomy approach (OAA), but a higher frequency of intra-abdominal abscess (IAA). The relationship between this higher frequency of IAA and the omission of appendicular stump invagination is difficult to explain, even though such invagination of the appendicular stump is the only difference between standard LAA and OAA. PMID: 31687786 [PubMed - as supplied by publisher]
CONCLUSIONInspection of the staple line, choosing the appropriate staple size and cartridge, and removing free malformed staples if seen should be employed during appendectomy to prevent rare but devastating complications.
Rationale: Mesenteric venous thrombosis is an uncommon but potentially fatal condition that can cause bowel ischemia. It results from a systemic hypercoagulable state or abdominal infection draining into the portal venous system. Several cases regarding portomesenteric venous thrombosis as a complication of appendicitis were reported in adults, but there are far fewer reports in pediatric patients. The mortality rate of the condition is high if untreated, especially in children, reaching up to 50%. Patient concerns: A healthy 15-year-old male with no significant past medical history presented with right lower quadrant...
We report on a 13-year-old boy who presented with right iliac fossa pain associated with anorexia, tenderness, guarding and rebound tenderness. Abdominal ultrasound showed findings of acute appendicitis. However, laparoscopy revealed a wooden toothpick perforating MD and a hyperemic appendix. The FB was removed and laparoscopic diverticulectomy and appendectomy performed. Perforation of MD by a FB is a diagnostic challenge and it should be included in the differential diagnosis of acute abdomen in children.
To determine the prevalence of appendiceal tumors in patients with chronic pelvic pain undergoing excisional surgery.