MedWorm: Appendectomy

Educational and training aspects of new surgical techniques: experience with the endoscopic–laparoscopic interdisciplinary training entity (ELITE) model in training for a natural orifice translumenal endoscopic surgery (NOTES) approach to appendectomy

Surgical Endoscopy — Sat, 28 Jan 2012 06:43:05 +0100

Conclusions This study was able to establish face and construct validity for the ELITE model with a large group of surgeons. The ELITE model seems to be well suited for the training of NOTES as a new surgical technique in an established gastrointestinal surgery skills course. Content Type Journal ArticleCategory Endoluminal SurgeryPages 1-7DOI 10.1007/s00464-012-2165-zAuthors Sonja Gillen, Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Strässe 22, 81675 München, GermanyJörn Gröne, Department of Surgery, Charité–Campus Benjamin Franklin, Berlin, GermanyFritz Knödgen, Research Group MITI, Minimally Invasive Therapy and Intervention, Munich, GermanyPetra Wolf, Institute of Medical Statistics and Epidemiology, Techn...

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Endoloop versus endostapler closure of the appendiceal stump in pediatric laparoscopic appendectomy.

Canadian Journal of Surgery — Fri, 27 Jan 2012 16:01:45 +0100

Conclusion: Our data suggest that in most cases of PA, the appendiceal stump can be safely controlled with EL. Within the PA group, the higher rates of IAA seen in ES patients may be attributable to the quality of the appendiceal stump rather than the technique of closure. PMID: 22269300 [PubMed - in process] (Source: Canadian Journal of Surgery)

Laparoscopic resection of a retroperitoneal schwannoma

Asian Journal of Endoscopic Surgery — Fri, 27 Jan 2012 11:25:39 +0100

AbstractHerein is a report of a case of a 34‐year‐old man whose chief complaint was right lower abdominal pain. He was diagnosed with acute appendicitis. Additionally, an abdominal CT scan found retroperitoneal tumor approximately 5 cm in size, with an imaging effect, located adjacent to the dorsal side of the inferior vena cava. For this suspected neurogenic tumor, laparoscopic appendectomy and retroperitoneal tumorectomy were performed after conservative treatment of appendicitis. The retroperitoneal tumor was 5.5 × 3.5 cm in size, had a capsule, smooth surface and soft elasticity, and the divided face was solid white. The histopathological work‐up revealed that the tumor was a benign mixed‐type schwannoma, in which spindle cells were arranged. The patient's postoperativ...

[Media Watch] Partnering to heal

The Lancet Infectious Diseases — Thu, 26 Jan 2012 23:05:13 +0100

We are introduced to a postsurgery ward in an American hospital, to which a healthy young female student has been admitted after an appendectomy. She acquires an intravenous-line-associated infection caused by meticillin-resistant Staphylococcus aureus (MRSA) and dies. The video then retraces the choices and actions of five individuals on the ward who collectively and unwittingly facilitated this outcome. These people include a family member of another patient with MRSA, the physician manager of the ward responsible for implementing and leading safety initiatives, the infection control practitioner providing support for the ward, a third-year medical student, and a registered nurse. (Source: The Lancet Infectious Diseases)

"Doctors make mistakes. Can we talk about that?" ED physician Brian Goldman's TED talk

Clinical Cases and Images — Thu, 26 Jan 2012 13:45:00 +0100

Dr. Goldman asks if you know your surgeon's "batting average" of operations with good outcomes. He mentions the three words you never want to hear: "Do you remember?" It's a good TED talk: Every doctor makes mistakes (just like everyone does). But, says Dr. Goldman, medicine's culture of denial (and shame) keeps doctors from ever talking about those mistakes, or using them to learn and improve. Telling stories from his own long practice, he calls on doctors to start talking about being wrong. Here are some simple steps to avoid medical errors from a patient's perspective (source: CNN): 1. Say: "My name is Mary Smith, my date of birth is October 21, 1965, and I'm here for an appendectomy." 2. Say: "Please check my ID bracelet." 3. Say: "Please look in my chart and tell me what procedur...

Comparison of Outcomes of Laparoscopic Versus Open Appendectomy in Children: Data from The Nationwide Inpatient Sample (NIS), 2006–2008

World Journal of Surgery — Tue, 24 Jan 2012 07:55:24 +0100

Conclusions LA is safe in children with acute perforated and nonperforated appendicitis, and is associated with shorter hospital stay than OA. The laparoscopic approach is associated with lower morbidity and mortality in perforated cases. However, in nonperforated cases, these benefits are modest and are associated with higher hospital charges. Content Type Journal ArticlePages 1-6DOI 10.1007/s00268-011-1417-8Authors Hossein Masoomi, Department of Surgery, University of California, Irvine, Medical Center, 333 City Blvd. West, Suite 700, Orange, CA 92868, USASteven Mills, Department of Surgery, University of California, Irvine, Medical Center, 333 City Blvd. West, Suite 700, Orange, CA 92868, USAMatthew O. Dolich, Department of Surgery, University of California, Irvi...

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The Life of John Wishart (1850–1926): Study of an Academic Surgical Career Prior to the Flexner Report

World Journal of Surgery — Tue, 24 Jan 2012 07:55:23 +0100

Conclusions Wishart’s career comprised all the elements of modern academic surgery, including pioneering service, research, and teaching. Surgery at Western owes as much to Wishart as it does to university reorganization in response to the Flexner report. Content Type Journal ArticlePages 1-5DOI 10.1007/s00268-011-1407-xAuthors Emily Claydon, Department of Surgery, University of Toronto, Toronto, ON, CanadaVivian C. McAlister, Department of Surgery, The University of Western Ontario and Canadian Forces Medical Service, London, ON, Canada Journal World Journal of SurgeryOnline ISSN 1432-2323Print ISSN 0364-2313 (Source: World Journal of Surgery)

[Surgical risk of transfusion in a French Universitary Hospital.]

Annales Francaises d'Anesthesie et de Reanimation — Tue, 24 Jan 2012 05:00:00 +0100

CONCLUSION: The emergency degree of the transfusion must be taken into account for such recommendation. Each hospital should perform its own cartography to justify its own protocols. PMID: 22281232 [PubMed - as supplied by publisher] (Source: Annales Francaises d'Anesthesie et de Reanimation)

[Intussusception of the appendix : A rare cause of acute abdominal pain in childhood.]

Der Chirurg — Sat, 21 Jan 2012 05:00:00 +0100

We report the case of a 12-year-old girl with right-sided abdominal pain and concomitant peranal bleeding. Preoperative abdominal ultrasound showed partial appendicular intussusception which was confirmed by laparotomy. Appendectomy was carried out including a wide peripheral cecal ring. Peranal bleeding restarted 7 weeks after discharge and colonoscopy revealed ulcerative colitis. The etiology, clinical manifestations, diagnostic and therapeutic approaches for appendicular intussusception are discussed. PMID: 22271057 [PubMed - as supplied by publisher] (Source: Der Chirurg)

Incidence and Outcomes of Unexpected Pathology Findings After Appendectomy

Journal of Surgical Research — Sat, 14 Jan 2012 22:30:13 +0100

(Source: Journal of Surgical Research)

Equivalent Outcomes in Normal Weight, Overweight and Obese Children After Laparoscopic Appendectomy

Journal of Surgical Research — Sat, 14 Jan 2012 22:30:08 +0100

(Source: Journal of Surgical Research)

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The Financial Burden of Training Surgical Residents: Who Should Bear the Cost?

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:47 +0100

This report analyses costs associated with five commonly performed surgical procedures with and without surgical resident assistance. 7146 surgical procedures performed between May 2004 and February 2011 were analyzed. Data pertaining to operative time, type surgery (open or laparoscopic), and training level of residents, if any, were abstracted. Two major groups and 11 procedure related subcategories were formed. Attending only (AO) cases did not involve residents, whereas cases designated as AR, involved attendings and residents. the difference in the operative times between these groups coupled with the hospital OR charges per minute of time ($15/min after the initial 30 minutes) was used to calculate the additional cost of care. the impact of resident training level on OR time was asse...

Progression of Acute Appendicitis to Perforation: Examination of a Two-Variant Disease Model in 683,590 Patients

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:23 +0100

Introduction: Recent studies have suggested that acute appendicitis may represent two discrete disease entities, one associated with frequent early perforation and the other associated with a low overall likelihood of perforation. One implication of this two-variant disease model has been greater emphasis by some authors on entirely nonsurgical management of non-perforated appendicitis. The present study examines the clinical evolution of acute appendicitis - from the time of hospital admission until appendectomy - to assess rates of perforation as they relate to the delay preceding appendectomy in a nationwide sample. Methods: A cross-sectional descriptive analysis was performed using the National Inpatient Sample (NIS) and Kids' Inpatient Database (KID) data from 1988-2008. Patients were...

Appendectomy and Pregnancy: Gestational age may not Affect Position of Incision

Journal of Surgical Research — Sat, 14 Jan 2012 22:28:55 +0100

(Source: Journal of Surgical Research)

Outcomes for Interval Appendectomy After Non-Operative Management of Perforated Appendicitis: What Are the Operative Risks and Luminal Patency Rates?

Journal of Surgical Research — Sat, 14 Jan 2012 22:28:54 +0100

(Source: Journal of Surgical Research)

Comparison of Pediatric Appendectomy Outcomes Between Pediatric Surgeons and General Surgery Residents

Journal of Surgical Research — Sat, 14 Jan 2012 22:28:54 +0100

(Source: Journal of Surgical Research)

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Teaching Single Incision Laparoscopic Appendectomy in Pediatric Patients to Mid Level Surgical Residents: An Early Experience

Journal of Surgical Research — Sat, 14 Jan 2012 22:28:54 +0100

(Source: Journal of Surgical Research)

Percutaneous drainage of intra-abdominal abscess in children with perforated appendicitis

Pediatric Radiology — Fri, 13 Jan 2012 16:54:41 +0100

Conclusion PCD can be effective for managing perforated appendicitis in children. Children with large and ill-defined abscess might be at increased risk for complication or recurrence. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00247-011-2337-3Authors Michael F. McNeeley, Department of Radiology, University of Washington, Seattle Children’s Hospital, Seattle, WA, USANghia Jack Vo, Department of Radiology, University of Washington, Seattle Children’s Hospital, Seattle, WA, USASomnath J. Prabhu, Department of Radiology, University of Washington, Seattle Children’s Hospital, Seattle, WA, USAJason Vergnani, Department of Radiology, University of Washington, Seattle Children’s Hospital, Seattle, WA, USADennis W. Shaw, Department of ...

The "BASE-FIRST" technique in laparoscopic appendectomy

Journal of Minimal Access Surgery — Fri, 13 Jan 2012 05:00:00 +0100

Conclusion : We recorded only one intraoperative haemorrhage, one bladder perforation due to trocar insertion and no conversion. Our goal is to standardize and simplify the laparoscopic approach in order to give any surgeon, even non-expert ones, a simple way to remove the viscum especially in complicated pictures. (Source: Journal of Minimal Access Surgery)

Development of Progeny After Appendectomy During PregnancyDevelopment of Progeny After Appendectomy During Pregnancy

Medscape Today Headlines — Tue, 10 Jan 2012 17:18:42 +0100

Commentary on a study on whether appendectomy during pregnancy affects the future development of progeny, published in November 2011 in Journal of the American College of Surgeons. Medscape General Surgery (Source: Medscape Today Headlines)

Incidental appendectomy ‐ Standard or unnecessary additional trauma in surgery for colorectal cancer? A retrospective analysis of histological findings in 380 specimens

Colorectal Disease — Tue, 10 Jan 2012 05:00:00 +0100

Conclusion: Incidental appendectomy is a safe procedure and can be integrated in surgery for colorectal carcinoma to avoid future complications. Pathological findings of the appendix, including neoplasm, are frequent but clinical relevance remains questionable. (Source: Colorectal Disease)

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Diagnostic Characteristics of S100A8/A9 in a Multicenter Study of Patients With Acute Right Lower Quadrant Abdominal Pain.

Accident and Emergency Nursing — Thu, 05 Jan 2012 05:00:00 +0100

Conclusions: In patients presenting with acute right lower quadrant abdominal pain, we found the investigational enzyme-linked immunosorbent assay (ELISA) test for S100A8/A9 to perform with high sensitivity but very limited specificity. We found that shipping effect and delay in analysis resulted in a subsequent rise in test values, thereby increasing the sensitivity and decreasing the specificity of the test. Further investigation with hospital-based laboratory analyzers is the next critical step for determining the ultimate clinical utility of the ELISA test for S100A8/A9 in ED patients presenting with acute right lower quadrant abdominal pain. PMID: 22221415 [PubMed - as supplied by publisher] (Source: Accident and Emergency Nursing)

Single-incision versus conventional three-incision laparoscopic appendectomy: a single centre experience

Surgery Today — Wed, 04 Jan 2012 16:48:36 +0100

Conclusion Both single-incision and conventional LA are effective and minimally invasive, and should be performed according to the experience of the surgeon. Single-incision LA results in faster recovery, but larger studies are required to confirm this and to determine if these techniques can be used safely for all indications of appendectomy. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s00595-011-0110-8Authors Siwo Ernest Amos, Department of Minimally Invasive Surgery, Shengjing Hospital, China Medical University, Sanhao Street 36#, Shenyang, People’s Republic of ChinaWu Shuo-Dong, Department of Minimally Invasive Surgery, Shengjing Hospital, China Medical University, Sanhao Street 36#, Shenyang, People’s Republic of ChinaYing Fan,...

Systemic Sclerosis and Multiple Cancers of the Female Genital Tract: Prolonged Survival following Current Treatment Strategies

Clinical and Developmental Immunology — Wed, 04 Jan 2012 14:29:49 +0100

Conclusion. Although our patient was diagnosed at advanced stage disease, prolonged survival may be related with radical surgery and postoperative adjuvant chemotherapy according to current treatment strategies. (Source: Clinical and Developmental Immunology)

Effect of the New Standards for Case Logging on Resident Operative Volume: Doing Better Cases or Better Numbers?

Journal of Surgical Education — Sun, 01 Jan 2012 05:00:00 +0100

Conclusions: Although some operative cases newly classified as major are technically advanced procedures (eg, Roux-en-Y gastric bypass), other cases are not (eg, breast lesion excision), which raises the issue as to whether the major case category has been diluted by less demanding case types. The implications of these findings may suggest preservation of case volumes at the expense of case quality. (Source: Journal of Surgical Education)

Evaluation of intestinal viability using 3–charge coupled device image enhancement technology in a pediatric laparoscopic appendectomy model

Journal of Pediatric Surgery — Sun, 01 Jan 2012 05:00:00 +0100

Conclusion: We have demonstrated proof of principle for the determination of bowel ischemia using 3-CCD image enhancement. By quantitatively identifying areas of ischemia, this technique has the potential to significantly change the management of ischemic bowel in the future. (Source: Journal of Pediatric Surgery)

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Immediate appendectomy for appendiceal mass.

Turkish Journal of Trauma and Emergency Surgery : TJTES — Sun, 01 Jan 2012 05:00:00 +0100

CONCLUSION: Immediate appendectomy in appendicular mass is a safe and effective alternative to conservative management. PMID: 22290054 [PubMed - in process] (Source: Turkish Journal of Trauma and Emergency Surgery : TJTES)

Is neopterin a diagnostic marker of acute appendicitis?

Turkish Journal of Trauma and Emergency Surgery : TJTES — Sun, 01 Jan 2012 05:00:00 +0100

CONCLUSION: This study was an experimental animal study; however, it provides valuable clues useful in clinical assessment. Neopterin seems to have great potential as a new diagnostic marker for the diagnosis of acute appendicitis. PMID: 22290042 [PubMed - in process] (Source: Turkish Journal of Trauma and Emergency Surgery : TJTES)

Transvaginal Appendectomy Feasible, Safe in Selected PatientsTransvaginal Appendectomy Feasible, Safe in Selected Patients

Medscape Medical News Headlines — Wed, 28 Dec 2011 18:59:30 +0100

The first series to compare transvaginal appendectomy (TVA) to conventional three-port laparoscopic appendectomy was published online December 1st in Annals of Surgery. Reuters Health Information (Source: Medscape Medical News Headlines)

Transvaginal appendectomy feasible, safe in selected patients

Modern Medicine — Wed, 28 Dec 2011 05:00:00 +0100

NEW YORK (Reuters Health) - The first series to compare transvaginal appendectomy (TVA) to conventional three-port laparoscopic appendectomy was published online December 1st in Annals of Surgery. (Source: Modern Medicine)

The Place Of Appendectomy in Women with Chronic Pelvic Pain and Pelvic Endometriosis

Journal of Gynecologic Surgery — Fri, 23 Dec 2011 14:18:14 +0100

Journal of Gynecologic Surgery Dec 2011, Vol. 27, No. 4: 253-256. (Source: Journal of Gynecologic Surgery)

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Appendectomy and diagnosis-related groups (DRGs): patient classification and hospital reimbursement in 11 European countries

Langenbeck's Archives of Surgery — Fri, 23 Dec 2011 06:47:46 +0100

Conclusions Large variations in the classification of appendectomy patients raise concerns whether all systems rely on the most appropriate classification variables. Surgeons and national DRG authorities should consider how other countries’ DRG systems classify appendectomy patients in order to optimize their DRG system and to ensure fair and appropriate reimbursement. Content Type Journal ArticleCategory Original ArticlePages 1-10DOI 10.1007/s00423-011-0877-5Authors Wilm Quentin, Department of Health Care Management, Technische Universität (TU) Berlin, Straße des 17, Juni 135, H80, 10623 Berlin, GermanyDavid Scheller-Kreinsen, Department of Health Care Management, Technische Universität (TU) Berlin, Straße des 17, Juni 135, H80, 10623 Berlin, GermanyAlexander...

Ovarian vein thrombosis mimicking acute abdomen: A case report and literature review

World Journal of Emergency Surgery — Fri, 23 Dec 2011 05:00:00 +0100

Conclusions: OVT is a rare condition, usually in the postpartum period. A high index of suspicion is required for the prompt diagnosis and management especially in cases that mimic acute abdomen. (Source: World Journal of Emergency Surgery)

Reassessment of CT images to improve diagnostic accuracy in patients with suspected acute appendicitis and an equivocal preoperative CT interpretation

European Radiology — Thu, 22 Dec 2011 12:51:13 +0100

Conclusions Knowledge of the identified CT findings was found to improve diagnostic accuracy for acute appendicitis in patients with equivocal CT findings. Key Points • Numerous patients with clinically equivocal appendicitis do not have acute appendicitis • Computed tomography (CT) helps to reduce the negative appendectomy rate • CT is not always infallible and may also demonstrate indeterminate findings • However knowledge of significant CT variables can further reduce negative appendectomy rate • An equivocal CT interpretation of appendicitis should be reassessed with this knowledge Content Type Journal ArticleCategory GastrointestinalPages 1-8DOI 10.1007/s00330-011-2362-5Authors Hyun Cheol Ki...

External validation of Lintula score in Turkish acute appendicitis patients

International Journal of Surgery — Thu, 15 Dec 2011 05:00:00 +0100

Conclusion: Lintula score seems to be useful method to diagnose acute appendicitis among Turkish patients and may reduce the rate of negative appendectomy. (Source: International Journal of Surgery)

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Physiological Impact of Pneumoperitoneum on Gastric Mucosal CO2 Pressure During Laparoscopic Versus Open Appendectomy in Children

Journal of Laparoendoscopic — Thu, 15 Dec 2011 04:11:15 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques , Vol. 0, No. 0. (Source: Journal of Laparoendoscopic)

Selected medical conditions and risk of pancreatic cancer

Molecular Carcinogenesis — Wed, 14 Dec 2011 11:13:15 +0100

AbstractWe review the current evidence for associations of several medical conditions with risk of pancreatic cancer, including allergies, pancreatitis, gall bladder disease, cholecystectomy, ulcers, gastrectomy, appendectomy, and tonsillectomy. There are consistent findings of reduced risk associated with presence of self‐reported allergies, particularly hay fever but not asthma; data on other allergies are limited and inconclusive. Several studies provide evidence that patients with pancreatic cancer are more likely than comparison groups to report pancreatitis. Those studies that investigated the time between onset of pancreatitis and diagnosis of pancreatic cancer found that risk estimates declined with longer periods of time; however, increased risks were noted for long‐term pancr...

Hantavirus and acute appendicitis—The diagnosis behind the diagnosis?

Journal of Clinical Virology — Mon, 12 Dec 2011 05:00:00 +0100

Abstract: A 33-year-old man with a history of acute lower abdominal pain was admitted to the emergency room. After laparoscopic appendectomy and pathological confirmed acute appendicitis the patient developed thrombocytopenia and acute renal failure. Serological testing for hantaviruses revealed a positive result for PUUV IgG and IgM. Immunohistochemical work-up detected PUUV antigen in endothelial cells of capillaries and larger vessels. The high percentage of patients with hantavirus infection and severe abdominal pain is remarkable and, up to now, unexplained. To our knowledge this is the first report demonstrating PUUV antigen in the human intestine. Further studies are warranted whether hantaviruses are setting the stage for a secondary bacterial infection or cause an inflammation its...

Laparoscopic Appendectomy: Vascular Control of the Appendicular Artery Using Monopolar Cauterization Versus Clips

Journal of Laparoendoscopic — Wed, 07 Dec 2011 04:12:40 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques , Vol. 0, No. 0. (Source: Journal of Laparoendoscopic)

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The Use of a Single Hem-o-lok Clip in Securing the Base of the Appendix During Laparoscopic Appendectomy

Journal of Laparoendoscopic — Tue, 06 Dec 2011 21:44:31 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques , Vol. 0, No. 0. (Source: Journal of Laparoendoscopic)

Laparoscopic Appendectomy: Vascular Control of the Appendicular Artery Using Monopolar Cauterization Versus Clips

Journal of Laparoendoscopic — Tue, 06 Dec 2011 21:39:02 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques , Vol. 0, No. 0. (Source: Journal of Laparoendoscopic)

Intracorporeal Knotting Versus Metal Endoclip Application for the Closure of the Appendiceal Stump During Laparoscopic Appendectomy in Uncomplicated Appendicitis

Journal of Laparoendoscopic — Tue, 06 Dec 2011 21:37:57 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques , Vol. 0, No. 0. (Source: Journal of Laparoendoscopic)

Single-Port Laparoscopic Appendectomy: Comparison with Conventional Laparoscopic Appendectomy

Journal of Laparoendoscopic — Tue, 06 Dec 2011 21:37:52 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques , Vol. 0, No. 0. (Source: Journal of Laparoendoscopic)

Appendectomy [JAMA Patient Page]

JAMA — Tue, 06 Dec 2011 05:00:00 +0100

(Source: JAMA)

The “all-in-one” appendectomy: quick, scarless, and less costly

Journal of Pediatric Surgery — Thu, 01 Dec 2011 05:00:00 +0100

Conclusions: We conclude that the all-in-one laparoscopic appendectomy technique is quick, scarless, and less costly than conventional multi-port techniques. Wider application of the all-in-one technique seems indicated. (Source: Journal of Pediatric Surgery)

Does age affect the outcomes and management of pediatric appendicitis?

Journal of Pediatric Surgery — Thu, 01 Dec 2011 05:00:00 +0100

Conclusions: Although older children had a higher risk of abscess drainage, younger children were more likely to have perforated appendicitis, be readmitted, and have longer LOH. Management of appendicitis differed according to age. Laparoscopic appendectomy was more frequently performed in older children, whereas the youngest children were more likely to be treated nonoperatively. (Source: Journal of Pediatric Surgery)

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Outcomes of perforated appendicitis in obese and nonobese children

Journal of Pediatric Surgery — Thu, 01 Dec 2011 05:00:00 +0100

Conclusions: Obese children undergoing laparoscopic appendectomy for perforated appendicitis experience longer operative times and suffer worse outcomes. (Source: Journal of Pediatric Surgery)

Morbidity of appendectomy and cholecystectomy in pregnant and nonpregnant women.

Obstetrics and Gynecology — Thu, 01 Dec 2011 05:00:00 +0100

CONCLUSION: : Pregnancy does not increase the occurrence of postoperative maternal morbidity related to appendectomy and cholecystectomy. LEVEL OF EVIDENCE: : II. PMID: 22105255 [PubMed - in process] (Source: Obstetrics and Gynecology)

Diagnostic Characteristics of S100A8/A9 in a Multicenter Study of Patients With Acute Right Lower Quadrant Abdominal Pain

Academic Emergency Medicine — Thu, 01 Dec 2011 05:00:00 +0100

Conclusions: In patients presenting with acute right lower quadrant abdominal pain, we found the investigational enzyme‐linked immunosorbent assay (ELISA) test for S100A8/A9 to perform with high sensitivity but very limited specificity. We found that shipping effect and delay in analysis resulted in a subsequent rise in test values, thereby increasing the sensitivity and decreasing the specificity of the test. Further investigation with hospital‐based laboratory analyzers is the next critical step for determining the ultimate clinical utility of the ELISA test for S100A8/A9 in ED patients presenting with acute right lower quadrant abdominal pain. (Source: Academic Emergency Medicine)

MDCT for suspected appendicitis in the elderly: diagnostic performance and patient outcome

Emergency Radiology — Wed, 30 Nov 2011 18:43:31 +0100

Abstract Elderly adults are at increased risk for complications related to both delayed diagnosis of appendicitis and to unnecessary appendectomy. We assessed the diagnostic performance of computed tomography (CT) in a consecutive elderly cohort with clinically suspected appendicitis. CT findings and clinical outcomes were analyzed for 262 consecutive adult patients age 65 and older (mean 75.6 ± 7.5 years; range 65–94; M/F 111:151) referred for clinically suspected appendicitis at a single medical center between January 2000 and December 2009. The overall prevalence of proven acute appendicitis in this elderly cohort with clinically suspected appendicitis was 16.8% (44/262). CT sensitivity, specificity, PPV, and NPV for acute appendicitis were 100% (44/44), 99....

Coincidence of Mature Cystic Teratoma and Serotonin-producing Neuroendocrine Tumor of the Ileum

Hormone and Metabolic Research — Mon, 21 Nov 2011 05:00:00 +0100

Horm Metab Res 2011; 43: 872-876DOI: 10.1055/s-0031-1291304Mature cystic teratomas are often found in gonadal sites, but are very rarely located extragonadally, for example, in retroperitoneum, mediastinum, central nervous system, lung, or liver. In the literature, only 10 cases of cystic teratoma originating from the diaphragm have been reported. Here, we report for the first time a metachronous occurrence of a benign mature cystic teratoma in the left diaphragm together with a serotonin-producing neuroendocrine tumor of the ileum. The 51-year-old, female patient received a partial resection of the ileum due to a neuroendocrine tumor (pT3N1M0) 4 years ago. Furthermore, she was operated for a benign cystadenoma of the right ovary 3 years ago. In her past medical history, she had an appende...

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Appendectomy versus antibiotic treatment for acute appendicitis.

Cochrane Database of Systematic Reviews — Sun, 20 Nov 2011 22:06:03 +0100

CONCLUSIONS: The upper bound of the 95% CI of ABT for cure within two weeks without major complications crosses the 20% margin of appendectomy, so the outcome is inconclusive. Also the quality of the studies was low to moderate, for that reason the results should be interpret with caution and definite conclusions cannot be made. Therefore we conclude that appendectomy remains the standard treatment for acute appendicitis. Antibiotic treatment might be used as an alternative treatment in a good quality RCT or in specific patients or conditions were surgery is contraindicated. PMID: 22071846 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

Septic Mesenteric Venous Thrombophlebitis: A Rare Complication of Acute Appendicitis

PPAR Research — Sun, 20 Nov 2011 07:53:48 +0100

Mesenteric venous thrombophlebitis represents a very rare complication of acute appendicitis. Based on the findings of a 45-year-old patient with mesenteric venous thrombophlebitis due to acute appendicitis, we herein describe the diagnostic difficulties and therapeutic options in this uncommon disease. The treatment in our case consisted of simple appendectomy and perioperative anticoagulation therapy. (Source: PPAR Research)

Role of Clinical Judgment and Tissue Harmonic Imaging Ultrasonography in Diagnosis of Paediatric Acute Appendicitis

World Journal of Emergency Surgery — Wed, 16 Nov 2011 05:00:00 +0100

The objective of this study was to investigate the hypothesis that the use of a modified clinical practice and harmonic ultrasonographic grading scores (MCPGS) may improve the accuracy in diagnosing acute appendicitis in the pediatric population.Patients & Methods:Main outcome measures: Sensitivity, specificity, and accuracy of the modified scoring system. Five hundred and thirty patients presented with suspected diagnosis of acute appendicitis during the period from December 2000 to December 2009 were enrolled in this study. Children's data that have already been published of those who presented with suspected diagnosis of acute appendicitis- to whom a special clinical practice grading scores (CPGS) incorporating clinical judgment and results of gray scale ultrasonography (US) was applied...

Appendix stump closure with titanium clips in laparoscopic appendectomy

Langenbeck's Archives of Surgery — Sat, 12 Nov 2011 06:48:04 +0100

Conclusion This study suggests that the presented titanium DS-Clip is a safe and cost-effective technique for securing the appendix base in laparoscopic appendectomy. The application is easy and can be learned quickly, making it a good option also for teaching hospitals. Content Type Journal ArticleCategory How-I-Do-It ArticlePages 1-5DOI 10.1007/s00423-011-0869-5Authors Alexander Rickert, Department of Surgery, University Hospital Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, GermanyRoderich Bönninghoff, Department of Surgery, University Hospital Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, GermanyStefan Post, Department of Surgery, University Hospital Mannheim, University of Heidelberg, Theodor-Kutzer...

Effect of intra-abdominal absorbable sutures on surgical site infection

Surgery Today — Wed, 09 Nov 2011 07:02:23 +0100

Conclusion Using intra-abdominal absorbable sutures instead of silk sutures may reduce the risk of SSI, but only in colorectal surgery. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00595-011-0024-5Authors Akihiro Watanabe, Surgical Site Infection Study Group, Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 JapanShunji Kohnoe, Surgical Site Infection Study Group, Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 JapanHideto Sonoda, Surgical Site Infection Study Group, Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maida...

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[Appendicitis in Hungary through the eyes of a health insurance specialist].

Orvosi Hetilap — Tue, 08 Nov 2011 21:09:08 +0100

Conclusions: In Hungary, there are large regional differences in the proportion of surgery. Orv. Hetil., 2011, 152, 1843-1848. PMID: 22030361 [PubMed - in process] (Source: Orvosi Hetilap)

Diet and risk of inflammatory bowel disease

Digestive and Liver Disease — Fri, 04 Nov 2011 04:00:00 +0100

Conclusions: A diet high in protein, particular animal protein, may be associated with increased risk of inflammatory bowel disease and relapses. N-6 polyunsaturated fatty acids may predispose to ulcerative colitis whilst n-3 polyunsaturated fatty acid may protect. These results should be confirmed in other countries and in younger subjects before dietary counselling is recommended in high risk subjects. (Source: Digestive and Liver Disease)

Qualitative and quantitative analysis of women’s perceptions of transvaginal surgery

Surgical Endoscopy — Wed, 02 Nov 2011 05:48:29 +0100

Conclusions As in prior studies, scarring and pain were important issues to be considered, but recovery time and increased invasiveness were also in the “top five” list. The surveyed women appeared to actively participate in evaluating the technical components of the procedures. Content Type Journal ArticlePages 1-7DOI 10.1007/s00464-011-1984-7Authors Juliane Bingener, Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USAJeff A. Sloan, Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USAKarthik Ghosh, Department of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, USAAndrea McConico, Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USAAndrea Mariani, Department of Obstet...

ACR Appropriateness Criteria® Right Lower Quadrant Pain—Suspected Appendicitis

Journal of the American College of Radiology : JACR — Tue, 01 Nov 2011 04:00:00 +0100

The diagnostic imaging of patients presenting with right lower quadrant pain and suspected appendicitis may be organized according to age and gender and to the presence or absence of “classic” signs and symptoms of acute appendicitis. Among adult patients presenting with clinical signs of acute appendicitis, the sensitivity and specificity of CT are greater than those of ultrasound, with improved performance when CT is performed with intravenous contrast. The use of rectal contrast has been associated with decreased time in the emergency department. Computed tomography has also been shown to reduce cost and negative appendectomy rates. Both CT and ultrasound are also effective in the identification of causes of right lower quadrant pain unrelated to appendicitis. Among pediatric patien...

Neonatal acute appendicitis: a proposed algorithm for timely diagnosis

Journal of Pediatric Surgery — Tue, 01 Nov 2011 04:00:00 +0100

We report 3 cases of NA seen at our institution during this period.Results: All 3 infants were previously well, born at term, and presented with signs consistent with abdominal sepsis. The first 2 diagnoses were not made until autopsy. The third case survived after having an urgent computed tomographic scan, exploratory laparotomy, and appendectomy.Discussion: The literature summarizing common presenting features of NA is reviewed. We present an algorithm to guide the workup of these neonates to facilitate earlier diagnosis and potentially improve outcomes. (Source: Journal of Pediatric Surgery)

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Pneumatosis intestinalis after laparoscopic appendectomy: case report and review of the literature

Journal of Pediatric Surgery — Tue, 01 Nov 2011 04:00:00 +0100

Abstract: Pneumatosis intestinalis (PI) is the presence of intraluminal gas within the wall of the intestine. As a marker for bowel injury owing to mucosal injury, PI may herald a severe underlying disease process in patients without a significant medical history. In other cases, PI is a benign process, and expectant management is appropriate. Here, we present the first reported case of pneumatosis associated with postoperative abscess after appendectomy and its successful management. Then, we describe the pathophysiology of pneumatosis and review the literature regarding its origin and management. (Source: Journal of Pediatric Surgery)

Incidental findings on computed tomography scans for acute appendicitis: prevalence, costs, and outcome.

The American Surgeon — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Ozao-Choy J, Kim U, Vieux U, Menes TS Abstract CT scan is increasingly being used to diagnose appendicitis due to its specificity and literature suggesting its cost-effectiveness. CT scans are associated with incidental findings. We sought to investigate the rates of incidental findings identified on CT scans, the follow-up of these findings, and the added cost associated with this follow-up. A retrospective review of patients who underwent appendectomies for acute appendicitis between 2003 and 2005 was completed at Elmhurst Hospital Center (Elmhurst, NY). Incidental findings were grouped into low and high significance, based on workup or follow-up needed. The diagnostic workup and cost of each incidental finding was ascertained. For patients who did not receive a workup d...

Retroperitoneal mucinous cystadenocarcinoma presenting seven years after appendectomy and right hemicolectomy.

Radiologia — Fri, 21 Oct 2011 04:00:00 +0100

We report the case of a patient who presented RMC seven years after appendectomy and right hemicolectomy. We discuss both diagnostic possibilities. PMID: 22019419 [PubMed - as supplied by publisher] (Source: Radiologia)

Natural orifice transluminal endoscopic surgery: New minimally invasive surgery come of age.

World Journal of Gastroenterology : WJG — Fri, 21 Oct 2011 04:00:00 +0100

Authors: Huang C, Huang RX, Qiu ZJ Abstract Although in the past two decades, laparoscopic surgery, considered as a great revolution in the minimally invasive surgery field, has undergone major development worldwide, another dramatic surgical revolution has quietly appeared in recent years. Ever since Kalloo's first report on transgastric peritoneoscopy in a porcine model in 2004, interest in a new surgical procedure named natural orifice transluminal endoscopic surgery (NOTES) has blossomed worldwide. Considering that a NOTES procedure could theoretically avoid any abdominal incision, operation-related pain and scarring, many surgeons and endoscopists have been enthusiastic in their study of this new technique. In recent years, several NOTES studies have been carried out on porcin...

Link Between Delayed Pediatric Appendicitis Treatment And Complications, Mortality

Health News from Medical News Today — Mon, 17 Oct 2011 08:00:00 +0100

An in-hospital delay of appendicitis treatment beyond two days was linked to an increased likelihood of complications, including perforation and abscess formation; longer hospitalization; increased costs; and more rarely, death, according an abstract presented Saturday, Oct. 15 at the American Academy of Pediatrics (AAP) National Conference and Exhibition in Boston. In "Missed Opportunities in the Treatment of Pediatric Appendicitis," researchers reviewed National Inpatient Sample (NIS) data on nearly 800,000 appendectomies, the most common inpatient surgical procedure in children... (Source: Health News from Medical News Today)

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Laparoscopic vs Open Appendectomy in Children: Outcomes Comparison Based on Age, Sex, and Perforation Status [Original Article]

Archives of Surgery — Mon, 17 Oct 2011 04:00:00 +0100

Conclusion Now the preferred operation for children with appendicitis, LA was associated with a decreased risk of wound infection, abscess drainage, and length of hospitalization compared with OA. (Source: Archives of Surgery)

Ectopic ACTH-syndrome due to a Neuroendocrine Tumour of the Appendix

Experimental and Clinical Endocrinology and Diabetes — Mon, 17 Oct 2011 04:00:00 +0100

Exp Clin Endocrinol Diabetes 2011; 119: 525-529DOI: 10.1055/s-0031-1284368Ectopic ACTH production causes 10% of Cushing’s syndromes. The diagnostic workup is difficult, can last more than 6 months (> 50% of cases), and the underlying tumour is still frequently not located (12%). Carcinoid tumours of the appendix are frequent and are revealed in 0.3% of patients undergoing routine appendectomy. However, neuroendocrine tumours of the appendix with ACTH production are an extremely rare entity.Here we report the case of a female patient with clinically overt Cushing’s syndrome due to ectopic ACTH-production from a carcinoid tumour of the appendix. During the diagnostic workup, repeated endocrine tests, multiple different imaging modalities and frequent and lengthy hospitalisations wer...

Pure transvesical NOTES uterine horn resection in swine as an appendectomy model

Surgical Endoscopy — Sat, 15 Oct 2011 05:48:33 +0100

Conclusions This study demonstrates the feasibility of a pure transvesical NOTES uterine horn resection in a porcine model. To the best of our knowledge, this is the world’s first report on a pure transvesical NOTES with a therapeutic purpose. This study shows the potential for adoption of the transvesical approach in NOTES procedures. Content Type Journal ArticleCategory Dynamic ManuscriptPages 1-7DOI 10.1007/s00464-011-1905-9Authors Chang Wook Jeong, Department of Urology, Seoul National University Bundang Hospital, 166 Gumiro, Bundang-gu, Seongnam, Gyeonggi-do 463-707, KoreaJong Jin Oh, Department of Urology, Seoul National University Bundang Hospital, 166 Gumiro, Bundang-gu, Seongnam, Gyeonggi-do 463-707, KoreaMurad Abdullajanov, Department of Urology, Seoul N...

Female Sexual Function After Pure Transvaginal Appendectomy: A Cohort Study

Journal of Gastrointestinal Surgery — Fri, 14 Oct 2011 05:50:38 +0100

Conclusions Neither LA nor TVA affected female sexual function scores. This suggests that TVA does not have negative effects on female sexual function. The results of this study may prove beneficial in consultations with patients concerning the sexual sequelae of transvaginal surgery. Content Type Journal ArticleCategory 2011 SSAT Plenary PresentationPages 1-5DOI 10.1007/s11605-011-1706-4Authors Daniel Solomon, Department of Surgery, Section of Gastrointestinal Surgery, Yale University School of Medicine, 40 Temple Street, Suite 7B, New Haven, CT 06510, USARachel Lentz, Department of Surgery, Section of Gastrointestinal Surgery, Yale University School of Medicine, 40 Temple Street, Suite 7B, New Haven, CT 06510, USAAndrew J. Duffy, Department of Surgery, Section of ...

Comparison of laparoscopic versus open appendectomy for acute nonperforated and perforated appendicitis in the obese population

American Journal of Surgery — Thu, 13 Oct 2011 04:00:00 +0100

Conclusions: LA can be performed safely with superior outcomes compared with OA in obese patients and should be considered the procedure of choice for perforated and nonperforated appendicitis in these patients. (Source: American Journal of Surgery)

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Appendectomy and cancer risk in Jewish BRCA1 and BRCA2 mutation carriers

Breast Cancer Research and Treatment — Sat, 08 Oct 2011 15:42:49 +0100

This study suggests that prior appendectomy is more frequently noted in BRCA1 and BRCA2 carriers with breast and ovarian cancer than in unaffected mutation carriers. The mechanism for this association is elusive, and future analyses of ethnically diverse mutation carriers are needed to validate these results. Content Type Journal ArticleCategory EpidemiologyPages 1-5DOI 10.1007/s10549-011-1807-5Authors Shiri Bernholtz, The Susanne-Levy Gertner Oncogenetics Unit, The Danek Gertner Institute of Genetics, Chaim Sheba Medical Center, Tel-Hashomer, 52621 IsraelAriella Jakobson-Setton, Department of Gyneco-Oncology, Chaim Sheba Medical Center, Tel-Hashomer, 52621 IsraelJacob Korach, Department of Gyneco-Oncology, Chaim Sheba Medical Center, Tel-Hashomer, 52621 IsraelGilad Ben Baruch, De...

Metal endoclips for the closure of the appendiceal stump in laparoscopic appendectomy

Techniques in Coloproctology — Sat, 08 Oct 2011 05:53:12 +0100

Abstract Closure of the appendiceal stump in laparoscopic appendectomy is the most crucial part of the procedure. In this retrospective clinical study, we describe a technique for laparoscopic appendectomy, in which the appendiceal stump is secured by metal endoclips. Medical data of the patients who underwent laparoscopic appendectomy for acute appendicitis between January 2005 and January 2011 at our institution were reviewed. The patients who had their appendiceal stump secured by metal endoclips were recruited for the study. The outcome measures were the rate of intraoperative and postoperative complications, operative time, and the length of hospital stay. A total of 233 patients were included to the study. The rate of intraoperative and postoperative complications, t...

Cost-effectiveness of open versus laparoscopic appendectomy: a multilevel approach with propensity score matching

The European Journal of Health Economics — Fri, 07 Oct 2011 16:00:39 +0100

Conclusion Predicted costs for LA were 1,856 US$ lower than for OA while the postoperative complication rate did not differ significantly. Thus, LA is the treatment of choice from a provider’s perspective. Content Type Journal ArticleCategory Original PaperPages 1-12DOI 10.1007/s10198-011-0355-6Authors Laura Haas, Institute of Health Economics and Health Care Management, Helmholtz Zentrum Muenchen, Ingolstädter Landstr. 1, 85764 Neuherberg/Munich, GermanyTom Stargardt, Institute of Health Economics and Health Care Management, Helmholtz Zentrum Muenchen, Ingolstädter Landstr. 1, 85764 Neuherberg/Munich, GermanyJonas Schreyoegg, Institute of Health Economics and Health Care Management, Helmholtz Zentrum Muenchen, Ingolstädter Landstr. 1, 85764 Neuherberg/Munich, G...

A rare case of perforated ileal diverticulitis

Digestive and Liver Disease — Wed, 05 Oct 2011 04:00:00 +0100

A 70-year-old male presented with generalised abdominal pain and fever of 7 days’ duration. Medical history included arterial hypertension and stable angina pectoris. The physical examination showed localized signs of peritonitis in the left lower quadrant; blood tests revealed leukocytosis (12.4×103/μL) and elevated C-reactive protein (26.7mg/dL). Abdominal computed tomography showed multiple diverticula in the distal ileum with circumferential thickening of the wall, dishomogeneity of mesenteric fat and perivisceral extraluminal air (Fig. 1); diverticula were present throughout the colon. Perforated diverticulits of the terminal ileum was diagnosed. Piperacillin/tazobactam therapy was started and explorative laparotomy was scheduled. Surgical exploration, through a minilaparotomy, co...

Single-site umbilical laparoscopic appendectomy

Seminars in Pediatric Surgery — Mon, 03 Oct 2011 17:22:54 +0100

This article will review the background of laparoscopy for appendectomy, the introduction of the single-incision approach, available data and outcomes from current literature, and a description of our technique. (Source: Seminars in Pediatric Surgery)

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The use of magnets with single-site umbilical laparoscopic surgery

Seminars in Pediatric Surgery — Mon, 03 Oct 2011 17:22:54 +0100

This study is a retrospective analysis of all magnet-assisted laparoscopic operations performed at the Fundacion Hospitalaria Private Children's Hospital from September 2009 to January 2011. Outcomes include demographics, diagnosis, operative time, intraoperative complications, and conversion rates. Forty-four magnet-assisted laparoscopic operations were performed. The operations included 23 appendectomies, 8 cholecystectomies, 3 Nissen fundoplications, 2 gastrojejunostomies, 2 splenectomies, 2 ovarian tumor/cyst resections, 1 retroperitoneal lymphangioma resection, 1 left adrenalectomy, 1 total abdominal colectomy and 1 pulmonary wedge resection. The mean operative times for the most commonly performed operations were 61 minutes for appendectomy and 93 minutes for cholecystectomy. The ope...

Peri-operative outcomes of patients with stage IV endometriosis undergoing robotic-assisted laparoscopic surgery

Journal of Robotic Surgery — Sun, 02 Oct 2011 05:46:56 +0100

Abstract We analyzed peri-operative outcomes of 80 patients who underwent robotic-assisted laparoscopic surgery and were diagnosed with stage IV endometriosis (revised American Society for Reproductive Medicine) between January 2007 and December 2010 at a tertiary gynecologic oncology referral center with a fellowship training program. Eligible women had a combination of one or more factors: pelvic mass, sub-acute or chronic pelvic pain, dysmenorrhea, dyspareunia, elevated serum CA-125, diagnosed with stage IV endometriosis at surgery with robotic-assisted gynecologic procedures using the da Vinci® Surgical System. The mean age was 43.7 ± 7.0 years, body mass index 27.5 ± 7.4 kg/m2, and 23 (28.9%) patients had prior endometriosis surgery. Pre...

Substantial postoperative pain is common among children undergoing laparoscopic appendectomy

Pediatric Anesthesia — Sat, 01 Oct 2011 04:00:00 +0100

Conclusion: These preliminary data suggest that substantial postoperative pain is common in children undergoing laparoscopic appendectomy. More studies of postoperative pain outcomes among children undergoing laparoscopic appendectomy and other common pediatric surgical procedures are needed. (Source: Pediatric Anesthesia)

Use of antibiotics alone for treatment of uncomplicated acute appendicitis: A systematic review and meta-analysis

Surgery — Sat, 01 Oct 2011 04:00:00 +0100

Conclusion: In some cases, antibiotic treatment may fail, and there is a risk of recurrence. However, surgically treated patients, including those with the potential for spontaneous resolution and those with a normal appendix, are subjected to the risks of operative morbidity and mortality. Antibiotic therapy incurs significantly fewer complications. Prospective randomized studies are urgently needed to conclusively define the roles of appendectomy and antibiotic treatment in the management of uncomplicated acute appendicitis. (Source: Surgery)

Context and significance of emergency department visits and readmissions after pediatric appendectomy

Journal of Pediatric Surgery — Sat, 01 Oct 2011 04:00:00 +0100

Abstract: Background: The readmission rate after pediatric appendectomy is frequently reported in clinical outcomes studies and quality improvement initiatives without proper description. Our aim was to delineate the context and significance of these encounters.Methods: Patients ( (Source: Journal of Pediatric Surgery)

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Comparison of bipolar electrosurgical devices with ligatures and endoclips in the rat appendicitis model

Journal of Pediatric Surgery — Sat, 01 Oct 2011 04:00:00 +0100

Conclusions: Bipolar radiofrequency–driven vessel sealer and bipolar electrocautery achieve safe stump closure with satisfactory bursting pressure values in an experimental rat appendicitis model. Decreased operative time and unimpaired healing are encouraging. (Source: Journal of Pediatric Surgery)

Stump appendicitis and chorioamnionitis due to incomplete appendectomy: A case report.

The Turkish Journal of Gastroenterology — Sat, 01 Oct 2011 04:00:00 +0100

We report a case of stump appendicitis and chorioamnionitis occurring three weeks after an appendectomy performed in another medical center. This will involve the discussion of clinical presentation, diagnosis, surgical management and literature review. PMID: 22234765 [PubMed - in process] (Source: The Turkish Journal of Gastroenterology)

AJR: Pre-op CT decreases negative appendectomy in both sexes

Health Imaging News — Thu, 29 Sep 2011 12:21:26 +0100

Negative appendectomy rates can be decreased with the use of preoperative CT in adult patients, both men and women, according to a study published in the October issue of the American Journal of Roentgenology. While preoperative CT has been used commonly to reduce the number of negative, or medically unnecessary, appendectomies, research has been split over whether or not both sexes benefit from the procedure. (Source: Health Imaging News)

Substantial postoperative pain is common among children undergoing laparoscopic appendectomy.

Paediatric Anaesthesia — Thu, 29 Sep 2011 04:00:00 +0100

Imaging of Acute Appendicitis in Adults and Children

Springer Medicine titles — Thu, 29 Sep 2011 00:11:46 +0100

series:Diagnostic ImagingImaging is increasingly used in patients suspected of having acute appendicitis in order to reduce the rates of perforation and negative appendectomy and to detect alternative diagnoses. As many of these patients are young, radiation dose is of particular concern. Numerous studies have therefore investigated reduction of the radiation dose delivered by CT and whether ultrasound may be a ... (Source: Springer Medicine titles)

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Postoperative Antibiotics Correlate with Worse Outcomes after Appendectomy for Nonperforated Appendicitis

Journal of the American College of Surgeons — Wed, 28 Sep 2011 04:00:00 +0100

Conclusions: Postoperative antibiotic treatment for nonperforated appendicitis did not reduce infectious complications and prolonged LOS while increasing postoperative morbidity. Therefore, postoperative antibiotics likely increase the treatment cost for nonperforated appendicitis while not adding an appreciable clinical benefit and, in some cases, actually worsening outcomes. (Source: Journal of the American College of Surgeons)

Totally transvaginal resection of the descending colon in an experimental model

Surgical Endoscopy — Fri, 23 Sep 2011 05:44:45 +0100

Conclusion Totally transvaginal resection of the colon (pure NOTES) is feasible in a sheep model. Content Type Journal ArticleCategory New TechnologyPages 1-5DOI 10.1007/s00464-011-1919-3Authors Francisco Alba Mesa, Consorcio Sanitario Publico del Aljarafe, Hospital San Juan de Dios, Bormujos (Sevilla), SpainAntonio Amaya Cortijo, Consorcio Sanitario Publico del Aljarafe, Hospital San Juan de Dios, Bormujos (Sevilla), SpainJose Manuel Romero Fernandez, Consorcio Sanitario Publico del Aljarafe, Hospital San Juan de Dios, Bormujos (Sevilla), SpainAndrzej L. Komorowski, Servicio de Cirugia General, Hospital Virgen del Camino, Carretera de Chipiona s/n, 11540 Sanlúcar de Barrameda (Cadiz), SpainMiguel Angel Sanchez Hurtado, Department of Laparoscopic Surgery, Minimally Inv...

Transumbilical laparoscopically assisted appendectomy in children: the results of a single-port, single-channel procedure

Surgical Endoscopy — Thu, 22 Sep 2011 05:47:59 +0100

Conclusions The TULAA procedure is a preferable operation for acute appendicitis in children because it is simple and provides good cosmetic results. Content Type Journal ArticlePages 1-5DOI 10.1007/s00464-011-1912-xAuthors Yasuharu Ohno, Department of Pediatric Surgery, Saitama Medical University, 38 Morohongo, Moroyama, Iruma, Saitama 350-0495, JapanToshiya Morimura, Department of Pediatric Surgery, Saitama Medical University, 38 Morohongo, Moroyama, Iruma, Saitama 350-0495, JapanShin-ichi Hayashi, Department of Pediatric Surgery, Saitama Medical University, 38 Morohongo, Moroyama, Iruma, Saitama 350-0495, Japan Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794 (Source: Surgical Endoscopy)

The Negative Appendectomy Rate: Who Benefits From Preoperative CT?

American Journal of Roentgenology — Wed, 21 Sep 2011 04:00:00 +0100

CONCLUSION. The negative appendectomy rate was decreased for adult patients who underwent preoperative CT compared with patients who did not undergo preoperative imaging. Although most prior studies have suggested that CT is efficacious only in decreasing the negative appendectomy rate among women, we found that men benefit from CT as well. (Source: American Journal of Roentgenology)

Internet personal health record services slow to catch on

ICMCC: The International Council on Medical and Care Compunetics — Mon, 19 Sep 2011 13:45:21 +0100

Source: John Przybys, Las Vegas Review-Journal Content: “When did you have that appendectomy? What’s the dosage of your blood pressure medication? What was your blood glucose level last Wednesday at noon? Admit it: If the specifics of our own health history formed the basis of questions on “Who Wants to be a Millionaire?” most of us [...] (Source: ICMCC: The International Council on Medical and Care Compunetics)

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Erratum: Costs and length of stay for patients with and without sickle cell disease after hysterectomy, appendectomy, or knee replacement

American Journal of Hematology — Mon, 19 Sep 2011 02:44:36 +0100

(Source: American Journal of Hematology)

Childhood appendectomy, tonsillectomy, and risk for premature acute myocardial infarction--a nationwide population-based cohort study

European Heart Journal — Wed, 14 Sep 2011 04:00:00 +0100

Conclusions We found a higher risk of AMI related to surgical removal of the tonsils and appendix before age 20. These results are consistent with the hypothesis that subtle alterations in immune function following these operations may alter the subsequent cardiovascular risk, but further studies are needed to confirm these findings and to explore possible mechanisms. (Source: European Heart Journal)

Acute appendicitis: emergency medicine physician and surgeon clinical judgment vs abdominal computed tomographic scan

The American Journal of Emergency Medicine — Mon, 12 Sep 2011 04:00:00 +0100

I agree with the authors that the best imaging modalities can never replace the clinical judgment of an experienced surgeon or emergency medicine physician, but it might be “in general” comment. Another study also showed that, even in clinically evident appendicitis, computed tomography (CT) has the potential to reduce negative appendectomies . In that study, the clinically evident appendicitis was defined by emergency medicine physician. Summing up with the results of the study entitled “The accuracy of emergency medicine and surgical residents in the diagnosis of acute appendicitis,” it is not easy to say that CT is not a necessary option in patients with typical findings in history and physical examination . I would not say that CT is a mandatory in all adults with suspected app...

Obscure gastrointestinal bleeding occurring 50 years after an appendectomy

Gut — Sun, 04 Sep 2011 23:00:00 +0100

Clinical presentation A 69-year-old male, with a history of an appendectomy 50 years previously, presented to hospital due to refractory dizziness and bloody stool. A routine blood test revealed that he had severe anaemia. Upper and lower endoscopy revealed no evidence of bleeding in the oesophagus, stomach, duodenum, terminal ileum or colorectum. He was diagnosed as having obscure gastrointestinal bleeding.1 Capsule endoscopy (CE) was performed and dark-bluish areas with whitish villi were detected in the jejunum (figure 1). Subsequently, double-balloon endoscopy (DBE) was performed orally and multiple dark-bluish areas coated with whitish villi were found at the distal jejunum (figure 2A), and white debris also oozed from the lesion after a target biopsy was obtained (figure 2B). CT...

Acute appendicitis and carcinoid tumor in Meckel’s diverticulum. Three pathologies in one: a case report

Techniques in Coloproctology — Fri, 02 Sep 2011 05:48:38 +0100

Abstract Incidental carcinoid tumor of the Meckel’s diverticulum is an uncommon event. Herein, a case of a carcinoid tumor in Meckel’s diverticulum that was incidentally found in a patient with acute appendicitis is presented. A 42-year-old Caucasian man presented with acute abdomen and clinical signs of acute appendicitis. A typical appendectomy was performed during which further abdominal exploration revealed a Meckel’s diverticulum 60 cm proximal to the ileocecal valve, with an irregular and somewhat indurated serosal region on one side. A stapled diverticulectomy was performed. Pathology revealed an incidental carcinoid tumor measuring 1 cm within the Meckel’s diverticulum. CT scan of the abdomen and 24-h urine 5-hydroxyindoleacetic acid results were n...

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Cecal volvulus after twin gestation: laparoscopic approach

Techniques in Coloproctology — Fri, 02 Sep 2011 05:48:28 +0100

Conclusions Cecal volvulus in pregnancy is a rare, difficult to diagnose, clinical entity. It is associated with high morbidity and mortality, both of mother and fetus, because of delayed diagnosis. A high index of clinical suspicion is required in pregnant or puerperant women with signs and symptoms of bowel obstruction and persistent pain at the right low abdominal quadrant. As long as diagnosis is timely set, laparoscopy is a safe and successful means of surgical treatment. Content Type Journal ArticlePages 1-3DOI 10.1007/s10151-011-0742-0Authors C. Kosmidis, Department of Surgery, Interbalkan European Medical Center, Thessaloniki, GreeceC. Efthimiadis, Department of Surgery, Interbalkan European Medical Center, Thessaloniki, GreeceG. Anthimidis, Department of S...

Immediate vs Delayed Appendectomy in ChildrenImmediate vs Delayed Appendectomy in Children

Medscape Today Headlines — Thu, 01 Sep 2011 14:38:00 +0100

Commentary on a study that compared immediate vs delayed appendectomy for children with perforated appendicitis, published June 2011 in the Archives of Surgery. Medscape General Surgery (Source: Medscape Today Headlines)

[Ulcerative colitis: Exceptional consequence after rituximab therapy].

Annales Pharmaceutiques Francaises — Thu, 01 Sep 2011 04:00:00 +0100

CONCLUSION: Gastrointestinal immunological consequences to the requirements of the targeted therapies deserved very careful and rigorous monitoring. However, at the slightest sign of digestive, a detailed morphological exploration is essential, to avoid in particular surgical emergency, evolution without treatment could engage in short-term vital prognosis. PMID: 21924127 [PubMed - in process] (Source: Annales Pharmaceutiques Francaises)

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Journal of Pediatric Surgery — Thu, 01 Sep 2011 04:00:00 +0100

Despite the relatively high incidence, the clinical evaluation of child with acute abdominal pain (AAP) including disease history, physical examination, and laboratory tests is frequently inaccurate. The authors evaluated the accuracy of high-resolution ultrasonography (US) with graded compression in the diagnosis of pediatric appendicitis. The medical records of consecutive 664 children (347 boys and 317 girls; mean age, 11.1 years) with AAP suggesting acute appendicitis treated between 2007 and 2009 were reviewed retrospectively and analyzed. Four hundred eight children (241 boys and 167 girls, with a mean age of 10.76 years) underwent appendectomy (61.4%) and 256 patients (106 boys and 150 girls; mean age, 11.67 years) were not qualified for surgery (38.6%). High-resolution US was perfo...

Successful management of contrast medium extravasation injury through stellate ganglion block and intra-arterial nitroglycerin.

Acta Anaesthesiologica Taiwanica — Thu, 01 Sep 2011 04:00:00 +0100

We describe the successful management of extravasation injury to the left hand by contrast medium with stellate ganglion block and intra-arterial nitroglycerin in a patient which befell during contrast-enhanced imaging. The incidence of contrast-medium extravasation injury is increasing because of the convenience and availability of contrast-enhanced imaging and ease of injection access. Extravasation of contrast medium may results in severe pain, erythema, cyanosis, and edema or even skin necrosis, which is largely related to the ionization, osmolarity, and volume of the contrast medium. The conservative treatment is often adequate in small amount extravasation, but if the extravasation is overwhelming further energetic management is mandatory. A 29-year-old man was brought to our emergen...

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Acute appendicitis—not just for the young

American Journal of Surgery — Sat, 27 Aug 2011 21:51:29 +0100

Conclusions: Older patients represent a substantial population of patients with appendicitis, with more complicated operative procedures, increased lengths of stay, and increased resource utilization. (Source: American Journal of Surgery)

Postoperative Morbidity Index: A Quantitative Measure of Severity of Postoperative Complications

Journal of the American College of Surgeons — Thu, 25 Aug 2011 04:00:00 +0100

Conclusions: Quantification of severity of postoperative complications is possible using American College of Surgeons' National Surgical Quality Improvement Program methods and the Accordion Severity Grading System. Procedural PMI can be useful in assessing surgical outcomes. Certain limitations, particularly the need for risk adjustment, still need to be addressed. (Source: Journal of the American College of Surgeons)

Appendectomy During Pregnancy: Follow-Up of Progeny

Journal of the American College of Surgeons — Fri, 19 Aug 2011 04:00:00 +0100

Conclusions: Appendectomy during pregnancy is not associated with developmental delays in children, regardless of which trimester the procedure was performed. All children in this study had normal motor, sensory, and social development by 3 years of age. (Source: Journal of the American College of Surgeons)

Cancers of the Appendix: Review of the Literatures

Infectious Diseases in Obstetrics and Gynecology — Mon, 15 Aug 2011 15:14:14 +0100

Cancers of the appendix are rare. Most of them are found accidentally on appendectomies performed for appendicitis. When reviewed, majority of the tumors were carcinoid, adenoma, and lymphoma. Adenocarcinomas of appendix are only 0.08% of all cancers and the treatment remains controversial. Here we are reporting a 46-year-old male presented with symptoms of appendicitis, diagnosed with adenocarcinoma of the appendix. The patient was treated with appendectomy and refused further surgical intervention to complete hemicolectomy. Up to date, he remains asymptomatic. We performed literature review of the tumors of the appendix. Most of the benign conditions are treated with surgery alone. Lymphomas require CHOP-like chemotherapy and carcinoid syndrome treatment with somatostatin analogues. ...

Histological origin of pseudomyxoma peritonei in Chinese women: Clinicopathology and immunohistochemistry.

World Journal of Gastroenterology : WJG — Sun, 14 Aug 2011 04:00:00 +0100

CONCLUSION: Most PMP originated from the appendix. Among women with PMP, the ovarian tumors were implanted rather than primary. For patients with PMP, appendectomy should be performed routinely. The ovaries, especially the right ovaries should be explored. PMID: 21941421 [PubMed - as supplied by publisher] (Source: World Journal of Gastroenterology : WJG)

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Dynamic Logistic Regression and Dynamic Model Averaging for Binary Classification

Biometrics — Thu, 11 Aug 2011 23:00:00 +0100

Summary We propose an online binary classification procedure for cases when there is uncertainty about the model to use and parameters within a model change over time. We account for model uncertainty through dynamic model averaging, a dynamic extension of Bayesian model averaging in which posterior model probabilities may also change with time. We apply a state‐space model to the parameters of each model and we allow the data‐generating model to change over time according to a Markov chain. Calibrating a “forgetting” factor accommodates different levels of change in the data‐generating mechanism. We propose an algorithm that adjusts the level of forgetting in an online fashion using the posterior predictive distribution, and so accommodates various levels of change at different ...

Cancers of the Appendix: Review of the Literatures

Journal of Cancer Epidemiology — Thu, 11 Aug 2011 16:20:49 +0100

Single port laparoscopic appendectomy: are we pursuing real advantages?

World Journal of Emergency Surgery — Tue, 09 Aug 2011 23:00:00 +0100

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Microbiology of surgical site infections in abdominal tract surgery patients.

Cirugia eEspanola — Tue, 02 Aug 2011 23:00:00 +0100

CONCLUSION: The microbiology of SSI produced after upper abdominal tract surgery did not show any significant differences compared to those of the lower tract. However, more cases of SSI were detected due to staphylococci, Klebsiella pneumoniae, Enterobacter spp., Acinetobacter spp. and Candida albicans and less caused by Escherichia coli, Bacteroides fragilis and Clostridium spp. PMID: 21820107 [PubMed - as supplied by publisher] (Source: Cirugia eEspanola)

Volvulus of the appendix: a case report

Journal of Pediatric Surgery — Sun, 31 Jul 2011 23:00:00 +0100

We describe a 2-year-old child who presented with right lower quadrant abdominal pain and was initially diagnosed as ruptured appendicitis with abscess. Attempt at computed tomography–guided drainage failed to produce purulent drainage, and the child was taken to the operating room for diagnostic laparoscopy. Operative findings revealed a volvulus of the appendix, and a laparoscopic appendectomy was performed. (Source: Journal of Pediatric Surgery)

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Delayed operating room availability significantly impacts the total hospital costs of an urgent surgical procedure

Surgery — Fri, 29 Jul 2011 19:52:50 +0100

Conclusion: A short delay in operating room availability for urgent cases is associated with significantly increased total hospital costs. Our data suggest this finding is attributable to inefficient care when the operating room volume nears total capacity. (Source: Surgery)

Single-Incision Laparoscopic Colorectal Surgery, Experience with 50 Consecutive Cases

Journal of Gastrointestinal Surgery — Wed, 27 Jul 2011 18:48:07 +0100

Conclusion SILS colectomy is a safe and feasible procedure even in more complex cases. Comparative studies are needed to demonstrate advantages over traditional laparoscopic surgery. Content Type Journal ArticlePages 1-6DOI 10.1007/s11605-011-1626-3Authors Peter B. van den Boezem, Department of Surgery, Gelderse Vallei Hospital, 6716 RP Ede, The NetherlandsColin Sietses, Department of Surgery, Gelderse Vallei Hospital, 6716 RP Ede, The Netherlands Journal Journal of Gastrointestinal SurgeryOnline ISSN 1873-4626Print ISSN 1091-255X (Source: Journal of Gastrointestinal Surgery)

Metastatic urachal carcinoma of the ovary

Journal of Obstetrics and Gynaecology Research — Tue, 26 Jul 2011 23:00:00 +0100

AbstractA 52‐year‐old woman had undergone a partial cystectomy for a cystic mass at the dome of the urinary bladder in 1997. The pathological diagnosis was a urachal mucinous cystadenoma with borderline malignancy. Twelve years later, multiple masses were noted on the uterus, ovaries and abdominal wall. She underwent debulking surgery, including a total hysterectomy, bilateral salpingo‐oophorectomy, pelvic lymph node dissection, infracolic omentectomy, appendectomy, colon mass removal and abdominal wall mass removal. Remnants of the tumor were seeded throughout the abdominal cavity. The pathological evaluation confirmed metastatic urachal mucinous adenocarcinoma in both ovaries, the abdominal wall, the colon mass, the uterosacral ligament and the bladder. Adjuvant chemotherapy with p...

Contemporary Predictors of Conversion from Laparoscopic to Open Appendectomy

Surgical Infections — Tue, 26 Jul 2011 20:06:53 +0100

Surgical Infections , Vol. 0, No. 0. (Source: Surgical Infections)

Appendectomy in pregnancy: evaluation of the risks of a negative appendectomy

American Journal of Surgery — Tue, 26 Jul 2011 04:00:00 +0100

Conclusions: NA during pregnancy is not free of risk to the fetus. We recommend careful assessment to avoid unnecessary exploration when appendicitis is suspected in pregnant women. (Source: American Journal of Surgery)

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Reply

Journal of the American College of Surgeons — Mon, 25 Jul 2011 16:11:56 +0100

A dictum of Sir Francis Bacon was that “Writing maketh an exact man.” My attribution of the Shah's biliary surgery to Dr Frank Glenn was inexact. The surgeon was Dr Bjorn Thorbjarnarson. Unfortunately, in none of the references that I used was the surgeon at New York Hospital identified by name. I erroneously assumed that it was Dr Frank Glenn because I associated his name with biliary surgery at New York Hospital. That was a wrong assumption. He had retired in 1976. (Incidentally, he had participated in the Shah's appendectomy in 1951.) (Source: Journal of the American College of Surgeons)

Economics of Appendicitis: Cost Trend Analysis of Laparoscopic Versus Open Appendectomy from 1998 to 2008

Journal of Surgical Research — Mon, 25 Jul 2011 04:00:00 +0100

Conclusions: LA is more prevalent but its cost is higher in both simple and complex cases. Cost and complications increase if the case is converted to open. OA remains the most cost effective approach for patients with acute appendicitis. (Source: Journal of Surgical Research)

Case of the Month # 168: Seminal Vesicle Cysts with Ipsilateral Renal Dysgenesis

Canadian Association of Radiologists Journal — Thu, 21 Jul 2011 19:26:04 +0100

An otherwise healthy 36-year-old man presented to the emergency department with left-sided abdominal pain and an absence of bowel movements for the preceding 4 days. A clinical diagnosis of benign constipation was made, and the patient was discharged home. He returned to the emergency department the following day with continued abdominal pain that was now accompanied with nausea, vomiting, and fever. A surgical history of a remote appendectomy and a vasectomy 3 weeks before presentation were noted. (Source: Canadian Association of Radiologists Journal)

Single-Incision Multiport Laparoscopy Does Not Cause More Pain Than Conventional Laparoscopy: A Prospective Evaluation in Children Undergoing Appendectomy

Journal of Laparoendoscopic — Thu, 21 Jul 2011 14:22:31 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques , Vol. 0, No. 0. (Source: Journal of Laparoendoscopic)

Abstracts from Around the World

Clinical Gastroenterology and Hepatology — Tue, 19 Jul 2011 23:00:00 +0100

This study updates in a larger cohort the use of multidetector CT scanning. At a single center, radiology records were retrospectively reviewed over a 9-year period using the search terms appendicitis, right lower quadrant pain, or appendix. Two thousand eight hundred seventy-one adults with suspected appendicitis were referred for CT. The final surgical pathology report was used as the gold standard for acute appendicitis supplemented by the intraoperative findings and clinical follow-up. After final review, acute appendicitis was confirmed in 675 (23.5%) patients. Acute appendicitis was confirmed in 662 and excluded in 54 of the 760 patients who had an appendectomy for a rate of negative findings of 7.5%. Other patients with acute appendicitis were managed nonoperatively and were include...

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2011 — July Case of the Month - Ileum

CAP Case of the Month — Mon, 18 Jul 2011 06:00:00 +0100

A mass in the ileum was noticed during surgery in a 60-year-old man undergoing appendectomy. Segmental bowel resection was performed which showed a 5.6 cm intramural mass. Sectioning revealed a circumscribed tumor without hemorrhage or necrosis. Immunohistochemistry showed that the tumor cells were Kit (CD117) (+), smooth muscle actin (+) and S100 (-). (Source: CAP Case of the Month)

An unexpected complication of acute appendicitis: Internal herniation

Digestive and Liver Disease — Wed, 13 Jul 2011 04:00:00 +0100

A 63-year-old woman was admitted to the emergency department with diffuse abdominal pain, distention, nausea, and vomiting. Physical examination revealed hyperactive bowel sounds, mild diffuse abdominal distention, and tenderness. Abdominal radiography showed a dilated small bowel with multiple air-fluid levels. The patient underwent an exploratory operation, where we discovered that the tip of the inflamed appendix had attached to the antimesenteric side of the ileum and had caused internal herniation (Fig. 1). As a result, obstruction and ischemic changes had developed at the herniated segments of the small bowel (Fig. 2). A dilatation was noted at the proximal segments of the ileum. The tip of the appendix was gently decomposed manually from the antimesenteric side, which eliminated the...

Narcotic bowel syndrome: an important diagnosis you may not have heard of (I hadn’t)

The Poison Review — Thu, 07 Jul 2011 23:33:46 +0100

3.5 out of 5 stars Narcotic Bowel Syndrome. Grover CA et al. J Emerg Med 2011 June 28; [Epub ahead of print] Abstract There are a number of patients who present to the emergency department with a history of chronic abdominal, and still do not have a diagnosis after multiple work-ups and interventions — CTs, MRIs, ultrasounds,colonoscopies, endoscopies, multiple blood tests, multiple admissions, sometimes laparotomy and/or cholecystectomy and/or appendectomy. Often, their complaints are not taken seriously, under the assumption that if no cause hasbeen identified after all those tests the pain can not be real. Invariably, someone along the line suggests porphyria, and the patient receives a workup for that. It’s virtually never porphyria. Narcotic bowel syndrome (NBS) is a...

Comparison of Outcomes of Laparoscopic Versus Open Appendectomy in Adults: Data from the Nationwide Inpatient Sample (NIS), 2006–2008

Journal of Gastrointestinal Surgery — Fri, 01 Jul 2011 17:43:28 +0100

Conclusion LA is safe and associated with lower morbidity, lower mortality, and shorter hospital stay with acute perforated and non-perforated appendicitis. Also, in perforated cases, LA had an advantage over OA in hospital charges. LA should be considered the procedure of choice for perforated and non-perforated appendicitis in adults. Content Type Journal ArticlePages 1-6DOI 10.1007/s11605-011-1613-8Authors Hossein Masoomi, Department of Surgery, University of California, Irvine, Medical Center, 333 City Blvd. West Suite 700, Orange, CA 92868, USASteven Mills, Department of Surgery, University of California, Irvine, Medical Center, 333 City Blvd. West Suite 700, Orange, CA 92868, USAMatthew O. Dolich, Department of Surgery, University of California, Irvine, Medica...

Laparoscopic versus open appendectomy

The Saudi Journal of Gastroenterology — Thu, 30 Jun 2011 23:00:00 +0100

Safiyya M Ali, Mazen HassanainSaudi Journal of Gastroenterology 2011 17(4):225-226 (Source: The Saudi Journal of Gastroenterology)

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Laparoscopic versus open appendectomy: A comparison of primary outcome measures

The Saudi Journal of Gastroenterology — Thu, 30 Jun 2011 23:00:00 +0100

Conclusion: LA is an equivalent procedure and not superior to OA in terms of primary outcome measures. (Source: The Saudi Journal of Gastroenterology)

Laparoscopic appendectomy decreases risks, hospital stay in children

Modern Medicine Contemporary Pediatrics — Thu, 30 Jun 2011 23:00:00 +0100

Findings of a large retrospective cohort study support the use of laparoscopic appendectomy (LA) in children. (Source: Modern Medicine Contemporary Pediatrics)

Small bowel obstruction subsequent to Essure microinsert sterilization: a case report

Fertility and Sterility — Thu, 30 Jun 2011 23:00:00 +0100

Conclusion(s): This case is reported to increase awareness that SBO is a potential complication of Essure microinsert placement. (Source: Fertility and Sterility)

Laparoscopic drainage of intraabdominal abscess after appendectomy: an alternative to laparotomy in cases not amenable to percutaneous drainage

Journal of Pediatric Surgery — Thu, 30 Jun 2011 23:00:00 +0100

Conclusion: Laparoscopic drainage is a safe and effective alternative for intraabdominal abscesses that occur after laparoscopic appendectomy. We recommend it as an alternative to open laparotomy when percutaneous drainage is not an option. (Source: Journal of Pediatric Surgery)

[Inflammatory pseudotumours of the liver associated with Crohn's disease: a possible pitfall in contrast-enhanced ultrasound].

Zeitschrift fur Gastroenterologie — Thu, 30 Jun 2011 23:00:00 +0100

We report of a 22-year-old man with persistant abdominal pain and fever after appendectomy. Fundamental ultrasound showed an inflammatory swelling of the terminal ileum, suspicious of Crohn's disease as well as two solid liver lesions and left portal vein thrombosis. The enhancement patterns of both liver tumors on CEUS showed inhomogeneous isoenhancement during the arterial and portal phases and hypoenhancement during the late phase, mimiking malignant lesions. Ultrasound-guided biopsy, histology and follow-up, however, confirmed the diagnosis of hepatic inflammatory pseudotumour (IPT). When diagnosing a pseudotumour of the liver, the rare coincidence with chronic inflammatory bowel disease should be considered. PMID: 21766261 [PubMed - in process] (Source: Zeitschrift fur Gastroente...

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A New Simple Scoring System for the Diagnosis of Acute Appendicitis

Journal of Pakistan Medical Students — Thu, 30 Jun 2011 04:00:00 +0100

Conclusion: The proposed scoring system introduces a quantitative combination of the clinical, laboratory, and imaging data, which may enhance the diagnostic accuracy of AA especially in those geographical regions where ultrasound scanning is readily available. Key words: Acute Appendicitis, Ultrasound, Scoring System INTRODUCTION Among patients presenting to an emergency department with acute lower abdominal pain, acute appendicitis (AA) is often suspected. AA is a common surgical cause of acute abdomen, the prompt diagnosis of which is rewarded by a marked decrease in morbidity and mortality1. Quite frequently, the decision to perform surgery is based solely on clinical evaluation supplemented by laboratory data. Therefore diagnostic errors are common, resulting in a medi...

Environmental factors in inflammatory bowel disease: A case-control study based on a Danish inception cohort

Journal of Critical Care — Wed, 29 Jun 2011 04:00:00 +0100

Conclusion: Among Danish patients with CD and UC belonging to an unselected cohort, disease occurrence was found to be associated both with well-known factors such as smoking and appendectomy, and with more debated factors including breastfeeding, tonsillectomy, childhood vaccinations, childhood infections, and dietary intake of fibres and sugar.Highlights: ► The aetiology of inflammatory bowel diseases remains uncertain. ► Smoking was positively associated with CD and negatively associated with UC. ► Low consumption of dietary fibres and high consumption of sugar increased the risk for IBD. ► Appendectomy decreased the risk for UC. Tonsillectomy decreased the risk for both UC and CD. ► Childhood infections and vaccinations may also play an aetiological role in IBD. (Source: Jour...

Protective pathways against colitis mediated by appendicitis and appendectomy

Clinical and Experimental Immunology — Sun, 26 Jun 2011 23:00:00 +0100

SummaryAppendicitis followed by appendectomy (AA) at a young age protects against inflammatory bowel disease (IBD). Using a novel murine appendicitis model, we showed that AA protected against subsequent experimental colitis. To delineate genes/pathways involved in this protection, AA was performed and samples harvested from the most distal colon. RNA was extracted from four individual colonic samples per group (AA group and double‐laparotomy control group) and each sample microarray analysed followed by gene‐set enrichment analysis (GSEA). The gene‐expression study was validated by quantitative reverse transcription–polymerase chain reaction (RT–PCR) of 14 selected genes across the immunological spectrum. Distal colonic expression of 266 gene‐sets was up‐regulated significan...

Effect of Pressure- Versus Volume-Controlled Ventilation on the Ventilatory and Hemodynamic Parameters During Laparoscopic Appendectomy in Children: A Prospective, Randomized Study

Journal of Laparoendoscopic — Fri, 24 Jun 2011 03:10:04 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques , Vol. 0, No. 0. (Source: Journal of Laparoendoscopic)

Laparoscopic appendectomy may be best for kids

Modern Medicine — Thu, 23 Jun 2011 23:00:00 +0100

NEW YORK (Reuters Health) - Pediatric patients needing appendectomy will have fewer infections and draining abscesses, and shorter hospital stays, if they have laparoscopic surgery rather than the open procedure, a multicenter California study found. (Source: Modern Medicine)

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The Distinction Between the Use of a Control Group in a Study and the Use of a Case-Control Design

Journal of the American College of Surgeons — Thu, 23 Jun 2011 00:50:03 +0100

We read with interest the recent article, “Impact of an Outpatient Appendectomy Protocol on Clinical Outcomes and Cost: A Case-Control Study” by Dubois and colleagues, and have several concerns regarding the design and analysis of this study. (Source: Journal of the American College of Surgeons)

Removing Appendix Laparoscopically Safer for Kids (CME/CE)

MedPage Today Pediatrics — Tue, 21 Jun 2011 18:30:00 +0100

(MedPage Today) -- Children who need an appendectomy may avoid complications and get home sooner when a laparoscopic approach is used, researchers found. (Source: MedPage Today Pediatrics)

CT use cuts negative appendectomy rates

AuntMinnie.com Headlines — Tue, 21 Jun 2011 15:25:35 +0100

CT is highly sensitive and specific for identifying acute appendicitis in both (more) (Source: AuntMinnie.com Headlines)

Diagnostic performance of multidetector computed tomography for suspected acute appendicitis.

Annals of Internal Medicine — Mon, 20 Jun 2011 23:00:00 +0100

Conclusion: Multidetector computed tomography is a useful test for routine evaluation of suspected appendicitis in adults. Primary Funding Source: None. PMID: 21690593 [PubMed - in process] (Source: Annals of Internal Medicine)

Multidetector CT Recommended Before AppendectomyMultidetector CT Recommended Before Appendectomy

Medscape Today Headlines — Mon, 20 Jun 2011 21:00:00 +0100

A study suggests that multidetector computed tomography is sensitive and specific and should be the standard of care for suspected appendicitis in adults. Medscape Medical News (Source: Medscape Today Headlines)

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Laparoscopic Approach to Appendectomy Preferred in ChildrenLaparoscopic Approach to Appendectomy Preferred in Children

Medscape Today Headlines — Mon, 20 Jun 2011 20:11:17 +0100

In children with appendicitis, laparoscopic vs open appendectomy was linked to reduced risks for wound infection, abscess drainage, and duration of hospitalization. Medscape Medical News (Source: Medscape Today Headlines)

Laparoscopic vs Open Appendectomy in Children: Outcomes Comparison Based on Age, Sex, and Perforation Status [Original Article]

Archives of Surgery — Sun, 19 Jun 2011 23:00:00 +0100

Early vs Interval Appendectomy for Children With Perforated Appendicitis [Original Article]

Archives of Surgery — Sun, 19 Jun 2011 23:00:00 +0100

Conclusions Early appendectomy significantly reduced the time away from normal activities. The overall adverse event rate after early appendectomy was significantly lower compared with interval appendectomy. Trial Registration clinicaltrials.gov Identifier: NCT00435032 (Source: Archives of Surgery)

Appendiceal stump closure in children with complicated appendicitis: A prospective analysis of endoloops versus endostaples

Asian Journal of Endoscopic Surgery — Sun, 19 Jun 2011 23:00:00 +0100

Conclusion: This is the first prospective study comparing EL and ES during LA for complicated appendicitis in children. ES is more expensive, but there was no significant difference in morbidity for this technique, particularly with regard to incidence of postoperative intra‐abdominal abscess. (Source: Asian Journal of Endoscopic Surgery)