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Wyszukujesz frazę "appendicitis" wg kryterium: Temat


Tytuł:
An Uncommon Course Of Acute Appendicitis With Sepsis – A Case Report
Autorzy:
Żyluk, Andrzej
Jagielski, Wojciech
Tematy:
acute appendicitis – complications
acute appendicitis – diagnosis
sepsis
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Wydawca:
Index Copernicus International
Powiązania:
https://bibliotekanauki.pl/articles/1395636.pdf  Link otwiera się w nowym oknie
Opis:
Authors report a case of 54-years-old patient, who presented to the hospital due to three-day history of weakness, abdominal pain and diarrhea. His general shape was severe, abdomen was tender at palpation in hypogastrium, peritoneal signs were positive, and blood tests showed highly elevated markers of inflammation, including procalcitonin, what suggested the sepsis. Despite unclear clinical picture, the presence sepsis was an argument to give the patient surgery. Intraoperatively, perforated appendix was found, being in mass with the omentum and small bowel. An appendectomy was performed. Postoperative course was complicated by the wound infection, but recovery progressed quickly and patient was dismissed at 5 days after operation. In the discussion the authors referred to the similar cases reported in the literature, concluding that acute appendicitis can be a life threating event for – to date – healthy adult person. Although a tendency to treat conservatively an uncomplicated acute appendicitis and to delay operations is supported by scientific evidence, the cases may occur in which only prompt surgical intervention protects the patient from serious complications.
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Does abdominal ultrasound is a useful tool in appendicitis diagnosis?
Autorzy:
Kamiński, Mateusz
Tematy:
appendicitis
ultrasonography
usg
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Wydawca:
Index Copernicus International
Powiązania:
https://bibliotekanauki.pl/articles/1392643.pdf  Link otwiera się w nowym oknie
Opis:
Introduction: Acute appendicitis is the most common acute abdominal illness. Despite progress in diagnosis, there is still a 20% negative appendectomy rate. The aim of the study was to determine the usefulness of abdominal sonography in the diagnosis of acute appendicitis. Materials and methods: Data were collected retrospectively from 326 patients operated with suspected appendicitis, who had undergone abdominal ultrasound prior to surgery. Appendicitis was confirmed by pathology reports. There were two variants of positive abdominal sonography. In the first, positive ultrasound was visualized inflamed appendix. In the second variant, the sonographic diagnosis of appendicitis was based on a visualized inflamed appendix or one of indirect signs of appendicitis – localized periappendiceal fluid collection, enlarged lymph nodes, thickening of the intestinal wall in the right iliac fossa. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were defined and compared. Results: 83.74% patients have appendicitis in their pathologic report. In 39.53% cases, the appendix was visualized via abdominal ultrasound. In 65.95% cases of sonography, there occurred indirect signs. In the first variant, sensitivity, specificity, PPV and NPV amounted to 47.99%, 79.25%, 92.25% and 22.83%, respectively. In the second variant, they amounted to 67.77%, 43.40%, 86.05% and 20.72%, respectively. In the second variant, sensitivity was significantly higher (p<0.001), however specificity was significantly lower (p<0.001). Conclusion: Limited sensitivity and specificity cannot be a confirmation of appendicitis. The typical clinical course with a negative ultrasound should not delay correct diagnosis and early surgical treatment.
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Differences in the clinical course of acute appendicitis in the elderly in comparison to younger populati
Autorzy:
Zbierska, Katarzyna
Kenig, Jakub
Lasek, Anna
Rubinkiewicz, Mateusz
Wałęga, Piotr
Tematy:
acute appendicitis
elderly
symptoms
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Wydawca:
Index Copernicus International
Powiązania:
https://bibliotekanauki.pl/articles/1394163.pdf  Link otwiera się w nowym oknie
Opis:
Acute appendicitis (AA) still remains the most common acute surgical abdominal emergency. Although 90% of cases occur in children and young adults, the incidence in the elderly amounts up to 10% and is constantly rising. The aim of the study was to assess the differences between clinical presentation in the elderly patients with AA compared to the younger patients. Additional aim was to assess the correlation between in-hospital time delays and patients’ outcomes. Material and methods. We conducted a retrospective analysis of medical data of 274 patients admitted to 3rd Department of General Surgery in Cracow between January 2011 and December 2013 due to AA. The elderly group comprised 23 patients aged 65 and above and the non-elderly group consisted of 251 patients. Results. The groups did not differ in symptoms and their duration, type of surgery and its duration. However, time from admission to ED to the beginning of the procedure was significantly lower in the elderly group (575.56 vs 858.9 min; p=0.03). The elderly had longer hospital stay (6.08 vs 4.69 days; p=0.004). In the elderly group the perforation rate was close to reaching statistical significance (26.1% vs 12.4%; p=0.06). No mortality was noted in both groups and morbidity was slightly higher in elderly group (17.4% vs 10%; p=0.26). Conclusions. There was no difference in the clinical presentation between elderly and non-elderly patients group. However, elderly patients presented with a more progressed inflammation of the appendix. The hospital stay was longer in the elderly group, without any mortality and with higher rate of morbidity in this group. The length of the preoperative phase was significantly shorter, confirming the awareness of importance of time in the elderly patients with acute abdomen.
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
The diagnostic role of hemogram parameters in pregnant appendicitis
Autorzy:
Somuncu, Erkan
Bozdag, Emre
sarici, inanc
Ozcan, Adem
Ozkan, Cenk
Basaran, Ceren
Tematy:
appendicitis
haemogram
NLR
pregnancy
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Wydawca:
Index Copernicus International
Powiązania:
https://bibliotekanauki.pl/articles/58459888.pdf  Link otwiera się w nowym oknie
Opis:
Introduction: Acute appendicitis is the most frequently encountered non-obstetric disease requiring surgical intervention during pregnancy. Early diagnosis reduces maternal and foetal morbidity/mortality rates. Aim: This study aims to investigate haemogram parameters in the diagnosis of acute appendicitis in pregnant women. Materials and methods: A retrospective case-controlled study was conducted in three groups. Thirty-nine pregnant patients with acute appendicitis (Group A), 39 fertile, non-pregnant patients with acute appendicitis (Group B) and 39 healthy pregnant women (Group C) were included in the study. The WBC, neutrophil and lymphocyte counts and NLR, PLR, MPV and RDW values were compared. Results: The mean NLR values in Groups A, B and C were 7.39 (1.58–46.6), 5.66 (1–20) and 4.23 (1.54–10.77), respectively, and there was a significant difference in NLR values between the groups (P = 0.002). The mean PLR values in Groups A, B and C were 159.09 (69.1–574), 134.28 (21.5–360) and 120 (68.7–334), respectively, and the difference was statistically significant (P = 0.019). The cutoff value for WBC count was 14 155 106/μL (51.3% sensitivity; 82.1% specificity), for neutrophil count it was 10 955 106/μL (53.8% sensitivity; 84.6% specificity), for NLR it was 9.23 (46.2% sensitivity; 92.3% specificity) and for PLR it was 157.6 (51.3% sensitivity; 82.1% specificity). NLR had the largest area under the curve, with 0.667 NLR. Conclusion: Neutrophil and WBC counts and PLR were found to be the most valuable inflammatory parameters. However, RDW, lymphocyte count and MPV levels were not found to be valuable markers in terms of sensitivity and specificity in the diagnosis of acute appendicitis in pregnant patients
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Treatment of acute appendicitis in geriatric patients – literature review
Autorzy:
Kot, Anna
Kenig, Jakub
Wałęga, Piotr
Tematy:
appendectomy
appendicitis
geriatric patients
elderly
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Wydawca:
Index Copernicus International
Powiązania:
https://bibliotekanauki.pl/articles/1394143.pdf  Link otwiera się w nowym oknie
Opis:
Demographic changes associated with the aging population mean that surgeons increasingly have contact and make decisions about treating patients from the oldest age groups. The aim of the study was to review the literature concerning the treatment of acute appendicitis in patients over the age of 60 years old. Material and methods. A review of the literature published in the years 2000-2015 has been carried out using the PubMed database. The initial number of results corresponding to the query in English, „appendicitis (MeSH) AND elderly (MeSH)” was 260. Selection based on the titles, abstracts, and eventually whole articles, ultimately resulted in 11 papers concerning the treatment of appendicitis in patients above 60 years of age. Results. Nine papers were retrospective and 2 were prospective. In total, the studies included 82,852 patients. Laparoscopic appendectomy was associated with a lower mortality rate, a smaller number of postoperative complications and a shorter length of hospital stay, which led to it being recommended by most authors. Four of the ten papers demonstrated that the patients who were qualified for laparoscopic surgery had less comorbidity and were in a lower ASA (American Society of Anaesthesiology) category. Antibiotic therapy as an independent method was assessed in one study in a group of elderly people, on a selected group of 26 patients, and its effectiveness was shown to be 70%. Most studies, however, are highly heterogeneous which significantly hindered comparisons. Conclusions. Currently, laparoscopic appendectomy seems to be the treatment of choice in the elderly with acute appendicitis. Antibiotic therapy, as an independent method of treatment of acute appendicitis, cannot currently be recommended. However, further, prospective, and better-designed studies are needed, involving a larger number of patients, and primarily dedicated to the elderly.
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Factors affecting the effectiveness of conservative management of appendicular mass
Autorzy:
Almoamin, Haithem Hussein Ali
Tematy:
appendicitis
complications
conservative
mass
pediatric
Pokaż więcej
Wydawca:
Index Copernicus International
Powiązania:
https://bibliotekanauki.pl/articles/1391541.pdf  Link otwiera się w nowym oknie
Opis:
Introduction: Acute appendicitis is the most common surgical emergency in children. Appendicular mass is a relatively common complication in improperly treated patients. The management of appendicular mass remains controversial. Aim: This study aims at determining factors affecting the effectiveness of conservative management of appendicular mass. Material and methods: This was a retrospective study of 71 children younger than 15 years with appendicular mass managed at Basra Children’s Specialty Hospital during the period between 2015 and 2019. Factors like age of the patient, duration of symptoms prior to hospital admission, size of the mass, complications, hospital stay and outcome are reviewed. Results: Appendicular mass complicates 3.9% of all cases of acute appendicitis. Conservative management of appendicular mass was effective in 84.5%. Appendicular mass occurred most frequently in children aged 5–10 years (48%). Male is more frequently affected than female with a ratio of 1.4. Regarding age effect on the efficacy of conservative management of appendicular mass, there is a significant association with P-value = 0.017. Duration of symptoms or size of the mass has no significant association with the success of conservative management. No mortality or major surgical complications are encountered. Although effective, conservative management prolongs the length of hospital stay. Conclusion: Conservative management of appendicular mass in children should be revised particularly in children younger than 5 years old, wherein operative treatment may be the first option. The reasons for that are high rate of failure of conservative management with early progress to appendicular abscess. These could be explained by the underdevelopment of the greater omentum lacking its protective effect in limiting the spread of inflammation. In addition, early appendectomy has the following advantages: decreased risk of adhesive intestinal obstruction, shortening of hospital stay (i.e, less economic burden), and avoidance of second readmission for interval appendectomy
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Computed tomography evaluation of variations in positions and measurements of appendix in patients with non-appendicular symptoms : time to revise the diagnostic criteria for appendicitis
Autorzy:
Kumar Singh, Deepak
Singh, Neha
Agrawal, Prasant
Agrawal, Gaurav Raj
Opis:
Purpose: To estimate the frequency distribution of different anatomical positions, and to measure the diameter, wall thickness, and length of appendix in patients with non-appendicular symptoms. Material and methods: This retrospective observational study was conducted among 1,575 patients, who had undergone computed tomography (CT) scan of abdomen for various non-appendicular signs and symptoms. Frequency of distribution of different anatomic locations and measurements of various morphologic parameters were recorded. Results: The most common location of appendix was retrocecal, followed by sub-cecal, post-ileal, and pelvic locations. The mean length of appendix was 66.7 mm (range, 6.3-123 mm), and the diameter was 6.3 mm (range, 2.8-11.3 mm). Diameter of > 6 mm was noted in 48.12% patients. The mean wall thickness was 2.37 mm, ranging 1.2-4.2 mm. The most common intra-luminal content was air-mixed with hypodense or hyperdense material observed in 70.5% of cases. Conclusions: Although an appendix with diameter less than 6 mm may be considered normal, a diameter above 6 mm has an overlap between a normal and inflamed appendix. Therefore, it should be considered in association with clinical and secondary findings to avoid overdiagnosis and unnecessary appendicectomies. We strongly recommend that diameter-based CT criteria to diagnose appendicitis should be revised and standardized.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł

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