Acute appendicitis with a neuroendocrine tumor G1 (carcinoid): pitfalls of conservative treatment

2016 ◽  
Vol 9 (4) ◽  
pp. 203-207 ◽  
Author(s):  
Hiroyuki A. Watanabe ◽  
Taketoshi Fujimoto ◽  
Yo Kato ◽  
Mayumi Sasaki ◽  
Toshikazu Ikusue
Keyword(s):  
Conservative Treatment ◽  
Acute Appendicitis ◽  
Neuroendocrine Tumor

scholarly journals APPENDICULAR MASS

2010 ◽  
Vol 17 (02) ◽  
pp. 180-184
Author(s):  
SARDAR ALI ◽  
HAFIZ MUHAMMED RAFIQUE
Keyword(s):  
Conservative Treatment ◽  
Acute Appendicitis ◽  
Cost Effective ◽  
Female Ratio ◽  
Surgical Exploration ◽  
Group I ◽  
Variable Extent ◽  
Group Ii ◽  
Adhesive Intestinal Obstruction ◽  
Appendicular Mass

Introduction: Appendicular mass is a common complication of acute appendicitis. The traditional treatment of this is conservative followed by delayed appendectomy. But now with advancement in all the fields of medicine early surgical exploration of the appendicular mass can be done with satisfactory results. Aims and objectives: A comparison of conservative treatment versus early surgical exploration of appendicular mass. Study Design: Experimental study. Material and Method: Two years study from December 2003 to November 2005 at district headquarters hospital Khanewal. Total 60 patients, both males and females between 12 to 65 years of age with symptoms and signs consistent with appendicular mass were included. They were randomly divided into group I (Early exploration) and group II (Conservative treatment) each containing 30 patients. A comparison of outcome between two groups was done statistically by applying studentChi-square test. Results: There was a peak incidence of acute appendicitis in Second and third decades of life. Male to female ratio was 2:1. More than 90% of patients had history of shifting of abdominal pain. 100% of the patients had inflamed appendix to variable extent on exploration. The complications in the form of adhesive intestinal obstruction; failure of treatment; lost follow up; misdiagnosis and re admissionwere less in group I. There was a significant less duration of hospital stay in group I as compared to Group II. The observations and outcome in this study are almost comparable and correspond with other studies done in this regard. Conclusion: Early surgical exploration of appendicular mass is safe and cost effective.

Ultrasonographic Findings after Conservative Treatment of Acute Appendicitis and Open Appendicectomy

1995 ◽  
Vol 36 (2) ◽  
pp. 173-177 ◽  
Author(s):  
S. Eriksson ◽  
Å. Tisell ◽  
L. Granström
Keyword(s):  
Conservative Treatment ◽  
Acute Appendicitis ◽  
Antibiotic Treatment ◽  
Randomized Study ◽  
Open Appendicectomy ◽  
Recurrent Appendicitis ◽  
Us Findings

In a randomized study we investigated the effects of antibiotics as the only treatment in acute appendicitis. Forty patients were examined, 19 after antibiotic treatment (one operated due to perforation) and 21 after surgery. All patients were examined prior to randomization, after 10 days and after 30 days. Of the positive ultrasonographic (US) findings, 18 (86%) of the 21 operated patients had histologically proven acute appendicitis. At the 10th day, 9 patients had a seroma under the scar, which had disappeared a month after surgery in all patients. In the 19 patients conservatively treated with antibiotics, the appendix could be visualized in 8 symptom-free cases on the 10th day. In 5 of the 8 patients the appendix was still visualized after 1 month. Three of these 5 had recurrent appendicitis within a year. It is concluded that US can be used not only in diagnosing acute appendicitis, but also in the evaluation of treatments such as antibiotics.

scholarly journals 1565 In Covid-19 Pandemic, Following the Updated Royal College of Surgeons of England Guidelines in Management of Acute Appendicitis; A General District Hospital Audit

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Dorra ◽  
M Abdellatif ◽  
W Fahmy ◽  
Y Salama
Keyword(s):  
Conservative Treatment ◽  
Acute Appendicitis ◽  
Royal College ◽  
Conservative Management ◽  
District Hospital ◽  
Admission Rate ◽  
Operative Management ◽  
Operative Intervention ◽  
Coding System ◽  
Conservative Group

Abstract Aim The Aim of the study is assessment of the compliance with the updated Royal College of Surgeons of England (RCS) guidelines in management of acute appendicitis in a general district hospital during COVID-19 pandemic. Conservative treatment of acute appendicitis is encouraged unless unresponsiveness to treatment or complications ensues. Method Collection of retrospective data using hospital coding system was done from 63 patients medical records who were diagnosed with acute appendicitis from April 2020 to June 2020. Results The collected data analysis showed adherence to conservative treatment in 16 out of 63 (16/63) patients (25.4%). It succeeded in 10/16 patients (63 %). 6/16 patients were switched to operative intervention (37 %). There were no complications in patients who needed operative intervention after failure of conservative management. Operative management was primarily chosen in 47/63 patients (74.6 %). Re-admissions were 3/16 patients (18.75 %) in conservative group in comparison to 1/47 patient (2.12 %) in primarily operative group. Conclusions The work showed a promising rate of success of conservative treatment. However, there is a low level of compliance with RCS guidelines in management of acute appendicitis during COVID-19 pandemic. The study showed increased re-admission rate for conservative management versus primarily operative management pathways. No complications were detected in cases who needed operative intervention after failure of conservative management. Re-auditing is to follow. The study recommends national comparison of data as it might be worthwhile considering primary management of acute appendicitis.

Conservative treatment in uncomplicated acute appendicitis: reassessment of practice safety

2017 ◽  
Vol 176 (4) ◽  
pp. 521-527 ◽  
Author(s):  
Zvi Steiner ◽  
Genady Buklan ◽  
Rodica Stackievicz ◽  
Michael Gutermacher ◽  
Ita Litmanovitz ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Acute Appendicitis ◽  
Uncomplicated Acute Appendicitis

scholarly journals Tu1575 Conservative Treatment and Interval Appendectomy for Acute Appendicitis

2014 ◽  
Vol 146 (5) ◽  
pp. S-1079
Author(s):  
Toshiyuki Moriya ◽  
Kenji Mase ◽  
Koichiro Ozawa ◽  
Shigeo Hasegawa ◽  
Masaomi Mizutani ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Acute Appendicitis ◽  
Interval Appendectomy

scholarly journals A clinical study on conservative management of acute appendicitis in a tertiary care centre

2021 ◽  
Vol 8 (4) ◽  
pp. 1190
Author(s):  
Bhanu Bharath Naik
Keyword(s):  
Conservative Treatment ◽  
Acute Appendicitis ◽  
Clinical Symptoms ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
Alvarado Score ◽  
Uncomplicated Appendicitis ◽  
Laboratory Investigations ◽  
Modified Alvarado Score ◽  
Uncomplicated Acute Appendicitis

Background: Acute appendicitis is the most common clinical entity which is treated surgically by appendectomy. In recent years acute uncomplicated appendicitis can also be managed non surgically with antibiotic therapy. Aim and Objective was to assess the outcome of conservative treatment in the management of acute appendicitis.Methods: All patients who were diagnosed as acute appendicitis radiologically were enrolled into the study considering inclusion and exclusion criteria. Modified Alvarado score (MAS) was calculated based on clinical symptoms, signs and laboratory investigations. Injection ceftriaxone and injection metronidazole was given for 48-72 hours. Patients who responded for i.v. antibiotics were switched to tablet ciprofloxacin and tablet metronidazole for 7 days and followed for 6 months. Patients who didn’t respond to conservative treatment or had recurrence were classified as treatment failure/recurrence.Results: Totally 100 patients were enrolled in the study, 43 males and 57 females with a ratio of 1:1.32. Majority were in age group of 21-30. Ultrasound was performed in 91 patients, CT scan in 9 patients. 28 patients had MAS between 4-6 and 72 had between 7-9. 82 patients were successfully managed conservatively. 12 patients had failure of conservative treatment and 6 patients had recurrence.Conclusions: Success rate of conservative treatment in patients with MAS 4-6 was more than those with MAS 7-9 in this study. Complicated acute appendicitis should be managed surgically and uncomplicated acute appendicitis can be managed by conservative treatment provided they are strictly followed every month for 6 months to detect recurrences.

scholarly journals TP10.2.2Adherence to the new Royal College of Surgeons (RCS) guidance pertaining to acute appendicitis management during COVID-19

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Rajab Khan ◽  
Sabina Shamsad ◽  
Umaimah Rahimi ◽  
Hamisha Salih ◽  
Humayun Razzaq ◽  
...  
Keyword(s):  
Severe Sepsis ◽  
Retrospective Study ◽  
Conservative Treatment ◽  
Acute Appendicitis ◽  
Antibiotic Therapy ◽  
Surgical Management ◽  
Complicated Appendicitis ◽  
Global Pandemic ◽  
Imaging Results ◽  
Recurrent Appendicitis

Abstract Aims The mainstay of acute appendicitis treatment is a surgical approach. However, in the tumultuous COVID-19 era, the approach to acute appendicitis management has altered. We sought to assess the applicability of the new RCS COVID-19 guidance after resolution of the global pandemic. Methods A retrospective study was conducted on 244 patients presenting between 01/03/2020 and 17/07/2020. Three sources of data were sought: patients presenting to A&E with signs of appendicitis, operative logs for patients who underwent removal of their appendix and all CT/US scans where the clinician had queried appendicitis in the request. Results 139 patients were treated conservatively with antibiotics (57.0%). 35 (25.2%) represented within 6 months. Conservative treatment was successful in 92.1% of cases. 65 appendectomies were completed during that time. 45 cases presented acutely whereby the surgical management of acute appendicitis was the primary choice. The decision to operate was due to: 13 (20%) because the patient was 16 or younger. 4 cases presenting with signs of severe sepsis. 4 cases had a complicated appendicitis on their imaging results. 22 (33.8%) cases were completed without initial conservative management. 9 (3.7%) cases failed conservative treatment thus requiring surgical management. 11 (4.5%) cases represented within 6 months due to recurrent appendicitis despite successful antibiotic treatment. Therefore, the recurrence rate following conservative treatment was 7.9%. Conclusions There was mixed adherence to the new guidance. Surgical management remains the best approach towards acute appendicitis. However, excellent results can still be achieved with appropriately targeted antibiotic therapy.

scholarly journals MALIGNANT TUMORS OF THE APPENDIX: CLINICAL AND MORPHOLOGICAL ANALYSIS OF CASES FROM THE PRACTICE

2021 ◽  
Vol 74 (5) ◽  
pp. 1277-1280
Author(s):  
Mykhailo S. Myroshnychenko ◽  
Olena O. Dyadyk ◽  
Nataliia V. Kapustnyk ◽  
Yuliia Ya. Fedulenkova ◽  
Iryna V. Borzenkova ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Neuroendocrine Tumor ◽  
Morphological Analysis ◽  
Malignant Tumors ◽  
Health Care Facilities ◽  
Medical Community ◽  
Morphological Examination ◽  
First Case ◽  
Analysis Of Cases ◽  
Medical Histories

The authors have analyzed medical histories of two patients, treated in health care facilities of Kharkiv region from 2008 to 2020. These patients underwent urgent appendectomy, given the existing clinic of acute appendicitis. Morphological examination of the surgical material allowed us to diagnose adenocarcinoma in one case, and neuroendocrine tumor in combination with endometriosis in the other case. Morphological examination of the surgical material in the first case revealed a moderately differentiated adenocarcinoma and diffuse neutrophilic infiltration in all layers of the appendix, and in the second case – a well-differentiated neuroendocrine tumor (G3), combined with the signs of phlegmonous-ulcerative appendicitis and loci of endometriosis. In both cases, there were no specific for the oncological process anamnestic and clinical-instrumental data, and these tumors were manifested by the clinic of acute appendicitis. Only morphological examination of the surgical material allowed identifying the pathological process. Clinical and morphological analysis of cases from the practice of malignant tumors of the appendix (neuroendocrine tumor and adenocarcinoma) will be useful and interesting for the medical community and should stimulate cancer vigilance in physicians.

scholarly journals Appendicectomy for Uncomplicated Simple Appendicitis: Is It Always Required?

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Ibrahim Falih Noori Alsubsiee ◽  
Ahmed Falih Noori Alsubsiee
Keyword(s):  
Conservative Treatment ◽  
Acute Appendicitis ◽  
Medical Treatment ◽  
Clinical Improvement ◽  
Antibiotic Treatment ◽  
Standard Treatment ◽  
Signs And Symptoms ◽  
Oral Antibiotics ◽  
Uncomplicated Appendicitis

Background. Although appendicectomy is still the classical and standard treatment for acute appendicitis, initial conservative antibiotic only treatment for simple uncomplicated cases has been proposed and tried as a feasible and effective approach. The objective of this study was to evaluate the efficacy and outcomes of antibiotics treatment for acute simple uncomplicated appendicitis. Methods. This is a prospective controlled nonrandomized study in which a total of 156 patients whose ages range from 16 to 54 years presenting with clinical diagnosis of acute uncomplicated appendicitis were assigned for conservative antibiotics treatment, which consists of ceftriaxone I gram twice daily and metronidazole infusions, 500 mg in 100 ml, 3 times daily for 48 to 72 hours to be converted on oral antibiotics after clinical improvement for 5 to 7 days. Patients who failed to initial conservative treatment and those who had recurring symptoms of appendicitis were presented for appendectomy. Results. Antibiotic treatment was successful and feasible in 138 (88.5%) patients. Progression of the signs and symptoms despite full medical treatment was observed in 11 (7%) patients during the same admission. Further 7 (4.5%) patients showed recurrence of the symptoms during follow-up period of 6–12 months after successful initial conservative treatment and also proceeded for appendicectomy. Conclusion. Nonoperative antibiotic treatment of acute simple appendicitis is safe, feasible, and effective for properly selected cases, thus avoiding unnecessary surgery with its possible complications.

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