scholarly journals Evaluation of early surgical management of complicated appendicitis by appendicular mass

2011 ◽  
Vol 9 (1) ◽  
pp. 101-103 ◽  
Author(s):  
M.A. Bahram
Keyword(s):  
Surgical Management ◽  
Complicated Appendicitis ◽  
Appendicular Mass

Early versus late surgical management of complicated appendicitis in children: A statewide database analysis with one-year follow-up

2018 ◽  
Vol 53 (7) ◽  
pp. 1339-1344 ◽  
Author(s):  
Saurabh Saluja ◽  
Tianyi Sun ◽  
Jialin Mao ◽  
Shaun A. Steigman ◽  
P. Stephen Oh ◽  
...  
Keyword(s):  
Surgical Management ◽  
Complicated Appendicitis ◽  
Database Analysis ◽  
One Year

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 Comparison of performance statistics of CT scan and ultrasonography in complicated appendicitis: experience in a tertiary care centre

2020 ◽  
Vol 8 (4) ◽  
pp. 1277
Author(s):  
Harekrishna Majhi ◽  
Pramit Ballav Panigrahi ◽  
Abinasha Mohapatra
Keyword(s):  
Ct Scan ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Complicated Appendicitis ◽  
P Value ◽  
Tertiary Care Centre ◽  
Conversion To Open Surgery ◽  
Negative Laparotomy ◽  
Performance Statistics ◽  
Appendicular Mass

Background: This study is conducted from November 2018 to November 2019 in this institute, where comparison of performance statistics is done between CT scan and Ultrasonography in patients with complicated appendicitis scheduled for conservative management, elective or emergency surgery.  Aim of the study was to evaluate and compare the performance statistics of CT scan and Ultrasonography in complicated appendicitis.Methods: The CT scan or USG findings of 87 patients were reviewed. The patients were divided into two groups i.e. CT scan group (group-1/18 patients), USG group (group-2/69 patients). Satistical analysis Student”s t-test, Fischer”s test, p-value, k-value.Results: Clinical signs, CT findings, USG findings, complications at surgery and histological examinations were noted. 2, 3, 13, patients presenting with CT features and 5, 13, 51 patients presenting with USG features of appendicular perforation, peri-appendicular abscess, inflammatory appendicular mass respectively. No clinical signs showed a significant association with the presence of appendicular perforation, peri-appendicular abscess, inflammatory appendicular mass or the complication encountered at surgery.Conclusions: In this study, by comparing CT scan group and USG group in complicated acute appendicitis, CT scan can change the plan of management in doubtful cases, decrease length of hospital stay and expenses, reduce the complication rate and negative laparotomy rate, and reduce the episodes of conversion to open surgery.

scholarly journals Outcomes of early surgical management of complicated appendicitis in children

2018 ◽  
Vol 5 (3) ◽  
pp. 1063
Author(s):  
Pramod S. ◽  
B. Revanth Kumar
Keyword(s):  
Surgical Management ◽  
Laparoscopic Appendectomy ◽  
Leucocyte Count ◽  
Complicated Appendicitis ◽  
Early Surgery ◽  
High Morbidity ◽  
Paediatric Surgery ◽  
Delayed Presentation ◽  
Duration Of Stay ◽  
Pain Abdomen

Background: Appendicitis is the most common surgical emergency in children. Nearly 30% of children present with complicated appendicitis. Controversy exists between early or delayed surgery in complicated appendicitis. Present study was done to evaluate the outcome of early surgical management of complicated appendicitis in children and also to analyze risk factors for complicated appendicitis.Methods: A retrospective observational study conducted by the department of Paediatric Surgery, KIMS, hospital Bangalore. All children with complicated appendicitis (perforated, gangrenous and mass) from October 2014 to October 2017 were included in the study. Clinical, biochemical and imaging findings of these children were tabulated. Children underwent either open or laparoscopic appendectomy. Intra operative data regarding the type of complication, presence or absence of Fecolith, position of appendix was documented. Post operatively duration of stay and complications were analyzed.Results: 47 children were included in the study. Mean age of presentation was 10.38±2.84 years. Most common presentation was pain abdomen. 65% of the patient had pain abdomen for duration of three days or more. Total leucocyte count of more than 15000 was seen in about 50% of the children. 68% of children underwent laparotomy, 23.5% underwent laparoscopic appendectomy. Intra operatively, perforation of the appendix with generalized peritonitis was the commonest finding. Fecolith was present in 32% of the cases. Mean duration of stay was 7.46 days. Wound infection was seen in 15% of the children. Late complication in the form of adhesive obstruction was seen in 5 patients.Conclusions: Complicated appendicitis is associated with high morbidity. High leucocyte count, delayed presentation and Fecolith are possible indicators of complicated appendicitis. Early surgery in complicated appendicitis is safe, feasible. The complication rate is acceptable and most of them can be managed conservatively. Hence early surgery in complicated appendicitis is an option to be considered.

scholarly journals MUCOSECTOMY IN COMPLICATED APPENDICITIS

2021 ◽  
Vol 71 (2) ◽  
pp. 711-14
Author(s):  
Syeda Rifaat Qamar Naqvi ◽  
Fahad Ali Khan ◽  
Ayesha Khan ◽  
Babar Sultan ◽  
Anam Haider ◽  
...  
Keyword(s):  
Experimental Study ◽  
Surgical Technique ◽  
Complication Rate ◽  
Complicated Appendicitis ◽  
Recurrent Appendicitis ◽  
Quasi Experimental ◽  
The Mean ◽  
Mean Time ◽  
Lower Morbidity ◽  
Appendicular Mass

Objective: To describe the technique and results of mucosectomy; A surgical technique that is easy to perform, and has a lower morbidity and complication rate as compared to standard appendectomy in cases of complicated appendicitis. Study Design: Quasi-experimental study. Place and Duration of Study: Surgical - A Unit, Ayub Teaching Hospital, in Abbottabad, from Mar 2017 to Mar 2019. Methodology: Patients included were those who presented with appendicular mass, phlegmon, recurrent appendicitis, appendicitis in uncommon locations, presence of adhesions, those cases of appendicular mass and phlegmon which was either not responding to medical treatment, or diagnosed per operatively being clinically not palpable or not seen on ultrasound. Per operative and post-operative variables were documented and analyzed. In mucosectomy, thesubserosal portion of the appendix i-emuscularis and mucosa of the appendix was dissected out from the serosa after ligation of the appendicular base, or ligation done after delivering the appendix out of the serosa. The serosa that was adherent to the surrounding gut, omentum or other viscera was left intact. Results: A total of 192 patients were included in this study, half of which underwent standard appendectomy and a mucosectomy was performed on the rest. The mean time of surgery was 30 ± 1.2min as compared to the standard appendectomy group (55min ± 3.6). More than half of the patients undergoing standard appendectomy required extension of the incision (56.2%), only 8% required so from those on whom mucosectomy was performed. Per operative hemorrhage was seen in 32.2%, however inmucosectomy group only 1%.

scholarly journals Management of Complicated Appendicitis in Al-Thawra Modern General Hospital Sana'a -Yemen from November 2019 to November 2020: علاج التهاب الزائدة الدودية المعقد

2021 ◽  
Vol 5 (3) ◽  
pp. 56-42
Author(s):  
Yasser Abdurabu Obadiel, Ibrahim Dahan Hussein Morshed Yasser Abdurabu Obadiel, Ibrahim Dahan Hussein Morshed
Keyword(s):  
Conservative Management ◽  
Prospective Observational Study ◽  
Perforated Appendicitis ◽  
Complicated Appendicitis ◽  
Midline Laparotomy ◽  
Female Ratio ◽  
Generalized Peritonitis ◽  
Male To Female ◽  
Appendicular Mass

Background: Complicated appendicitis causes morbidity and mortality more than simple appendicitis. Complicated appendicitis includes appendicular mass, appendicular abscess, perforated appendicitis. Objective: To study presentation of complicated appendicitis regarding to age, sex and complain duration, also to study management of complicated appendicitis and his response to conservative management. Methods: A prospective, observational study was conducted in the department of general surgery at AL-Thawra hospital during the period from Nov 2019 to Nov2020. The data was collected using clinical examination and follow up, and was analyzed using SPSS 24. Results: A total of 57 patients diagnosed as complicated appendicitis, aged from 6 to 60 years were admitted, mean age was 28 years. Male to female ratio was 1.6:1. The complaint duration was more than 3 days in 34 cases (59%), total leucocytes count was >18 × 103 in 28 cases (49.1%). Twenty patients (35.1%) diagnosed as generalized peritonitis, 18 cases (31.6%) diagnosed as localized peritonitis, 14 patients (24.6%) diagnosed as appendicular mass, and 5 cases (8.8%) diagnosed as appendicular abscess. Forty cases (70.2%) underwent surgical intervention, whereas 17 cases (29.8%) improved with conservative management. Fifteen cases (37.5%) of operated patients underwent simple appendectomy and 13 cases (32.5%) underwent appendectomy with drain, and 12 cases (30%) underwent midline laparotomy. Most appendicular mass cases 12 (85.7%) were managed conservatively and 2 cases (14.3%) were operated. Three cases (60%) of appendicular abscess were aspirated, 2 cases (40%) were drained. Surgical site infection was 27.5% of operated cases. Conclusions: Complicated appendicitis can be suspected through clinical presentation, duration of complains and inflammatory response. Management of complicated appendicitis varies accordingly from conservative conventional to midline laparotomy.

Surgical Management of Patients With 22q11.2 Deletion Syndrome

2019 ◽  
Vol 4 (5) ◽  
pp. 857-869
Author(s):  
Oksana A. Jackson ◽  
Alison E. Kaye
Keyword(s):  
Surgical Management ◽  
Preoperative Evaluation ◽  
Preoperative Assessment ◽  
22Q11.2 Deletion Syndrome ◽  
Deletion Syndrome ◽  
22Q11.2 Deletion ◽  
Surgical Decision ◽  
Obstructive Sleep ◽  
Spine Abnormalities ◽  
Speech Assessment

Purpose The purpose of this tutorial was to describe the surgical management of palate-related abnormalities associated with 22q11.2 deletion syndrome. Craniofacial differences in 22q11.2 deletion syndrome may include overt or occult clefting of the palate and/or lip along with oropharyngeal variances that may lead to velopharyngeal dysfunction. This chapter will describe these circumstances, including incidence, diagnosis, and indications for surgical intervention. Speech assessment and imaging of the velopharyngeal system will be discussed as it relates to preoperative evaluation and surgical decision making. Important for patients with 22q11.2 deletion syndrome is appropriate preoperative screening to assess for internal carotid artery positioning, cervical spine abnormalities, and obstructive sleep apnea. Timing of surgery as well as different techniques, common complications, and outcomes will also be discussed. Conclusion Management of velopharyngeal dysfunction in patients with 22q11.2 deletion syndrome is challenging and requires thoughtful preoperative assessment and planning as well as a careful surgical technique.

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