scholarly journals The radiologic roadmap for treatment of an acute appendicitis patient who tested positive for coronavirus disease 19

2021 ◽  
Author(s):  
Şeref Barbaros Arik ◽  
Elif Gunaydin ◽  
Celal İsmail Bİlgiç ◽  
İnanç Güvenç
Keyword(s):  
Emergency Department ◽  
Acute Appendicitis ◽  
Standard Treatment ◽  
Surgical Intervention ◽  
Ultrasound Examination ◽  
Bridging Therapy ◽  
Emergency Surgical Intervention ◽  
Pelvic Ct Scan

Objective: In this study, we aimed to emphasize the role of radiological imaging in determining the treatment of a patient, who tested positive for COVID-19 and diagnosed with acute appendicitis during the pandemic. Methods: A 31-year-old patient presented to the emergency department due to abdominal pain. Ultrasound examination, thoracic and pelvic CT scan were performed. Results: Non-complicated appendicitis can be treated conservatively with antibiotics. Treatment can be maintained by starting with IV antibiotics and bridging therapy with oral antibiotics. Conclusion: This study aims to summarize how radiological follow-up can be used to decide on the suitability of the patient for appropriate medical treatment as an alternative to surgery in a patient, whose gold standard treatment is emergency surgical intervention, which is frequently encountered in the emergency department during the COVID-19 pandemic.

The role of ultrasound examination in early detection and follow-up of arterio-portal shunts

2008 ◽  
Vol 29 (S 1) ◽  
Author(s):  
S Ioanitescu ◽  
L Micu ◽  
A Rampoldi ◽  
N Masala ◽  
V Marcu ◽  
...  
Keyword(s):  
Early Detection ◽  
Ultrasound Examination

The Role of Renal Scintigraphy in the Diagnosis and Follow-Up of Unilateral ATN After Complete Bilateral Distal Ureteral Obstruction As a Complication of Acute Appendicitis

1998 ◽  
Vol 23 (3) ◽  
pp. 141-145 ◽  
Author(s):  
MONIQUE M.C. TIEL-VAN BUUL ◽  
DANIËL C. ARONSON ◽  
JAAP W. GROOTHOFF ◽  
ROBERTINE VAN BAREN ◽  
JOOST FRENKEL ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Ureteral Obstruction ◽  
Renal Scintigraphy

scholarly journals Feasibility of surgical management in patients with mammary tuberculosis-study of 100 cases.

2018 ◽  
Vol 27 (1) ◽  
pp. 44-49
Author(s):  
RN Laila ◽  
B Islam ◽  
S Banu ◽  
J Raihan
Keyword(s):  
Surgical Intervention ◽  
Treatment Strategies ◽  
Diagnosis And Treatment ◽  
Idiopathic Granulomatous Mastitis ◽  
Breast Tuberculosis ◽  
Chest Disease ◽  
Disease Hospital ◽  
Anti Tubercular Therapy

Tuberculous mastitis is a rare entity in patients with mammary disease even in countries where incidence of tuberculosis is high. In Bangladesh, TB is an endemic disease but breast tuberculosis is rarely reported. Its clinical patterns and treatment strategies are changing day by day. With this study, we aimed to analyze the role of surgery in diagnosis and treatment of hundred (100) cases received care for tuberculous mastitis at the Chest Disease Hospital, Rajshahi, from July’ 2012 to July’ 2016. This is a prospective nonrandomized descriptive study. Diagnosis was made in all patients initially by cytological examination from suspected lesions, which revealed typical tuberculous lesions. In all the patients the diagnosis was confirmed by biopsy of the lesion (open biopsy or core cut biopsy) with histological examination and detection of acid fast bacilli in discharge by Gene x-pert test and Z-N staining to exclude idiopathic granulomatous mastitis, malignancy and very rare concomitant malignancy. Medical therapy with anti-tubercular drugs (ATT) ranging from 9 to 12 months with follow up monthly was the mainstay of treatment. Surgical intervention reserved for selected refractory cases (36%). Extension of anti-tubercular therapy from 9 to 12 or 18 months required in fifty-eight(58) patients on the basis of slow clinical response. Complete resolution obtained in 92 patients but residual tiny mass in eight patients confirmed by repeated FNAC or biopsy to be fibrotic. Surgery play an essential role both in diagnosis and treatment of tubercular mastitis in addition with ATT but beware about unnecessary surgical intervention as majority of patients cured with only ATT.TAJ 2014; 27(1): 44-49

scholarly journals Conservative management of early uncomplicated appendicitis in children

2017 ◽  
Vol 4 (3) ◽  
pp. 1024 ◽  
Author(s):  
Sunil Kumar Maini ◽  
Neeraj Kumar Jain ◽  
Manjari Goel Jain ◽  
Vicky Khobragade
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Conservative Management ◽  
Medical Management ◽  
Surgical Intervention ◽  
Lower Abdominal Pain ◽  
Primary Treatment ◽  
Research Centre ◽  
Uncomplicated Appendicitis

Background: Right lower abdominal pain management in children is a challenging task for the surgeon. Most of the time right lower abdominal pain ends up in acute appendicitis. For long time appendicetomy was the treatment of choice. However surgical intervention has its own disadvantages such as pain, scarring, adhesions, hernia development and venous thrombosis disease. Anxiety and fear of surgery were also two difficulties in obtaining consent for surgery. Parents often request and insist for medical management. Their unwillingness for surgical intervention was the most important reason for medical management of uncomplicated acute appendicitis.Methods: Our prospective observational study was conducted in the Department of General Surgery, R.K.D.F. Medical College and Research Centre, Bhopal, Madhya Pradesh, India during period of January 2014 to January 2016 and follow up was done till December 2016. Our target group was children under 16 years. A total of 92 children with complaint of right lower abdominal pain attended the hospital for treatment. Routine investigations including ultrasonography of abdomen were performed for all the patients. Out of 92 patients diagnosis of acute appendicitis was made in 74 patients, Surgery was performed in 32 patients, while remaining 42 patients were treated conservatively and the results were analyzed.Results: In this study of 92 patients of pain in right iliac fossa below 16 years, 74 (80.43%) were diagnosed as acute appendicitis. 32 (43.24%) Patients were operated earlier. 42 (56.75%) Patient were treated conservatively. Out of 42 patients, 12 (16.21%) patients were operated within 1 year, 30 (40.54%) Patients didn’t require any surgical intervention during 1 year follow up. In present study, significant role of antibiotic was found in conservative management of acute appendicitis in children. So it can be concluded that conservative management of acute appendicitis in children can be attempted under observation.Conclusions: Antibiotics are both effective and safe as primary treatment for patients with uncomplicated acute appendicitis. Initial antibiotic treatment merits consideration as a primary treatment option for early uncomplicated appendicitis. Appendicectomy should be done but conservative management of acute appendicitis in children can be attempted under observation.

The role of primary care physician and cardiologist follow-up for low-risk patients with chest pain after emergency department assessment

2014 ◽  
Vol 168 (3) ◽  
pp. 289-295 ◽  
Author(s):  
Andrew Czarnecki ◽  
Julie T. Wang ◽  
Jack V. Tu ◽  
Douglas S. Lee ◽  
Michael J. Schull ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Chest Pain ◽  
Primary Care Physician ◽  
Care Physician ◽  
Low Risk ◽  
Risk Patients

scholarly journals Traumatic Orbital Subperiosteal Hematoma With Acute Visual Compromise: Role of the Head and Neck Surgeon

2019 ◽  
Vol 98 (10) ◽  
pp. 617-620
Author(s):  
Tom Shokri ◽  
Vijay A. Patel ◽  
Neerav Goyal
Keyword(s):  
Surgical Intervention ◽  
Ocular Injury ◽  
Optimal Method ◽  
Craniomaxillofacial Trauma ◽  
Institutional Experience ◽  
Sudden Blindness ◽  
Age Range

The primary goal was to report our institutional experience of a rare, vision-threatening complication following craniomaxillofacial trauma. A retrospective review was performed between January 2016 and January 2018 to identify 3 patients with traumatic orbital subperiosteal hematoma (OSPH). Visual acuity, intraocular pressures (IOPs), and the need for surgical intervention were abstracted. The age range was 36 to 88 years. Indications for surgical intervention include relative afferent pupillary defect, gaze restriction, visual impairment, and elevated IOP. Preoperatively, IOP range was 15.0 to 25.0. Two patients required OSPH evacuation via a medial brow approach. Follow-up after ocular injury ranged from 25 to 41 days, with IOP range of 13.0 to 16.0. Traumatic OSPH is an uncommon clinical finding; prompt assessment with consideration of surgical intervention may mitigate deleterious long-term morbidity, chiefly sudden blindness. Further research efforts may elucidate the optimal method in the management of this complex clinical entity.

Dalbavancin Use in the Emergency Department Setting

2019 ◽  
Vol 53 (11) ◽  
pp. 1093-1101 ◽  
Author(s):  
Mitulkumar Patel ◽  
Samantha Smalley ◽  
Yanina Dubrovskaya ◽  
Justin Siegfried ◽  
Christopher Caspers ◽  
...  
Keyword(s):  
Emergency Department ◽  
Selection Criteria ◽  
Primary Objective ◽  
Ambulatory Setting ◽  
Time To Recurrence ◽  
Emergency Department Setting ◽  
Patient Selection Criteria ◽  
Dosing Strategy

Background: Although dalbavancin’s (DBV’s) long half-life and one-time dosing strategy confer ideal administration in the ambulatory setting, the optimal role of DBV in the management of acute bacterial skin and skin structure infections (ABSSSIs) remains to be elucidated. Objectives: The primary objective of this study was to compare treatment outcomes of ABSSSI between patients who received DBV in the emergency department (ED) as part of standard care versus patients who received DBV as part of a telehealth program. Methods: This was a retrospective cohort study evaluating patients who received DBV at 3 urban EDs. The primary end point was the incidence of ABSSSI recurrence. Secondary outcomes included need for hospital admission and ED length of stay (LOS; in hours). Results: A total of 65 ABSSSI treatment courses were included; 42 were included in the telehealth criteria (TC) cohort and 23 in the initial criteria (IC) cohort. There were 14% (6/42) infection recurrences in the TC cohort and 22% (5/23) in the IC cohort, with median time to recurrence being 4 and 14 days, respectively. Median ED LOS was significantly shorter in the TC (5 vs 25 hours, P < 0.05). Numerically fewer individuals in the TC cohort required inpatient admission (0 vs n = 2, 9%). Conclusion and Relevance: Our results suggest that patients may be safely administered DBV in an ED setting, with telehealth follow-up. Providing structured patient selection criteria is an effective method of assisting ED providers in selecting appropriate DBV candidates to limit potential recurrences and readmissions.

C-reactive protein to predict the need for surgical intervention in acute renal colic

2013 ◽  
Vol 7 (6) ◽  
pp. 380-383 ◽  
Author(s):  
ST McSorley ◽  
M Drury ◽  
P Majumdar ◽  
A Halsall ◽  
SK Nalagatla
Keyword(s):  
Renal Colic ◽  
Surgical Intervention ◽  
Strong Predictor ◽  
Serum Marker ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
A Value ◽  
Acute Renal Colic ◽  
Emergency Surgical Intervention

Objectives: C-reactive protein (CRP) is a serum marker of systemic inflammation which has been suggested to predict need for emergent surgical intervention in patients with acute renal colic at a value of > 28 mg/l on admission.1 We aimed to determine if this applied to our patients. Patients and methods: We prospectively collected data from all patients admitted with symptomatic urolithiasis, confirmed by CT-KUB, over three months. Fifty-nine patients were included; however, four were excluded because of co-morbidites which could influence CRP, or recent urological surgery, giving N = 55, age 50.0±14.6 years (mean±SD), M:F 40:15. The decision to proceed to intervention was made by each patient’s clinical team and not by the authors; however, there was no blinding to CRP. Results: A total of 24 of 55 patients required intervention on their index admission (22 retrograde ureteric stent, one nephrostomy, one ureteroscopic stone extraction), and 31 were managed conservatively. Those undergoing intervention had higher CRP on admission (mean 16.3 vs 9.4 mg/l, p = 0.06) and higher maximum CRP (mean 94.7 vs 25.7 mg/l, p < 0.001) than those managed conservatively. Nineteen (79%) of those requiring intervention had CRP < 28 mg/l on admission. There were no deaths, no intensive care admissions and all were discharged to outpatient follow-up. Conclusion: Rising CRP during admission is a strong predictor of the need for emergency surgical intervention in patients with acute renal colic; however, CRP at admission is less useful.

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.

scholarly journals Different Cytokine Profiles in Children with Acute Appendicitis and Acute Mesenteric Lymphadenitis / Atðíirîga Citokînu Grupas Seruma Iekaisuma Mediatoru Izpausme Akûta Apendicîta Un Akûta Mezenteriâla Limfadenîta Gadîjumâ Bçrniem

2015 ◽  
Vol 69 (6) ◽  
pp. 283-289
Author(s):  
Astra Zviedre ◽  
Arnis Eòìelis ◽  
Pçteris Tretjakovs ◽  
Antra Jurka ◽  
Irisa Zîle ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Surgical Intervention ◽  
Serum Levels ◽  
Mesenteric Lymphadenitis ◽  
Surgical Disease ◽  
Serum Cytokines ◽  
Tnf Α ◽  
Significant Difference ◽  
Wilks Lambda

Abstract The aim of this study was to investigate the role of serum cytokines in the diagnosis of acute appendicitis (AA) and acute mesenteric lymphadenitis (AML). Data were collected prospectively on 7 to 18 year old children (October 2010 - October 2013): 31 patients with AA, 26 patients with AML, and 17 patients with elective non-inflammatory surgical disease were selected as controls. Serum levels of IL-10, IL-12(p70), IL-1β, IL-4, IL-6, IL-8, IL-17, MCP-1, EGF, TNF-α were measured. Patients with AA had significantly increased serum levels of IL-6(1) (z = -3.72; p = 0.0002) and IL-10(1) (z = -2.81; p = 0.005) compared to AML before any treatment. The consecutive measurements of MCP-1 in serum demonstrated a significant difference within 72 hours in the AA group (Wilks’ Lambda test 0.80; F(2;29) = 3.5; p = 0.04) and also in the AML group (Wilks’ Lambda test 0.70; F(2;24) = 5.0; p = 0.01). The increased values of IL-6 and IL-10 were the most reliable cytokines one hour before surgical intervention for patients with AA. MCP-1 values changed significantly within 72 hours after patient hospitalisation but did not differ between the groups, and could not be a helpful serum biomarker in distinguishing patients with AA and AML.

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