scholarly journals Seasonal variations in the occurrence of acute appendicitis and their relationship with the presence of fecaliths in children

2019 ◽  
Author(s):  
Yao-Jen Hsu ◽  
Yu-Wei Fu ◽  
Taiwai Chin
Keyword(s):  
Acute Appendicitis ◽  
Laboratory Data ◽  
Lymphoid Hyperplasia ◽  
Clinical Findings ◽  
Enterovirus Infection ◽  
Number Of Patients ◽  
Computed Tomography Scans ◽  
Laboratory Results ◽  
Pathology Reports ◽  
Surgical Condition

Abstract Background Acute appendicitis (AA) is the most common surgical condition in children. Although a higher incidence of AA in summer has been reported, the reason for this observation remains unclear. The purpose of this study was to compare the clinical findings of AA patients who underwent appendectomies during the summer months with those who underwent the procedure during the non-summer months. Methods The clinical data of 171 patients who underwent appendectomy from January 2013 to December 2016 were reviewed. The patients were divided into a summer group (from May to October) and a non-summer group (from November to April) based on the month when appendectomy was performed. All patients were under 18 years of age at the time of surgery. Laboratory data, computed tomography scans, pathology reports and operative records were reviewed. Results The number of patients with AA was higher in the summer group than in the non-summer group (101 vs. 70 patients). No significant differences in the laboratory results between the two groups of patients were observed. The percentage of AA patients who presented with a fecalith was significantly lower in the summer group (33.6%) than in the non-summer group (55.7%). No significant differences in the incidence of appendiceal perforations and abscesses were observed between the two groups. Conclusions The percentage of AA patients with fecaliths in summer was lower than that in the non-summer months. The increase in the number of AA patients in summer may be due to the increased occurrence of lymphoid hyperplasia, which may be correlated with the yearly outbreak of enterovirus infection during this period.

scholarly journals Seasonal variations in the occurrence of acute appendicitis and their relationship with the presence of fecaliths in children

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yao-Jen Hsu ◽  
Yu-Wei Fu ◽  
Taiwai Chin
Keyword(s):  
Acute Appendicitis ◽  
Medical Records ◽  
Laboratory Data ◽  
Lymphoid Hyperplasia ◽  
Clinical Findings ◽  
Number Of Patients ◽  
Computed Tomography Scans ◽  
Pathology Reports ◽  
Operative Notes ◽  
Surgical Condition

Abstract Background Acute appendicitis (AA) is the most common surgical condition in children. Although a higher incidence of AA in summer has been reported, the reason for this observation remains unclear. The purpose of this study was to compare the clinical findings of AA patients who underwent appendectomies during the summer months with those who underwent the procedure during the non-summer months. Methods The clinical data of 171 patients who underwent appendectomy from January 2013 to December 2016 were reviewed. The patients were divided into a summer group (from May to October) and a non-summer group (from November to April) based on the month when appendectomy was performed. All patients were under 18 years of age at the time of surgery. The medical records including laboratory data, computed tomography scans, pathology reports and operative notes were reviewed. Results The number of patients with AA was higher in the summer group than in the non-summer group (101 vs. 70 patients). No significant differences in the laboratory results between the two groups of patients were observed. The percentage of AA patients who presented with a fecalith was significantly lower in the summer group (33.6%) than in the non-summer group (55.7%). No significant differences in the incidence of appendiceal perforations and abscesses, as well as postoperative complications were observed between the two groups. Conclusions The percentage of AA patients with fecaliths in summer was lower than that in the non-summer months. The increase in the number of AA patients in summer may be due to the increased occurrence of lymphoid hyperplasia, which may be correlated with the yearly outbreak of enterovirus infection during this period.

scholarly journals Seasonal variations in the occurrence of acute appendicitis and their relationship with the presence of fecaliths in children

2019 ◽  
Author(s):  
Yao-Jen Hsu ◽  
Yu-Wei Fu ◽  
Taiwai Chin
Keyword(s):  
Acute Appendicitis ◽  
Medical Records ◽  
Laboratory Data ◽  
Lymphoid Hyperplasia ◽  
Clinical Findings ◽  
Number Of Patients ◽  
Computed Tomography Scans ◽  
Pathology Reports ◽  
Operative Notes ◽  
Surgical Condition

Abstract Background Acute appendicitis (AA) is the most common surgical condition in children. Although a higher incidence of AA in summer has been reported, the reason for this observation remains unclear. The purpose of this study was to compare the clinical findings of AA patients who underwent appendectomies during the summer months with those who underwent the procedure during the non-summer months. Methods The clinical data of 171 patients who underwent appendectomy from January 2013 to December 2016 were reviewed. The patients were divided into a summer group (from May to October) and a non-summer group (from November to April) based on the month when appendectomy was performed. All patients were under 18 years of age at the time of surgery. The medical records including laboratory data, computed tomography scans, pathology reports and operative notes were reviewed. Results The number of patients with AA was higher in the summer group than in the non-summer group (101 vs. 70 patients). No significant differences in the laboratory results between the two groups of patients were observed. The percentage of AA patients who presented with a fecalith was significantly lower in the summer group (33.6%) than in the non-summer group (55.7%). No significant differences in the incidence of appendiceal perforations and abscesses, as well as postoperative complications were observed between the two groups. Conclusions The percentage of AA patients with fecaliths in summer was lower than that in the non-summer months. The increase in the number of AA patients in summer may be due to the increased occurrence of lymphoid hyperplasia, which may be correlated with the yearly outbreak of enterovirus infection during this period.

scholarly journals Seasonal variations in the occurrence of acute appendicitis and their relationship with the presence of fecaliths in children

2019 ◽  
Author(s):  
Yao-Jen Hsu ◽  
Yu-Wei Fu ◽  
Taiwai Chin
Keyword(s):  
Acute Appendicitis ◽  
Medical Records ◽  
Laboratory Data ◽  
Lymphoid Hyperplasia ◽  
Clinical Findings ◽  
Number Of Patients ◽  
Computed Tomography Scans ◽  
Pathology Reports ◽  
Operative Notes ◽  
Surgical Condition

Abstract Background Acute appendicitis (AA) is the most common surgical condition in children. Although a higher incidence of AA in summer has been reported, the reason for this observation remains unclear. The purpose of this study was to compare the clinical findings of AA patients who underwent appendectomies during the summer months with those who underwent the procedure during the non-summer months. Methods The clinical data of 171 patients who underwent appendectomy from January 2013 to December 2016 were reviewed. The patients were divided into a summer group (from May to October) and a non-summer group (from November to April) based on the month when appendectomy was performed. All patients were under 18 years of age at the time of surgery. The medical records including laboratory data, computed tomography scans, pathology reports and operative notes were reviewed. Results The number of patients with AA was higher in the summer group than in the non-summer group (101 vs. 70 patients). No significant differences in the laboratory results between the two groups of patients were observed. The percentage of AA patients who presented with a fecalith was significantly lower in the summer group (33.6%) than in the non-summer group (55.7%). No significant differences in the incidence of appendiceal perforations and abscesses, as well as postoperative complications were observed between the two groups. Conclusions The percentage of AA patients with fecaliths in summer was lower than that in the non-summer months. The increase in the number of AA patients in summer may be due to the increased occurrence of lymphoid hyperplasia, which may be correlated with the yearly outbreak of enterovirus infection during this period.

scholarly journals Seasonal variations in the occurrence of acute appendicitis and their relationship with the presence of fecaliths in children

2019 ◽  
Author(s):  
Yao-Jen Hsu ◽  
Yu-Wei Fu ◽  
Taiwai Chin
Keyword(s):  
Acute Appendicitis ◽  
Medical Records ◽  
Laboratory Data ◽  
Lymphoid Hyperplasia ◽  
Clinical Findings ◽  
Number Of Patients ◽  
Computed Tomography Scans ◽  
Pathology Reports ◽  
Operative Notes ◽  
Surgical Condition

Abstract Background Acute appendicitis (AA) is the most common surgical condition in children. Although a higher incidence of AA in summer has been reported, the reason for this observation remains unclear. The purpose of this study was to compare the clinical findings of AA patients who underwent appendectomies during the summer months with those who underwent the procedure during the non-summer months. Methods The clinical data of 171 patients who underwent appendectomy from January 2013 to December 2016 were reviewed. The patients were divided into a summer group (from May to October) and a non-summer group (from November to April) based on the month when appendectomy was performed. All patients were under 18 years of age at the time of surgery. The medical records including laboratory data, computed tomography scans, pathology reports and operative notes were reviewed. Results The number of patients with AA was higher in the summer group than in the non-summer group (101 vs. 70 patients). No significant differences in the laboratory results between the two groups of patients were observed. The percentage of AA patients who presented with a fecalith was significantly lower in the summer group (33.6%) than in the non-summer group (55.7%). No significant differences in the incidence of appendiceal perforations and abscesses, as well as postoperative complications were observed between the two groups. Conclusions The percentage of AA patients with fecaliths in summer was lower than that in the non-summer months. The increase in the number of AA patients in summer may be due to the increased occurrence of lymphoid hyperplasia, which may be correlated with the yearly outbreak of enterovirus infection during this period.

scholarly journals Seasonal variation of acute appendicitis and fecaliths in children

2019 ◽  
Author(s):  
Yao-Jen Hsu ◽  
Yu-Wei Fu ◽  
Taiwai Chin
Keyword(s):  
Acute Appendicitis ◽  
Laboratory Data ◽  
Lymphoid Hyperplasia ◽  
Clinical Findings ◽  
Ct Scans ◽  
Lower Percentage ◽  
Significant Difference ◽  
Laboratory Results ◽  
The Difference ◽  
Appendiceal Perforation

Abstract Purpose A higher incidence of acute appendicitis (AA) in summer has been reported. The reason of this observation is uncertain. The purpose of this study is to analyze the difference of the clinical findings between summer and non-summer AA. Methods We reviewed the clinical data of 171 patients who had an appendectomy from 2013 to 2016. The patients were under 18 years of age by the time of surgery. Laboratory data, CT scans, pathologic reports and operative records were reviewed. Results More appendectomies were performed in summer than non-summer months (101 patients vs 70 patients). There is no significant difference of laboratory results between the summer and non-summer patients. The percentage of AA patients with a fecalith is significantly lower in the summer (33.6%) than non-summer months (55.7%). There was no significant difference in appendiceal perforation/abscess between summer and non-summer months. Conclusions We observed a lower percentage of AA with a fecalith in summer. To our knowledge, this observation has not been reported in literature. The increase of AA in summer may be a result of more lymphoid hyperplasia in summer. This may correlate with the yearly outbreak of enteroviral infections in this area.

scholarly journals Can Clinical Findings Prevent Negative Laparotomy in Parasitosis Mimicking Acute Appendicitis?

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Musa Zorlu ◽  
İbrahim Tayfun Şahiner ◽  
Ahmet Çınar Yastı ◽  
Ethem Zobacı ◽  
Ramazan Kocabaş ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Rural Areas ◽  
Young Patients ◽  
Diagnostic Value ◽  
Lymphoid Hyperplasia ◽  
Clinical Findings ◽  
City Centre ◽  
Negative Laparotomy ◽  
Number Of Patients ◽  
Significant Difference

Objectives. Rates of negative laparotomy (NL) for acute appendicitis have been reported as 15% and parasitosis contributed to 2%. This study was planned to reduce the rates of NL by preoperative determination of parasitosis. Methods. In retrospective examination of 2730 appendectomy specimens in Hitit University Department of General Surgery between 2008 and 2012, 55 patients were determined with parasitosis and compared with 102 age-matched randomly selected patients with lymphoid hyperplasia. Results. The parasite group comprised 63.6% females with a mean age of 15.1 years. The number of patients in the parasitosis group increased from city centre to rural areas of towns and villages (p<0.001). While a lower rate of sonographic findings was found in the parasitosis group, the findings of inflammation in the histopathological evaluation were significantly low (p=0.014, p=0.0011, resp.). A significant difference was determined between groups in respect of the eosinophil and haematocrit values. In the differentiation of patients with parasites, eosinophil of >2.2% was determined as a diagnostic value. Conclusion. It is important to determine parasitosis to prevent NL. When acute appendicitis is considered for young patients living in rural areas, the observation of high eosinophil together with negative sonographic findings should bring Enterobius vermicularis parasitosis to mind and thereby should prevent NL.

scholarly journals Evaluation of Children's Appendicitis Score Compared With Pediatric Appendicitis Score in Diagnosis of Pediatric Appendicitis

2020 ◽  
Author(s):  
Mohammad Khaasteh ◽  
Fariba Heidari ◽  
Akram Motamedi ◽  
Kafieh Aslani ◽  
Masoud Jamshidi ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Clinical Findings ◽  
Diagnostic Methods ◽  
Diagnostic Tools ◽  
Diagnostic Challenge ◽  
Diagnostic Features ◽  
Surgical Field ◽  
Us Findings ◽  
Pathology Reports ◽  
Appendicitis Score

Introduction: Identification and promotion of diagnostic methods has been a continuous effort to reduce disease and its complications and reduce costs associated with treatment. Despite all these efforts and improving our knowledge of diseases and diagnostic tools, pediatric appendicitis remains part of the diagnostic challenge in the surgical field. The aim of this is to compare the two diagnostic criteria of appendicitis (Children's Appendicitis Score [PAS] Versus Pediatric Appendicitis Score [CAS]) and evaluation of the diagnostic features of them. Methods: A retrospective cohort study was conducted on all children admitted to the hospital's emergency center with a possible diagnosis of appendicitis (270 patients) during 2018 and 2019 at Tabriz Pediatric Hospital. Based on the clinical examinations and para-clinical findings some of the patients were underwent the surgical intervention (220 cases) and some discharged and followed up for a period of 2 and 4 weeks later (50 cases). The data were analyzed through SPSS ver. 16 software. Results: The results of the present study indicated that if CAS was associated with ultrasound, the specificity of these criteria would improve and could be more acceptable compared with the PAS. In addition, it was revealed that WBC≥11000, as well as PMN≥65% and guarding were very specific for diagnosis and complication of acute appendicitis. There was a significant relationship between US findings and pathology reports (P<0.05). Conclusion: In conclusion, the CAS criteria were more sensitive and the PAS was more specific in diagnosing pediatric acute appendicitis.

The Accuracy of Point-of-Care Ultrasound in the Diagnosis of Acute Cholecystitis

2021 ◽  
pp. 000313482198905
Author(s):  
Chase J. Wehrle ◽  
Asif Talukder ◽  
Lillie Tien ◽  
Soham Parikh ◽  
Aditya Devarakonda ◽  
...  
Keyword(s):  
Acute Cholecystitis ◽  
Point Of Care ◽  
Tertiary Care ◽  
Laboratory Data ◽  
Final Diagnosis ◽  
Gallbladder Wall ◽  
Clinical Findings ◽  
Point Of Care Ultrasound ◽  
Tokyo Guidelines ◽  
Pathology Reports

Purpose Acute cholecystitis (AC) affects 50-200 000 patients per year. Early surgery is the treatment of choice for AC. Therefore, timely diagnosis is important to begin proper management. Recently, emergency departments have adopted point-of-care ultrasound (POCUS) for the initial evaluation of AC. The accuracy of POCUS for AC has not been well studied. Methods Patients receiving POCUS for evaluation of AC in the emergency department at our tertiary care institution for 2 years were considered. Patients with previous biliary diagnoses were excluded. Patients were deemed to have AC from a recorded POCUS result or 2/3 of the following POCUS findings: pericholecystic fluid, gallbladder wall hyperemia, and sonographic Murphy’s sign. Formal ultrasound and final diagnosis from surgical and pathology reports were used as gold standards for comparison. Results In total, 147 patients met inclusion criteria. POCUS had a sensitivity and specificity of .4 (95% CI: .1216-.7376) and .99 (.9483-.9982), respectively, when compared to a final diagnosis and .33 (.0749-.7007) and .94 (.8134-.9932) when compared to formal US. The modified Tokyo guidelines for suspicion of AC had a sensitivity of .2 (.0252-.5561) and specificity of .88 (.8173-.931) compared to the final diagnosis. Conclusion Point-of-care ultrasound was not a better screening test than the modified Tokyo guidelines. We recommend a simplified screening approach for AC using clinical findings and laboratory data, followed by confirmatory formal imaging. This strategy could prevent unnecessary delays in surgical management and use of physician resources.

Improving diagnosis of acute appendicitis with atypical findings by Tc-99m HMPAO leukocyte scan

2002 ◽  
Vol 41 (01) ◽  
pp. 37-41 ◽  
Author(s):  
S. Shung-Shung ◽  
S. Yu-Chien ◽  
Y. Mei-Due ◽  
W. Hwei-Chung ◽  
A. Kao
Keyword(s):  
Acute Appendicitis ◽  
False Positive ◽  
False Positive Rate ◽  
Accurate Method ◽  
Clinical Findings ◽  
Pathological Findings ◽  
Lower Quadrant ◽  
Predictive Values ◽  
Positive Rate

Summary Aim: Even with careful observation, the overall false-positive rate of laparotomy remains 10-15% when acute appendicitis was suspected. Therefore, the clinical efficacy of Tc-99m HMPAO labeled leukocyte (TC-WBC) scan for the diagnosis of acute appendicitis in patients presenting with atypical clinical findings is assessed. Patients and Methods: Eighty patients presenting with acute abdominal pain and possible acute appendicitis but atypical findings were included in this study. After intravenous injection of TC-WBC, serial anterior abdominal/pelvic images at 30, 60, 120 and 240 min with 800k counts were obtained with a gamma camera. Any abnormal localization of radioactivity in the right lower quadrant of the abdomen, equal to or greater than bone marrow activity, was considered as a positive scan. Results: 36 out of 49 patients showing positive TC-WBC scans received appendectomy. They all proved to have positive pathological findings. Five positive TC-WBC were not related to acute appendicitis, because of other pathological lesions. Eight patients were not operated and clinical follow-up after one month revealed no acute abdominal condition. Three of 31 patients with negative TC-WBC scans received appendectomy. They also presented positive pathological findings. The remaining 28 patients did not receive operations and revealed no evidence of appendicitis after at least one month of follow-up. The overall sensitivity, specificity, accuracy, positive and negative predictive values for TC-WBC scan to diagnose acute appendicitis were 92, 78, 86, 82, and 90%, respectively. Conclusion: TC-WBC scan provides a rapid and highly accurate method for the diagnosis of acute appendicitis in patients with equivocal clinical examination. It proved useful in reducing the false-positive rate of laparotomy and shortens the time necessary for clinical observation.

Computer-Aided Diagnosis in Jaundice: Comparison of Knowledge-based and Probabilistic Approaches

1996 ◽  
Vol 35 (01) ◽  
pp. 41-51 ◽  
Author(s):  
F. Molino ◽  
D. Furia ◽  
F. Bar ◽  
S. Battista ◽  
N. Cappello ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Clinical Information ◽  
Diagnostic Value ◽  
Clinical Findings ◽  
Clinical Documentation ◽  
Data Set ◽  
Knowledge Based ◽  
Number Of Patients ◽  
Support Tools ◽  
Aided Diagnosis

AbstractThe study reported in this paper is aimed at evaluating the effectiveness of a knowledge-based expert system (ICTERUS) in diagnosing jaundiced patients, compared with a statistical system based on probabilistic concepts (TRIAL). The performances of both systems have been evaluated using the same set of data in the same number of patients. Both systems are spin-off products of the European project Euricterus, an EC-COMACBME Project designed to document the occurrence and diagnostic value of clinical findings in the clinical presentation of jaundice in Europe, and have been developed as decision-making tools for the identification of the cause of jaundice based only on clinical information and routine investigations. Two groups of jaundiced patients were studied, including 500 (retrospective sample) and 100 (prospective sample) subjects, respectively. All patients were independently submitted to both decision-support tools. The input of both systems was the data set agreed within the Euricterus Project. The performances of both systems were evaluated with respect to the reference diagnoses provided by experts on the basis of the full clinical documentation. Results indicate that both systems are clinically reliable, although the diagnostic prediction provided by the knowledge-based approach is slightly better.

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