scholarly journals CURRENT GUIDELINES ON EVIDENCED-BASED DIAGNOSIS AND MANAGEMENT OF ACUTE APPENDICITIS

2021 ◽  
Vol 5 (10) ◽  
Author(s):  
Manish R. Malani
Keyword(s):  
Acute Appendicitis ◽  
Respiratory Infection ◽  
Bacterial Overgrowth ◽  
Vermiform Appendix ◽  
Mucus Production ◽  
Diagnosis And Management ◽  
Generalized Peritonitis ◽  
Group 2 ◽  
Evidenced Based ◽  
Group 1

Introduction: Appendicitis is the inflammation of the vermiform appendix.  Appendicitis can be considered the most commonly interpretive cause of acute and severe abdominal pain. Acute Appendicitis (AA) is mainly caused by luminal obstruction obstructed by numerous etiologies. This causes an increase in the rate of bacterial overgrowth and mucus production thereby causing necrosis, wall tension and potential perforation. Materials and Methods: The study is a Retrospective cohort and was conducted during the periods of 11 months. The study included 97 patients with appendicitis and divided them based on the protocol by which they receive diagnosis and management. Out of 97 patients, 49 patients were assigned to group 1 and the other 48 patients were assigned to group 2. Group 1 includes those patients who were treated symptomatically and diagnosis and management were given to them according to the wish of the consulting physician. For the determination of outcomes of treatments given to Group 1 and Group 2 patients, the study considered complications found in the patients. These complications are recorded for each of the groups. Also, the study recorded the complication in each of the treatment methods of Group 1 patients. This allowed the authors of this study to find out how outcomes vary when treatment is given differently from that of Alvarado Scoring criteria. Results: The complications that were found in the study participants are fever, generalized peritonitis, perforation, abscess, a mild respiratory infection. The study found that the complications among the patients in Group 1 and Group 2 separately. In Group 1, 8 patients had a fever, while 3 patients had a fever in Group 2. Group 1 patients had all the listed complications including perforation (n=7), abscess (n=4), mild respiratory infection (n=3) and peritonitis (n=2). In Group 2, only 4 patients showed complications including fever in 3 patients and perforation in 1 patient. Conclusion: The study has concluded that following Alvarado criteria in diagnosis and management of acute appendicitis results in the least possible complications. The study suggests the clinicians follow Alvarado criteria for proper management of acute appendicitis. Keywords: Acute appendicitis, Alvarado criteria, appenditis complications, appendicitis diagnosis, appendicitis treatment

scholarly journals The evaluation of ENA-78 and fibrinogen levels for the differential diagnosis of familial Mediterranean fever and acute appendicitis

2019 ◽  
Vol 43 (3) ◽  
pp. 141-147
Author(s):  
Murat Güzel ◽  
Recep Aktimur ◽  
Kadir Yıldırım ◽  
Sude Hatun Aktimur ◽  
Mehmet Hakan Taşkın ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Familial Mediterranean Fever ◽  
Acute Appendicitis ◽  
Acute Peritonitis ◽  
Significant Difference ◽  
Mediterranean Fever ◽  
Group 2 ◽  
Wbc Count ◽  
Higher Sensitivity ◽  
Group 1

Abstract Background Familial Mediterranean fever (FMF) is a disorder mainly present in the Mediterranean region, characterized by abdominal attacks that mimic acute peritonitis. Therefore, FMF might be confused with other conditions presenting with acute abdominal pain, particularly acute appendicitis (AA). We aimed to evaluate whether epithelial-derived neutrophil-activating peptide-78 (ENA-78) and fibrinogen levels and white blood cell (WBC) counts could be used as potential markers in the differential diagnosis of acute FMF attacks and AA. Methods The study involved three groups: patients with AA who underwent surgery (group 1, n = 30), patients with FMF attacks (group 2, n = 30), and patients with FMF who were attack-free (n = 30, controls), which included patients who were diagnosed as having FMF previously but had no attacks for a month. Results Significant differences were detected in the ENA-78 and fibrinogen levels between group 1 and group 2. No significant difference was found in the WBC count between group 1 and group 2. It was concluded that the WBC count was more sensitive (66%) for group 1, and fibrinogen showed higher sensitivity (86%) and specificity (96%) for group 2 compared with the other parameters. Conclusions We suggest that AA can be distinguished in patients with signs of peritonitis who were diagnosed as having FMF previously with the use of ENA-78 and fibrinogen levels; fibrinogen and ENA-78 might be helpful in discriminating between FMF attacks and AA.

scholarly journals Role of Mean Platelet Volume in Diagnosis of Childhood Acute Appendicitis

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Bunyamin Uyanik ◽  
Cemil Kavalci ◽  
Engin Deniz Arslan ◽  
Fevzi Yilmaz ◽  
Ozgur Aslan ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Mean Platelet Volume ◽  
Diagnostic Value ◽  
Control Group ◽  
Healthy Children ◽  
Platelet Volume ◽  
Pediatric Age Group ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Introduction. Acute appendicitis is the leading cause of abdominal pain in children requiring emergency surgical intervention. The aim of this study is to investigate the diagnostic value of MPV in early diagnosis of acute appendicitis cases in pediatric age group.Methods. This study was performed retrospectively. Three hundred five patients operated on with the diagnosis of appendicitis and pathologically found to be acute appendicitis were classified as Group 1 and 305 healthy children were classified as control Group 2.Results. One hundred ninety-seven of 305 cases in Group 1 are males (64.6%), in Group 2, 151 of 305 cases are males (49.5%). The mean MPV in Group 1 was7.9±0.9(fL), and whereas in Group 2 was7.7±0.8(fL). There was no statistically significant difference regarding MPV values (P>0.05).Conclusion. In our study we detected that mean platelet volume has no diagnostic value in pediatric acute appendicitis cases.

The importance of laboratory tests and Body Mass Index in the diagnosis of acute appendicitis

2020 ◽  
Vol 92 (5) ◽  
pp. 1-5
Author(s):  
Atakan Ozkan ◽  
Aylin Hande Gokce ◽  
Feridun Suat Gokce
Keyword(s):  
Body Mass Index ◽  
Acute Appendicitis ◽  
Body Mass ◽  
The Body ◽  
Distribution Width ◽  
Lymphocyte Ratio ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

<b>Background:</b> Acute appendicitis is the most common cause of acute abdomen. Delay in diagnosis increases the mortality and morbidity. <br><b>Aim: </b>In this study, we aimed to investigate whether the body mass index is useful in diagnosis and whether the neutrophil /lymphocyte and platelet/lymphocyte ratios can help in determining the inflammation level of acute appendicitis. <br><b>Meterial and Methods:</b> Cases of appendectomy performed between June 2012 and December 2018 in our clinic were analyzed retrospectively. Based on the pathology results of the cases included in the study, 4 groups were formed, i.e.: Group 1 (initial stage), Group 2 (catarrhal stage), Group 3 (phlegmonous-gangrenous stage) and Group 4 (perforation). The study compared age, body mass index, leukocyte values, red cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR), platelet /lymphocyte ratio (PLR), and mean platelet volume (MPV) between groups. <br><b> Results:</b> 828 cases were included in the study. When compared between groups, the values of Group 3 and Group 4 were higher than those of Group 1 and Group 2 for PLR and NLR. There was no difference in RDW and MPV values in the blood. When Body Mass Index (BMI) was compared between groups, it was found to be significantly higher with increasing histopathological stage. <br><b>Conclusion:</b> In acute appendicitis, the blood leukocyte value, elevated PLR and NLR are helpful in diagnosis. We aimed to emphasize that the diagnosis of acute appendicitis is delayed in patients with a BMI above 30 and/or at age of over 40 years, with the perforation rate being determined more frequently.

Evaluation of laboratory parameters in the diagnosis of acute appendicitis

2016 ◽  
Vol 43 (1) ◽  
pp. 64-70 ◽  
Author(s):  
Suat Can Ulukent ◽  
Nuri Alper Şahbaz ◽  
Eser Şefik Özyürek ◽  
İnanç Şamil Sarıcı ◽  
Özlem Akça ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Neutrophil Count ◽  
Lymphocyte Count ◽  
Diagnostic Value ◽  
Neutrophil Lymphocyte Ratio ◽  
Reactive Protein ◽  
The Difference ◽  
Group 2 ◽  
Periappendiceal Abscess ◽  
Group 1

AbstractIntroduction:The aim of this prospective study was to investigate the diagnostic value of the fibrinogen level, platelet (PLT) count, mean platelet volume (MPV), lymphocyte count, neutrophil/lymphocyte ratio (NLR) and C-reactive protein (CRP) level with white blood cell (WBC) and neutrophil count in acute appendicitis (AA).Methods:One hundred and ninety-seven patients who were admitted with the findings of acute abdomen and operated on with a preoperative diagnosis of AA were included in this prospective observational study. After surgery, according to the histopathological results of the appendix, patients were classified as Group 1; with normal histology of appendix vermicularis, Group 2; patients with positive histology for appendicitis with or without perforation, periappendiceal abscess, suppurative, gangrenous or ulcerophlegmonous appendicitis.Results:In the comparison of the two groups, the difference between CRP and MPV were insignificant (p=0.12 and p=0.09, respectively). WBC, neutrophil count, NLR were significantly higher in Group 2 (p<0.001 for each), whereas fibrinogen levels, lymphocyte count and the PLT counts were significantly higher in Group 1 (p=0.03, 0.002 and 0.003, respectively).Discussion and conclusion:WBC, neutrophil and NLR are predictive for the diagnosis of AA, whereas elevated levels of fibrinogen, high lymphocyte and PLT count are predictive for non-appendicial pathology with low diagnostic accuracies.

scholarly journals Effects of different dietary manganese sources on thickness of mucus layer and selected biochemical and haematological indicators in sheep

2018 ◽  
Vol 87 (4) ◽  
pp. 351-356
Author(s):  
Zuzana Maková ◽  
Zita Faixová ◽  
Lucia Tarabová ◽  
Elena Piešová ◽  
Katarína Venglovská ◽  
...  
Keyword(s):  
Basal Diet ◽  
Mucus Layer ◽  
Total Proteins ◽  
Mucus Production ◽  
Intestinal Mucus ◽  
Intestinal Segments ◽  
Group 3 ◽  
Mucus Barrier ◽  
Group 2 ◽  
Group 1

The effects of manganese from organic and inorganic sources supplemented to diets of sheep on intestinal mucus production and on selected biochemical and haematological indicators were investigated. The experiment was carried out on 18 sheep of the Improved Valachian breed aged seven months over the period of four months. The animals were divided into three groups of six animals each (group 1 – control, basal diet with 31 mg Mn/kg, group 2 – basal diet + manganese sulphate (MnSO4) with 120 mg Mn/kg, group 3 – basal diet + manganese chelate of glycine hydrate (Mn-Gly) with 120 mg Mn/kg). Intestinal segments (duodenum, jejunum, ileum, caecum) were collected and mucus production was assessed using the quantification method. Mucus production in the duodenum and jejunum was significantly lower (P < 0.05) in group 3 (Mn-Gly) compared to the control and group 2 (MnSO4). In the duodenum in group 2 (MnSO4) mucus production was similar to the control. Biochemical indicators were determined using spectrophotometry, and haematological indicators were measured using a haematology analyzer. Significant changes (P < 0.05) were found for the concentrations of total proteins and albumins. The concentration of total proteins was lower in group 3 (Mn-Gly) compared to the control and group 2 (MnSO4). In the latter group it was higher compared to the control. The concentration of albumins was higher in group 3 (Mn-Gly) compared to the control and group 2 (P < 0.05). The results indicate a decrease of intestinal mucus in the group supplemented by Mn-Gly chelate, which may mean a lower mucus barrier for manganese absorption.

Comparative study of aural microflora in healthy cats, allergic cats and cats with systemic disease

2014 ◽  
Vol 16 (12) ◽  
pp. 992-996 ◽  
Author(s):  
Charline Pressanti ◽  
Clémence Drouet ◽  
Marie-Christine Cadiergues
Keyword(s):  
Systemic Disease ◽  
Bacterial Overgrowth ◽  
Clinical Score ◽  
Experimental Unit ◽  
Clinically Normal ◽  
Group 3 ◽  
Group 2 ◽  
A Prospective Study ◽  
Otoscopic Examination ◽  
Group 1

Twenty healthy cats (group 1) with clinically normal ears, 15 cats with systemic disease (group 2) and 15 allergic cats (group 3) were included in a prospective study. The experimental unit was the ear. A clinical score was established for each ear canal after otoscopic examination. Microbial population was assessed on cytological examination of smears performed with the cotton-tipped applicator smear technique. Fungal population was significantly more prominent in allergic cats ( P <0.001) and in diseased cats compared with healthy cats ( P <0.02). Bacterial population was significantly higher in allergic cats than in healthy cats ( P <0.001) and cats suffering from systemic disease ( P <0.001). Bacterial overgrowth was also higher in cats with systemic disease than healthy cats. In cats from group 2, only fungal overgrowth was associated with otitis severity. In group 3, only bacterial overgrowth was associated with otitis severity.

scholarly journals Are Average Platelet Volume (MPV), Red Cell Distribution Width (RDW) and Platelet Distribution Width (PDW) Guiding Markers for Acute Appendicitis Treatment Options?

2021 ◽  
Author(s):  
Erkan Dalbaşı ◽  
Omer Lutfi Akgül
Keyword(s):  
Platelet Count ◽  
Acute Appendicitis ◽  
Antibiotic Therapy ◽  
Laparoscopic Appendectomy ◽  
Standard Treatment ◽  
Treatment Options ◽  
Abdominal Ct ◽  
Distribution Width ◽  
Group 2 ◽  
Group 1

Background: Acute appendicitis (AA) is the most common cause of surgery performed for acute abdomen. The standard treatment for AA patients has been appendectomy for more than a century. use of broad-spectrum antibiotics, the medical treatment option has come to the fore in the treatment of uncomplicated AA. Aim: Evaluate whether WBC, platelet count, MPV, PDW, RDW, and C-reactive protein (CRP) values of patients diagnosed with uncomplicated AA clinically, with laboratory tests and radiologically with abdominal CT could be a marker for choosing medical or surgical treatment. Material and Method: 519 patients aged between 20 and 65 years who were diagnosed with uncomplicated AA by abdominal CT in our centre between January 2016 and January 2019 were retrospectively analysed. . The presence of at least one of the criteria of 7 mm or more appendix diameter and oedema or fluid accumulation around the appendix was accepted as uncomplicated AA. After the diagnosis of AA, 223 patients were treated medically, while 296 patients underwent laparoscopic appendectomy. The first group included patients who were treated medically and the second group included patients who underwent laparoscopic appendectomy. Results: Group 2 patients had higher mean platelet count (p <.005) and RDW (p = .003) values compared to Group 1 patients, while mean PDW (p <.001) values were lower compared to those of Group 1 patients. The differences between the mean WBC, CRP and MPV values of the groups were not statistically significant (p>0.05). Conclusions: The standard treatment for acute appendicitis is surgery. Recently, studies supporting antibiotic therapy have been conducted in patients diagnosed with AA. As a result, we think that PDW, RDW, and platelet values in patients diagnosed with uncomplicated AA may be a guide in choosing patients to be treated with surgery or antibiotics. Key Words: acute appendicitis, laparoscopic appendectomy, antibiotic therapy.

scholarly journals The peculiarity of appendectomy of patients with high risk of cardiopulmonary insufficiency

2018 ◽  
Vol 22 (3) ◽  
pp. 456-459
Author(s):  
B.S. Zaporozhchenko ◽  
Hasan Yahya ◽  
I.I. Borodaev ◽  
V.N. Kachanov ◽  
O.A. Vasyliev
Keyword(s):  
High Risk ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Abdominal Cavity ◽  
Open Appendectomy ◽  
Pulmonary Insufficiency ◽  
Results Of Treatment ◽  
Cardiopulmonary Failure ◽  
Group 2 ◽  
Group 1

Acute appendicitis (AA) ranks first in the frequency of emergence of urgent surgical diseases in hospitals in Ukraine. In recent years, laparoscopic appendectomy has become one of the “gold standards” of surgery. Of particular interest in this group of patients is a gasless and with small amount of gas laparoscopy, in which the endosurgical space in the abdominal cavity is created with the help of endolifts, in which the abdominal wall is raised mechanically, without creating a pneumoperitoneum. Objective — to determine the feasibility and effectiveness of the use of various techniques for laparoscopic appendectomy of patients with a high risk of cardiopulmonary insufficiency. All patients with АA were divided into 2 groups: Group 1 — 72 patients with АA diagnosis, with a high risk of cardiopulmonary failure, who underwent open appendectomy; Group 2 — 85 patients with АA diagnosis with a high risk of cardiopulmonary failure, who underwent laparoscopic appendectomy with pneumoperitoneum and using laparolifting method of patients. The laparolifting was performed with the help of the device developed by the clinic for laparolifting on Zaporozhchenko-Kolodii. When analyzing the results of treatment of patients with IІ group, it should be noted that laparoscopic appendectomy, especially with laparolifting, may be the operation of choice in the treatment of patients with acute appendicitis. This technique is absolutely safe, reliable and affordable in the implementation of most surgeons. So, laparoscopic appendectomy can be performed in virtually all patients with acute appendicitis with high risk of cardio-pulmonary insufficiency with the avoidance of postoperative complications.

scholarly journals Pre operative use of injection diclofenac versus injection tramadol for pain management of acute appendicitis in emergency department

2017 ◽  
Vol 13 (1) ◽  
pp. 40-48
Author(s):  
Saroj Giri ◽  
S Chaudhuri ◽  
S Jirel ◽  
BD Aryal ◽  
DR Kumar ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Acute Appendicitis ◽  
Drug Administration ◽  
Vas Score ◽  
Significant Difference ◽  
Common Causes ◽  
Diagnosis Accuracy ◽  
Group 2 ◽  
Group 1

Background: Acute appendicitis is one of the most common causes of acute abdominal pain presenting in emergency department. Preoperative use of adequate analgesia markedly reduces pain without affecting diagnosis accuracy and furthermore no single analgesia has been used for this purpose.Objective: To determine and compare the efficacy of injection diclofenac and injection tramadol for rapid pain management of acute appendicitis in emergency department.Methods: An experimental clinical trial was done including 50 patients aged _8 years who were clinically diagnosed as acute appendicitis and had not received analgesia prior to examination by the researcher. They were randomly divided into 2 groups: 25 patients (group 1) were given injection diclofenac intramuscularly and 25 patients (group 2) were given injection tramadol intravenously. Comparative analysis was carried out regarding the decrease in pain intensity using visual analogue scale (VAS) score for pain at presentation, at half an hour and at one hour of drug administration.Results: All the patients had VAS score of _5 at presentation without significant difference in the two groups. Half an hour after drug administration, 64% of subjects still had a VAS score of _6 in the first group while only 12% in the second group (p=0.005). At one hour of drug administration, 64% of subjects had a VAS score between 4 and 7 and 36% had score between 0 and 3 in group 1. In contrast to this score, in group 2 only 16% of the subjects scored between 4 and 7 and 84% between 0 and 3 (p=0.001).Conclusion: There was rapid and marked decrease of VAS score or pain in tramadol group as compared to diclofenac group. Hence, we can recommend that injection tramadol intravenous be considered for preoperative use for pain management of acute appendicitis in emergency department. Health Renaissance 2015;13 (1): 

scholarly journals Comparing Appendectomy and Conservative Treatment for Patients with Uncomplicated Acute Appendicitis

2018 ◽  
Vol 5 (4) ◽  
pp. 3768-3771
Author(s):  
Murat Kendirci
Keyword(s):  
Acute Appendicitis ◽  
Physical Examination ◽  
Medical Treatment ◽  
Radiological Examination ◽  
Urgent Surgery ◽  
Laboratory Values ◽  
Hospitalization Period ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Background: Acute appendicitis is one of the most common causes of acute abdomen pain. Gold standard treatment of acute appendicitis is the appendectomy. In this study, we investigated in selected cases whether antibiotherapy can be preferred instead of urgent surgery. Material and Method: Patients who were admitted to the emergency room between January 1, 2016, and December 31, 2016, with abdominal pain and who were diagnosed with acute appendicitis as a result of physical examination, laboratory and radiological examination were divided into two groups. Patients who did not want to undergo surgery and received medical treatment were determined as group 1 antibiotherapy and who underwent appendectomy were determined as group 2. Physical examination, laboratory values, radiological examination results, scores according to the Alvarado scoring system, clinical follow-up data, receivedtreatment, complications were recorded. Hospitalization period, return period to work, post-treatment complaints, control findingsand laboratory values were compared. Results:  Of the 133 patients included in the study, 59 (44.4%) were female and 74 (55.6%) were male. Mean age was 42.8 (18-92 years). Whereas antibiotherapy was given 54 patients (group 1, 40.6%), 79 patients were urgently preparedfor appendectomy (group 2, 59.4%). No differences were found between the two groups in terms of gender. The mean age was 53.8 (18-93 years) in group 1 and 35.3 (18-71 years) in group 2. The mean erythrocyte was 14844 (4400-22000/mm3) in the group 1 and 11800 (6500-21000/mm3) in the group 2. The mean C-reactive protein was 64.5% in the antibiotherapy group and 39.9% in the appendectomy group. The mean appendicitis diameter was determined as 9.4 (6-13 mm) in the group 1, and as 8.5 (6-13 mm) in the group 2. The mean Alvarado scores were 8.62 inthe group 1 and8.51 in the group 2. None of the 43 patients in group 1 have had relapsed acute appendicitis and appendectomy has not been performed again, even in another center. Conclusion:  For acute appendicitis, patients who do not accept the operation for various reasons or who are at high risk of having surgery due to existing health problems, medical treatment approach instead of emergency surgery may be a safe and easy option.

Sign in / Sign up

Export Citation Format

Share Document