Latest & greatest articles for appendicitis

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Appendicitis

Appendicitis is an inflammation of the appendix. Both children and adults can suffer from appendicitis. If untreated the appendix can perforate, causing the release of infectious material in the body, which can be life threatening.

Symptoms and causes of appendicitis

Common symptoms of appendicitis include sharp pain in the abdomen, loss of appetite, fever, severe cramps, diarrhoea and nausea.

It is believed that the main cause of appendicitis is an obstruction of the appendix. The blockage can eventually lead to necrosis giving bacteria and opportunity to cause infection. The blockages is typically calcified faecal deposits.

Diagnosis is typically based on a clinical examination and this can be supported by ultrasound and/or CT scan.

Typically the main cure for an appendicitis has been surgery, but more recently other interventions – namely antibiotics have been tried.

The evidence base, clinical trials, studies etc.

Experts have believed for a long time that the appendix has little purpose in the human body as it shows no negative affects to the body once removed, thus the human body can function perfectly fine without it. However, extensive appendicitis research concludes that the appendix protects good bacteria in the gut. Clinical trials and case studies are ongoing to help understand appendicitis.

Trip is an excellent source of evidence around appendicitis including clinical guidelines, systematic reviews, randomised controlled trials, case studies etc. These can easily be found via a search of the site.

Top results for appendicitis

1. Laparoscopic versus open surgery for suspected appendicitis.

Laparoscopic versus open surgery for suspected appendicitis. BACKGROUND: The removal of the acute appendix is one of the most frequently performed surgical procedures. Open surgery associated with therapeutic efficacy has been the treatment of choice for acute appendicitis. However, in consequence of the evolution of endoscopic surgery, the operation can also be performed with minimally invasive surgery. Due to smaller incisions, the laparoscopic approach may be associated with reduced

Cochrane2018

3. Five-Year Follow-up of Antibiotic Therapy for Uncomplicated Acute Appendicitis in the APPAC Randomized Clinical Trial.

Five-Year Follow-up of Antibiotic Therapy for Uncomplicated Acute Appendicitis in the APPAC Randomized Clinical Trial. Importance: Short-term results support antibiotics as an alternative to surgery for treating uncomplicated acute appendicitis, but long-term outcomes are not known. Objective: To determine the late recurrence rate of appendicitis after antibiotic therapy for the treatment of uncomplicated acute appendicitis. Design, Setting, and Participants: Five-year observational follow-up (...) of patients in the Appendicitis Acuta (APPAC) multicenter randomized clinical trial comparing appendectomy with antibiotic therapy, in which 530 patients aged 18 to 60 years with computed tomography-confirmed uncomplicated acute appendicitis were randomized to undergo an appendectomy (n = 273) or receive antibiotic therapy (n = 257). The initial trial was conducted from November 2009 to June 2012 in Finland; last follow-up was September 6, 2017. This current analysis focused on assessing the 5-year

JAMA2018

4. Meta-analysis of in-hospital delay before surgery as a risk factor for complications in patients with acute appendicitis

Meta-analysis of in-hospital delay before surgery as a risk factor for complications in patients with acute appendicitis 29902346 2018 07 13 1365-2168 105 8 2018 Jul The British journal of surgery Br J Surg Meta-analysis of in-hospital delay before surgery as a risk factor for complications in patients with acute appendicitis. 933-945 10.1002/bjs.10873 The traditional fear that every case of acute appendicitis will eventually perforate has led to the generally accepted emergency appendicectomy (...) with minimized delay. However, emergency and thereby sometimes night-time surgery is associated with several drawbacks, whereas the consequences of surgery after limited delay are unclear. This systematic review aimed to assess in-hospital delay before surgery as risk factor for complicated appendicitis and postoperative morbidity in patients with acute appendicitis. PubMed and EMBASE were searched from 1990 to 2016 for studies including patients who underwent appendicectomy for acute appendicitis, reported

EvidenceUpdates2018 Full Text: Link to full Text with Trip Pro

5. Appendicitis

Appendicitis Top results for appendicitis - Trip Database or use your Google+ account Turning Research Into Practice My query is: English Français Deutsch Čeština Español Magyar Svenska ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box (...) and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Latest & greatest articles for appendicitis The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical

Trip Latest and Greatest2018

6. Bedside Sonography Performed by Emergency Physicians to Detect Appendicitis in Children

Bedside Sonography Performed by Emergency Physicians to Detect Appendicitis in Children 29738103 2018 05 28 1553-2712 2018 May 08 Academic emergency medicine : official journal of the Society for Academic Emergency Medicine Acad Emerg Med Bedside Sonography Performed by Emergency Physicians to Detect Appendicitis in Children. 10.1111/acem.13445 The aim of this study was to evaluate the ability of emergency physicians with various levels of point-of-care ultrasound (POCUS) experience to detect (...) appendicitis with POCUS among children visiting a pediatric emergency department (ED). A prospective cohort study was conducted in an urban, tertiary care pediatric ED. Children aged 2 to 18 years old who presented with acute abdominal pain suggesting appendicitis were included. Patients were excluded if they had a history of appendectomy or hemodynamic instability requiring resuscitation or were transferred with proven diagnosis of appendicitis. Participating physicians had various levels of POCUS

EvidenceUpdates2018

7. Abdominal drainage to prevent intra-peritoneal abscess after open appendectomy for complicated appendicitis.

Abdominal drainage to prevent intra-peritoneal abscess after open appendectomy for complicated appendicitis. BACKGROUND: Appendectomy, the surgical removal of the appendix, is performed primarily for acute appendicitis. Patients who undergo appendectomy for complicated appendicitis, defined as gangrenous or perforated appendicitis, are more likely to suffer from postoperative complications. The routine use of abdominal drainage to reduce postoperative complications after appendectomy (...) for complicated appendicitis is controversial.This is an update of the review first published in 2015. OBJECTIVES: To assess the safety and efficacy of abdominal drainage to prevent intra-peritoneal abscess after open appendectomy for complicated appendicitis. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2017, Issue 6), Ovid MEDLINE (1946 to 30 June 2017), Ovid Embase (1974 to 30 June 2017), Science Citation Index Expanded (1900 to 30 June

Cochrane2018

8. Acute appendicitis

Acute appendicitis Acute appendicitis - Symptoms, diagnosis and treatment | BMJ Best Practice   Search  Acute appendicitis Last reviewed: August 2018 Last updated: June 2018 Summary Acute inflammation of the vermiform appendix. Typically presents as acute abdominal pain starting in the mid-abdomen and later localising to the right lower quadrant. Associated with fever, anorexia, nausea, vomiting, and elevation of the neutrophil count. Diagnosis is usually made clinically. If investigation (...) is required, CT scan or ultrasonography may show dilatation of the appendix outer diameter to more than 6 mm. Definitive treatment is surgical appendectomy. Definition Acute appendicitis is an acute inflammation of the vermiform appendix, Fitz RH. Perforating inflammation of the vermiform appendix with special reference to its early diagnosis and treatment. Am J Med Sci. 1886;92:321-346. most likely due to obstruction of the lumen of the appendix (by faecolith, normal stool, infective agents, or lymphoid

BMJ Best Practice2018

9. Randomized clinical trial of antibiotic therapy for uncomplicated appendicitis

Randomized clinical trial of antibiotic therapy for uncomplicated appendicitis 28925502 2017 11 27 2017 11 28 1365-2168 104 13 2017 Dec The British journal of surgery Br J Surg Randomized clinical trial of antibiotic therapy for uncomplicated appendicitis. 1785-1790 10.1002/bjs.10660 Uncomplicated appendicitis may resolve spontaneously or require treatment with antibiotics or appendicectomy. The aim of this randomized trial was to compare the outcome of a non-antibiotic management strategy (...) with that of antibiotic therapy in uncomplicated appendicitis. Patients presenting to a university teaching hospital with CT-verified uncomplicated simple appendicitis (appendiceal diameter no larger than 11 mm and without any signs of perforation) were randomized to management with a no-antibiotic regimen with supportive care (intravenous fluids, analgesia and antipyretics as necessary) or a 4-day course of antibiotics with supportive care. The primary endpoint was rate of total treatment failure, defined as initial

EvidenceUpdates2017

10. Randomized clinical trial of Appendicitis Inflammatory Response score-based management of patients with suspected appendicitis

Randomized clinical trial of Appendicitis Inflammatory Response score-based management of patients with suspected appendicitis 28730753 2017 07 21 2017 09 19 2017 09 19 1365-2168 104 11 2017 Oct The British journal of surgery Br J Surg Randomized clinical trial of Appendicitis Inflammatory Response score-based management of patients with suspected appendicitis. 1451-1461 10.1002/bjs.10637 The role of imaging in the diagnosis of appendicitis is controversial. This prospective interventional (...) study and nested randomized trial analysed the impact of implementing a risk stratification algorithm based on the Appendicitis Inflammatory Response (AIR) score, and compared routine imaging with selective imaging after clinical reassessment. Patients presenting with suspicion of appendicitis between September 2009 and January 2012 from age 10 years were included at 21 emergency surgical centres and from age 5 years at three university paediatric centres. Registration of clinical characteristics

EvidenceUpdates2017

11. Comparison of Superficial Surgical Site Infection Between Delayed Primary Versus Primary Wound Closure in Complicated Appendicitis: A Randomized Controlled Trial

Comparison of Superficial Surgical Site Infection Between Delayed Primary Versus Primary Wound Closure in Complicated Appendicitis: A Randomized Controlled Trial 28796014 2017 08 10 2017 08 10 1528-1140 2017 Aug 04 Annals of surgery Ann. Surg. Comparison of Superficial Surgical Site Infection Between Delayed Primary Versus Primary Wound Closure in Complicated Appendicitis: A Randomized Controlled Trial. 10.1097/SLA.0000000000002464 To compare superficial surgical site infection (SSI) rates (...) between delayed primary wound closure (DPC) and primary wound closure (PC) for complicated appendicitis. SSI is common in appendectomy for complicated appendicitis. DPC is preferentially used over PC, but its efficacy is still controversial. A multicenter randomized controlled trial was conducted in 6 hospitals in Thailand, enrolling patients with gangrenous and ruptured appendicitis. Patients were randomized to PC (ie, immediately wound closure) or DPC (ie, wound closure at postoperative days 3-5

EvidenceUpdates2017

12. There is insufficient evidence to consider non-operative treatment of uncomplicated acute appendicitis.

There is insufficient evidence to consider non-operative treatment of uncomplicated acute appendicitis. Evidencias en pediatría - Tratamiento con antibióticos de la apendicitis aguda no complicada: aún en fase experimental Buscando, por favor espere. Mostrar menú Gestión de biblioteca Aún no ha añadido ningún artículo a su biblioteca. | Buscar Toma de decisiones clínicas basadas en pruebas científicas Toma de decisiones clínicas basadas en pruebas científicas Mostrar menú Gestión de biblioteca (...) imagen. Enviar AVC | Artículos Valorados Críticamente Georgiou R, Eaton S, Stanton MP, Pierro A, Hall NJ. Efficacy and safety of nonoperative treatment for acute appendicitis: a meta-analysis. Revisores: Cuestas Montañés E 1 , Aparicio Rodrigo M 2 . 1 Servicio de Pediatría y Neonatología. Hospital Privado. Centro Formador. Facultad de Ciencias Médicas. Universidad Nacional de Córdoba. Córdoba. Argentina. 2 CS Entrevías. Departamento de Pediatría. Facultad de Medicina. Universidad Complutense de

Evidencias en Pediatría2017

14. Can Abdominal Ultrasonography Be Used to Accurately Diagnose Acute Appendicitis?

Can Abdominal Ultrasonography Be Used to Accurately Diagnose Acute Appendicitis? DEFINE_ME_WA This site requires Cookies to be enabled to function. Please ensure Cookies are turned on and then re-visit the desired page.

Annals of Emergency Medicine Systematic Review Snapshots2017

17. The Influence of Age on the Diagnostic Performance of White Blood Cell Count and Absolute Neutrophil Count in Suspected Pediatric Appendicitis

The Influence of Age on the Diagnostic Performance of White Blood Cell Count and Absolute Neutrophil Count in Suspected Pediatric Appendicitis 27251399 2016 06 02 2017 01 13 1553-2712 23 11 2016 Nov Academic emergency medicine : official journal of the Society for Academic Emergency Medicine Acad Emerg Med The Influence of Age on the Diagnostic Performance of White Blood Cell Count and Absolute Neutrophil Count in Suspected Pediatric Appendicitis. 1235-1242 10.1111/acem.13018 White blood cell (...) (WBC) count and absolute neutrophil count (ANC) are a standard part of the evaluation of suspected appendicitis. Specific threshold values are utilized in clinical pathways, but the discriminatory value of WBC count and ANC may vary by age. The objective of this study was to investigate whether the diagnostic value of WBC count and ANC varies across age groups and whether diagnostic thresholds should be age-adjusted. This is a multicenter prospective observational study of patients aged 3-18 years

EvidenceUpdates2016

18. Computed Tomography Utilization for the Diagnosis of Acute Appendicitis in Children Decreases With a Diagnostic Algorithm

Computed Tomography Utilization for the Diagnosis of Acute Appendicitis in Children Decreases With a Diagnostic Algorithm 27433918 2016 08 12 2016 08 12 1528-1140 264 3 2016 Sep Annals of surgery Ann. Surg. Computed Tomography Utilization for the Diagnosis of Acute Appendicitis in Children Decreases With a Diagnostic Algorithm. 474-81 10.1097/SLA.0000000000001867 The primary objective of this project was to decrease computed tomography (CT) utilization for the diagnosis of appendicitis (...) in an academic children's hospital emergency department (ED) through a multidisciplinary quality improvement initiative. Appendicitis is the most common abdominal diagnosis leading to the hospitalization of children in the United States. However, the diagnosis of appendicitis in children can be difficult and many centers rely heavily upon CT scans. Recent recommendations emphasize decreasing CT use among pediatric patients because of an increased lifetime risk of radiation-induced malignancies

EvidenceUpdates2016

19. Appendicitis

Appendicitis Appendicitis - NICE CKS Clinical Knowledge Summaries Share Appendicitis - summary Appendicitis is an acute inflammation of the appendix, which is a small, narrow tube (about 5–10 cm) that is connected to the caecum (the proximal part of the large intestine). It is thought to be caused by infection secondary to obstruction of the lumen of the appendix, usually by a faecolith (hard mass of faecal matter), normal stool, and/or lymphoid hyperplasia secondary to viral infection. Risk (...) factors for appendicitis include age (most common between the ages of 10–20 years), male sex, frequent antibiotic use, and smoking. Appendicitis accounts for more than 40,000 hospital admissions in England every year. It is one of the most common causes of abdominal pain in young adults and children in the UK. Complications of appendicitis include appendix perforation, generalized peritonitis, appendix mass or abscess, adhesions, sepsis, and death. However, the prognosis is good if the person

NICE Clinical Knowledge Summaries2016