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

21. Unilateral Stimulation of the Right Ovary in a 10-Year-Old Girl with Perforated Appendicitis

Unilateral Stimulation of the Right Ovary in a 10-Year-Old Girl with Perforated Appendicitis 27689178 2016 10 05 2016 12 30 2509-596X 2 3 2016 Sep Ultrasound international open Ultrasound Int Open Unilateral Stimulation of the Right Ovary in a 10-Year-Old Girl with Perforated Appendicitis. E102-4 10.1055/s-0042-110658 Stranzinger E E Scherer C C Pabst W W Schuster F F Flück C C eng Journal Article 2016 08 24 Germany Ultrasound Int Open 101674542 2199-7152 2016 10 1 6 0 2016 10 1 6 0 2016 10 1 6

Ultrasound international open2016 Full Text: Link to full Text with Trip Pro

22. Computed tomography to rule out suspected appendicitis in adults and reduce the negative appendectomy rate

Computed tomography to rule out suspected appendicitis in adults and reduce the negative appendectomy rate Health Policy Advisory Committee on Technology Technology Brief Computed tomography to rule out suspected appendicitis in adults and reduce the negative appendectomy rate (NAR) August 2016 © State of Queensland (Queensland Department of Health) 2016 This work is licensed under a Creative Commons Attribution Non-Commercial No Derivatives 3.0 Australia licence. In essence, you are free (...) Council (AHMAC), reporting to AHMAC’s Hospitals Principal Committee (HPC). AHMAC supports HealthPACT through funding. This brief was prepared by Deanne Forel from the Australian Safety and Efficacy Register of New Interventional Procedures – Surgical (ASERNIP-S). CT to rule out suspected appendicitis in adults and reduce the negative appendectomy rate: August 2016 i Summary of findings The purpose of this Technology Brief was to examine the evidence base for the routine use of computed tomography (CT

COAG Health Council - Horizon Scanning Technology Briefs2016

23. Diagnosis of right lower quadrant pain and suspected acute appendicitis

Diagnosis of right lower quadrant pain and suspected acute appendicitis Diagnosis of right lower quadrant pain and suspected acute appendicitis Diagnosis of right lower quadrant pain and suspected acute appendicitis Agency for Healthcare Research and Quality (AHRQ) Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Agency for Healthcare (...) Research and Quality (AHRQ). Diagnosis of right lower quadrant pain and suspected acute appendicitis. Rockville: Agency for Healthcare Research and Quality (AHRQ). Comparative Effectiveness Review No. 157. 2015 Authors' conclusions The literature on the test performance of clinical symptoms and signs, laboratory and imaging tests, and multivariable diagnostic scores for the diagnosis of acute appendicitis is large, but it consists almost exclusively of studies at moderate risk of bias, primarily

Health Technology Assessment (HTA) Database.2016

24. Diagnosis of Right Lower Quadrant Pain and Suspected Acute Appendicitis

Diagnosis of Right Lower Quadrant Pain and Suspected Acute Appendicitis Diagnosis of Right Lower Quadrant Pain and Suspected Acute Appendicitis Comparative Effectiveness Review Number 157 Comparative Effectiveness Review Number 157 Diagnosis of Right Lower Quadrant Pain and Suspected Acute Appendicitis Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 5600 Fishers Lane Rockville, MD 20857 www.ahrq.gov Contract No. 290-2012-00012-I Prepared (...) Lower Quadrant Pain and Suspected Acute Appendicitis. Comparative Effectiveness Review No. 157. (Prepared by the Brown Evidence-based Practice Center under Contract No. 290-2012-00012-I.) AHRQ Publication No. 15(16)-EHC025-EF. Rockville, MD: Agency for Healthcare Research and Quality; December 2015. www.effectivehealthcare.ahrq.gov/reports/final.cfm .iii Preface The Agency for Healthcare Research and Quality (AHRQ), through its Evidence-based Practice Centers (EPCs), sponsors the development

Effective Health Care Program (AHRQ)2016

25. 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

26. Retrospective audit of patients presenting for ultrasound with suspicion of appendicitis

Retrospective audit of patients presenting for ultrasound with suspicion of appendicitis 28191243 2018 11 13 1836-6864 18 2 2015 May Australasian journal of ultrasound in medicine Australas J Ultrasound Med Retrospective audit of patients presenting for ultrasound with suspicion of appendicitis. 67-69 10.1002/j.2205-0140.2015.tb00044.x Purpose : To assess the ultrasound performance on patients presenting to Waikato hospital ultrasound department with a clinical suspicion of appendicitis. Method (...) : This was a retrospective audit of 309 patients presenting to our department within business hours with clinical suspicion of appendicitis between September 2012 and March 2014. The patients were evaluated by operators of mixed experience. The scan reports, surgical reports, histology and discharge summaries were reviewed. Results : The overall sensitivity of ultrasound on detecting appendicitis was 50%, the specificity was 98.5%. The positive predictive value and the negative predictive value were 84% and 92.6

Australasian journal of ultrasound in medicine2015 Full Text: Link to full Text with Trip Pro

27. Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management.

Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management. Acute appendicitis is one of the most common abdominal emergencies worldwide. The cause remains poorly understood, with few advances in the past few decades. To obtain a confident preoperative diagnosis is still a challenge, since the possibility of appendicitis must be entertained in any patient presenting with an acute abdomen. Although biomarkers and imaging are valuable adjuncts to history and examination (...) , their limitations mean that clinical assessment is still the mainstay of diagnosis. A clinical classification is used to stratify management based on simple (non-perforated) and complex (gangrenous or perforated) inflammation, although many patients remain with an equivocal diagnosis, which is one of the most challenging dilemmas. An observed divide in disease course suggests that some cases of simple appendicitis might be self-limiting or respond to antibiotics alone, whereas another type often seems

Lancet2015

28. Saline vs Tissue Plasminogen Activator Irrigations after Drain Placement for Appendicitis-Associated Abscess: A Prospective Randomized Trial

Saline vs Tissue Plasminogen Activator Irrigations after Drain Placement for Appendicitis-Associated Abscess: A Prospective Randomized Trial 26141467 2015 07 24 2015 10 05 2015 11 19 1879-1190 221 2 2015 Aug Journal of the American College of Surgeons J. Am. Coll. Surg. Saline vs Tissue Plasminogen Activator Irrigations after Drain Placement for Appendicitis-Associated Abscess: A Prospective Randomized Trial. 390-6 10.1016/j.jamcollsurg.2015.03.043 S1072-7515(15)00248-3 Emerging data suggest (...) instillation of tissue plasminogen activator (tPA) is safe and potentially efficacious in the treatment of intra-abdominal abscess. To date, prospective comparative data are lacking in children. Therefore, we conducted a randomized trial comparing abscess irrigation with tPA and irrigation with saline alone. After IRB approval, children with an abscess secondary to perforated appendicitis who had a percutaneous drain placed for treatment were randomized to twice-daily instillation of 13 mL 10% tPA or 13 mL

EvidenceUpdates2015

29. Impact of point-of-care ultrasound on length of stay for paediatric appendicitis

Impact of point-of-care ultrasound on length of stay for paediatric appendicitis BestBets: Impact of point-of-care ultrasound on length of stay for paediatric appendicitis Impact of point-of-care ultrasound on length of stay for paediatric appendicitis Report By: �lizabeth Lalande - PGY-5 Search checked by Dr Marc-Charles Parent, MD, FRCPC - Institution: Laval University, Emergency Medicine Residency Program, Centre Universitaire de L'universit� Laval (CHUL), CHU de Quebec. Date Submitted: 6th (...) April 2015 Date Completed: 1st July 2015 Last Modified: 1st July 2015 Status: Green (complete) Three Part Question In [children with suspected appendicitis] is [POC US as good as radiology departmental ultrasound or CT scanning] at [safely shortening LOS in the emergency department]? Clinical Scenario An 8-year-old boy presents to the emergency department with right lower quadrant abdominal pain with features suggestive of appendicitis. The surgeons are not immediately available and suggest imaging

BestBETS2015

30. Antibiotic Therapy vs Appendectomy for Treatment of Uncomplicated Acute Appendicitis: The APPAC Randomized Clinical Trial.

Antibiotic Therapy vs Appendectomy for Treatment of Uncomplicated Acute Appendicitis: The APPAC Randomized Clinical Trial. 26080338 2015 06 17 2015 06 22 2016 11 18 1538-3598 313 23 2015 Jun 16 JAMA JAMA Antibiotic Therapy vs Appendectomy for Treatment of Uncomplicated Acute Appendicitis: The APPAC Randomized Clinical Trial. 2340-8 10.1001/jama.2015.6154 An increasing amount of evidence supports the use of antibiotics instead of surgery for treating patients with uncomplicated acute (...) appendicitis. To compare antibiotic therapy with appendectomy in the treatment of uncomplicated acute appendicitis confirmed by computed tomography (CT). The Appendicitis Acuta (APPAC) multicenter, open-label, noninferiority randomized clinical trial was conducted from November 2009 until June 2012 in Finland. The trial enrolled 530 patients aged 18 to 60 years with uncomplicated acute appendicitis confirmed by a CT scan. Patients were randomly assigned to early appendectomy or antibiotic treatment

JAMA2015

31. Risk stratification by the Appendicitis Inflammatory Response score to guide decision-making in patients with suspected appendicitis

Risk stratification by the Appendicitis Inflammatory Response score to guide decision-making in patients with suspected appendicitis 25727811 2015 03 13 2015 05 05 2015 03 13 1365-2168 102 5 2015 Apr The British journal of surgery Br J Surg Risk stratification by the Appendicitis Inflammatory Response score to guide decision-making in patients with suspected appendicitis. 563-72 10.1002/bjs.9773 Current management of suspected appendicitis is hampered by the overadmission of patients with non (...) -specific abdominal pain and a significant negative exploration rate. The potential benefits of risk stratification by the Appendicitis Inflammatory Response (AIR) score to guide clinical decision-making were assessed. During this 50-week prospective observational study at one institution, the AIR score was calculated for all patients admitted with suspected appendicitis. Appendicitis was diagnosed by histological examination, and patients were classified as having non-appendicitis pain if histological

EvidenceUpdates2015

32. Acute appendicitis - appendectomy or the "antibiotics first" strategy.

Acute appendicitis - appendectomy or the "antibiotics first" strategy. Clinical practice. Acute appendicitis--appendectomy or the "antibiotics first" strategy. - PubMed - NCBI Warning: The NCBI web site requires JavaScript to function. Search database Search term Search Result Filters Format Summary Summary (text) Abstract Abstract (text) MEDLINE XML PMID List Apply Choose Destination File Clipboard Collections E-mail Order My Bibliography Citation manager Format Create File 1 selected item (...) : 25970051 Format MeSH and Other Data E-mail Subject Additional text E-mail Add to Clipboard Add to Collections Order articles Add to My Bibliography Generate a file for use with external citation management software. Create File 2015 May 14;372(20):1937-43. doi: 10.1056/NEJMcp1215006. Clinical practice. Acute appendicitis--appendectomy or the "antibiotics first" strategy. . Erratum in [N Engl J Med. 2015] Comment in [Surg Infect (Larchmt). 2016] PMID: 25970051 DOI: [Indexed for MEDLINE] Publication type

NEJM2015

33. Integration of Ultrasound Findings and a Clinical Score in the Diagnostic Evaluation of Pediatric Appendicitis

Integration of Ultrasound Findings and a Clinical Score in the Diagnostic Evaluation of Pediatric Appendicitis 25708690 2015 04 29 2015 06 29 2016 11 25 1097-6833 166 5 2015 May The Journal of pediatrics J. Pediatr. Integration of ultrasound findings and a clinical score in the diagnostic evaluation of pediatric appendicitis. 1134-9 10.1016/j.jpeds.2015.01.034 S0022-3476(15)00081-5 To determine the predictive value of ultrasonography (US) for appendicitis in children when combined with clinical (...) assessment based on the Pediatric Appendicitis Score (PAS). Observational study of children aged 3-18 years who had an US examination for possible appendicitis. A PAS was calculated on the basis of historical elements, examination, and laboratory studies and was used to classify patients into 3 risk groups (low, medium, high). The predictive value of the PAS for appendicitis was calculated and stratified by the result of the US (positive, negative, or equivocal). A total of 728 children with a median age

EvidenceUpdates2015

34. Computed Tomography to Evaluate Children with Suspected Appendicitis

Computed Tomography to Evaluate Children with Suspected Appendicitis Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources of the best evidence on the topic that CADTH could identify using all reasonable efforts within the time allowed. Rapid responses should be considered (...) with Suspected Appendicitis: Clinical and Cost-Effectiveness, Diagnostic Accuracy, and Guidelines DATE: 17 April 2015 RESEARCH QUESTIONS 1. What is the clinical effectiveness of computed tomography to evaluate children with suspected appendicitis? 2. What is the diagnostic accuracy of computed tomography to evaluate children with suspected appendicitis? 3. What is the cost-effectiveness of computed tomography compared with ultrasound when evaluating children with suspected appendicitis? 4. What

Canadian Agency for Drugs and Technologies in Health - Rapid Review2015

35. Harms of CT scanning prior to surgery for suspected appendicitis

Harms of CT scanning prior to surgery for suspected appendicitis Harms of CT scanning prior to surgery for suspected appendicitis | Evidence-Based Medicine This site uses cookies. By continuing to browse the site you are agreeing to our use of cookies. Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username (...) and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Harms of CT scanning prior to surgery for suspected appendicitis Article Text Perspective Harms of CT scanning prior to surgery for suspected appendicitis Free William Rogers , Jerome Hoffman , Naudereh Noori Statistics from Altmetric.com No Altmetric data available for this article. Introduction Abdominal pain in young adults is a common symptom in the emergency

Evidence-Based Medicine (Requires free registration)2015 Full Text: Link to full Text with Trip Pro

36. Predicting Acute Appendicitis? A comparison of the Alvarado Score, the Appendicitis Inflammatory Response Score and Clinical Assessment

Predicting Acute Appendicitis? A comparison of the Alvarado Score, the Appendicitis Inflammatory Response Score and Clinical Assessment 25245432 2014 12 22 2015 07 20 2014 12 22 1432-2323 39 1 2015 Jan World journal of surgery World J Surg Predicting acute appendicitis? A comparison of the Alvarado score, the Appendicitis Inflammatory Response Score and clinical assessment. 104-9 10.1007/s00268-014-2794-6 Patients presenting with suspected appendicitis pose a diagnostic challenge (...) . The appendicitis inflammatory response (AIR) score has outperformed the Alvarado score in two retrospective studies. The aim of this study was to evaluate the AIR Score and compare its performance in predicting risk of appendicitis to both the Alvarado score and the clinical impression of a senior surgeon. All parameters included in the AIR and Alvarado scores as well as the initial clinical impression of a senior surgeon were prospectively recorded on patients referred to the surgical on call team with acute

EvidenceUpdates2014

37. Management of Acute Appendicitis in Ambulatory Surgery: Is It Possible? How to Select Patients?

Management of Acute Appendicitis in Ambulatory Surgery: Is It Possible? How to Select Patients? 24950287 2015 08 21 2016 04 28 2016 07 04 1528-1140 261 6 2015 Jun Annals of surgery Ann. Surg. Management of Acute Appendicitis in Ambulatory Surgery: Is It Possible? How to Select Patients? 1167-72 10.1097/SLA.0000000000000795 Establish a protocol of management of acute appendicitis (AA) in ambulatory surgery (AmbSurg) on the basis of preoperative criteria. Ambulatory laparoscopic appendectomy (LA (...) -5 26079902 Adult Ambulatory Surgical Procedures Appendectomy Appendicitis surgery Clinical Protocols Female Humans Laparoscopy Length of Stay Male Patient Selection Predictive Value of Tests Preoperative Period Retrospective Studies Young Adult 2014 6 21 6 0 2014 6 21 6 0 2016 4 29 6 0 ppublish 24950287 10.1097/SLA.0000000000000795

EvidenceUpdates2014

38. A simple clinical decision rule to rule out appendicitis in patients with nondiagnostic ultrasound results

A simple clinical decision rule to rule out appendicitis in patients with nondiagnostic ultrasound results 24842498 2014 05 20 2014 10 07 2016 11 25 1553-2712 21 5 2014 May Academic emergency medicine : official journal of the Society for Academic Emergency Medicine Acad Emerg Med A simple clinical decision rule to rule out appendicitis in patients with nondiagnostic ultrasound results. 488-96 10.1111/acem.12374 The objective was to identify a set of clinical features that can rule out (...) appendicitis in patients with suspected acute appendicitis and nondiagnostic ultrasound (US) results, allowing safe discharge and next-day reevaluation without initial computed tomography (CT) or magnetic resonance imaging (MRI). Data on clinical and US evaluation, including a number of prespecified variables potentially associated with acute appendicitis, were prospectively collected in two diagnostic accuracy studies of imaging. These studies included patients with suspected appendicitis seen

EvidenceUpdates2014 Full Text: Link to full Text with Trip Pro

39. Antibiotic therapy for acute appendicitis in adults

Antibiotic therapy for acute appendicitis in adults Prescrire IN ENGLISH - Spotlight ''Antibiotic therapy for acute appendicitis in adults '', 1 June 2014 {1} {1} {1} | | > > > Antibiotic therapy for acute appendicitis in adults Spotlight Every month, the subjects in Prescrire’s Spotlight. 100 most recent :  |   |   |   |   |   |   |   |   |  Spotlight Antibiotic therapy for acute appendicitis in adults FEATURED REVIEW How (...) effective are antibiotics in adults with uncomplicated acute appendicitis, and what is the risk of complications? To answer these questions, we conducted a review of the literature using the standard Prescrire methodology. Full review (3 pages) available for download by subscribers. Abstract Appendectomy is the standard treatment for acute appendicitis. Since the 1990s, antibiotic therapy has sometimes been proposed as an alternative to immediate appendectomy. How effective are antibiotics in adults

Prescrire2014

40. Prospective evaluation of a clinical pathway for suspected appendicitis

Prospective evaluation of a clinical pathway for suspected appendicitis 24379237 2014 01 03 2014 02 24 2016 11 25 1098-4275 133 1 2014 Jan Pediatrics Pediatrics Prospective evaluation of a clinical pathway for suspected appendicitis. e88-95 10.1542/peds.2013-2208 To evaluate the diagnostic accuracy of a clinical pathway for suspected appendicitis combining the Samuel's pediatric appendicitis score (PAS) and selective use of ultrasonography (US) as the primary imaging modality. Prospective (...) , observational cohort study conducted at an urban, academic pediatric emergency department. After initial evaluation, patients were determined to be at low (PAS 1-3), intermediate (PAS 4-7), or high (PAS 8-10) risk for appendicitis. Low-risk patients were discharged with telephone follow-up. High-risk patients received immediate surgical consultation. Patients at intermediate risk for appendicitis underwent US. Of the 196 patients enrolled, 65 (33.2%) had appendicitis. An initial PAS of 1-3 was noted in 44

EvidenceUpdates2014