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

42. Ultrasound versus computed tomography for children with suspected appendicitis: clinical evidence, cost-effectiveness, and guidelines

Ultrasound versus computed tomography for children with suspected appendicitis: clinical evidence, cost-effectiveness, and guidelines Ultrasound versus computed tomography for children with suspected appendicitis: clinical evidence, cost-effectiveness, and guidelines Ultrasound versus computed tomography for children with suspected appendicitis: clinical evidence, cost-effectiveness, and guidelines CADTH 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 CADTH. Ultrasound versus computed tomography for children with suspected appendicitis: clinical evidence, cost-effectiveness, and guidelines. Ottawa: Canadian Agency for Drugs and Technologies in Health (CADTH). Rapid Response - Reference List. 2013 Authors' conclusions Ten non-randomized studies and one economic evaluation were identified regarding diagnostic imaging with computed

Health Technology Assessment (HTA) Database.2013

43. Systematic review with meta-analysis: Non-operative management of uncomplicated acute appendicitis: using antibiotics is effective and decreases morbidity

Systematic review with meta-analysis: Non-operative management of uncomplicated acute appendicitis: using antibiotics is effective and decreases morbidity Non-operative management of uncomplicated acute appendicitis: using antibiotics is effective and decreases morbidity | 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 Non-operative management of uncomplicated acute appendicitis: using antibiotics is effective and decreases morbidity Article Text Therapeutics Systematic review with meta-analysis Non-operative management of uncomplicated acute

Evidence-Based Medicine (Requires free registration)2013

44. Cohort study: Abdominal pain duration impacts the accuracy of ultrasound for diagnosing paediatric appendicitis

Cohort study: Abdominal pain duration impacts the accuracy of ultrasound for diagnosing paediatric appendicitis Abdominal pain duration impacts the accuracy of ultrasound for diagnosing paediatric 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 Abdominal pain duration impacts the accuracy of ultrasound for diagnosing paediatric appendicitis Article Text Diagnosis Cohort study Abdominal pain duration impacts the accuracy of ultrasound for diagnosing paediatric appendicitis Andrea S Doria Statistics from Altmetric.com No Altmetric data

Evidence-Based Medicine (Requires free registration)2013

45. Meta-analysis of randomized trials comparing antibiotic therapy with appendectomy for acute uncomplicated (no abscess or phlegmon) appendicitis

Meta-analysis of randomized trials comparing antibiotic therapy with appendectomy for acute uncomplicated (no abscess or phlegmon) appendicitis Meta-analysis of randomized trials comparing antibiotic therapy with appendectomy for acute uncomplicated (no abscess or phlegmon) appendicitis Meta-analysis of randomized trials comparing antibiotic therapy with appendectomy for acute uncomplicated (no abscess or phlegmon) appendicitis Mason RJ, Moazzez A, Sohn H, Katkhouda N CRD summary Authors (...) concluded that management of appendicitis with antibiotics was associated with fewer complications, better pain control and shorter sick leave. However, antibiotics were generally less effective due to a higher rate of recurrence compared to appendectomy. Overall, the reliability of the authors' conclusions is uncertain given the poor quality and variability of studies and small number of participants. Authors' objectives To evaluate the efficacy of antibiotics versus appendectomy in the management

DARE.2013

47. Pain over speed bumps in diagnosis of acute appendicitis: diagnostic accuracy study.

Pain over speed bumps in diagnosis of acute appendicitis: diagnostic accuracy study. OBJECTIVE: To assess the diagnostic accuracy of pain on travelling over speed bumps for the diagnosis of acute appendicitis. DESIGN: Prospective questionnaire based diagnostic accuracy study. SETTING: Secondary care surgical assessment unit at a district general hospital in the UK. PARTICIPANTS: 101 patients aged 17-76 years referred to the on-call surgical team for assessment of possible appendicitis. MAIN (...) OUTCOME MEASURES: Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios for pain over speed bumps in diagnosing appendicitis, with histological diagnosis of appendicitis as the reference standard. RESULTS: The analysis included 64 participants who had travelled over speed bumps on their journey to hospital. Of these, 34 had a confirmed histological diagnosis of appendicitis, 33 of whom reported increased pain over speed bumps. The sensitivity

BMJ2012 Full Text: Link to full Text with Trip Pro

48. Validation and refinement of a prediction rule to identify children at low risk for acute appendicitis

Validation and refinement of a prediction rule to identify children at low risk for acute appendicitis 22869405 2012 08 07 2012 11 02 2016 10 25 1538-3628 166 8 2012 Aug Archives of pediatrics & adolescent medicine Arch Pediatr Adolesc Med Validation and refinement of a prediction rule to identify children at low risk for acute appendicitis. 738-44 To validate and refine a clinical prediction rule to identify which children with acute abdominal pain are at low risk for appendicitis (Low-Risk (...) Appendicitis Rule). Prospective, multicenter, cross-sectional study. Ten pediatric emergency departments. Children and adolescents aged 3 to 18 years who presented with suspected appendicitis from March 1, 2009, through April 30, 2010. The test performance of the Low-Risk Appendicitis Rule. Among 2625 patients enrolled, 1018 (38.8% [95% CI, 36.9%-40.7%]) had appendicitis. Validation of the rule resulted in a sensitivity of 95.5% (95% CI, 93.9%-96.7%), specificity of 36.3% (33.9%-38.9%), and negative

EvidenceUpdates2012 Full Text: Link to full Text with Trip Pro

49. Is abdominal pain when asked to hop suggestive of appendicitis in children?

Is abdominal pain when asked to hop suggestive of appendicitis in children? BestBets: Is abdominal pain when asked to hop suggestive of appendicitis in children? Is abdominal pain when asked to hop suggestive of appendicitis in children? Report By: Craig McRoberts - CT3 Emergency Medicine Search checked by Dr Vincent Choudhery - Consultant Paediatric Emergency Medicine Institution: Royal Hospital for Sick Children, Glasgow Date Submitted: 12th January 2012 Date Completed: 13th June 2012 Last (...) Modified: 13th June 2012 Status: Green (complete) Three Part Question In [children with suspected appendicitis] how [useful is abdominal pain when asked to hop] at [confirming or refuting the diagnosis] Clinical Scenario A 9 year old presents to the ED with acute abdominal pain; is pain on hopping/jumping indicative of appendicitis? Search Strategy Medline 1946-February week 3 2012 using the OVID interface {(appendicitis/ OR acute appendicitis/ OR appendicitis.mp) AND (hop.mp OR hopping.mp OR jump$.mp

BestBETS2012

50. Safety and efficacy of antibiotics compared with appendicectomy for treatment of uncomplicated acute appendicitis: meta-analysis of randomised controlled trials

Safety and efficacy of antibiotics compared with appendicectomy for treatment of uncomplicated acute appendicitis: meta-analysis of randomised controlled trials Safety and efficacy of antibiotics compared with appendicectomy for treatment of uncomplicated acute appendicitis: meta-analysis of randomised controlled trials. Safety and efficacy of antibiotics compared with appendicectomy for treatment of uncomplicated acute appendicitis: meta-analysis of randomised controlled trials. Varadhan KK (...) , Neal KR, Lobo DN CRD summary The authors concluded that antibiotics could be used safely and effectively as primary treatment for uncomplicated acute appendicitis. Although based on a small number of trials, this was a well-conducted review. The authors' conclusion reflects the evidence presented and seems reliable. Authors' objectives To compare the safety and efficacy of antibiotic treatment versus appendicectomy for treatment of uncomplicated acute appendicitis. Searching MEDLINE, EMBASE

DARE.2012

51. Novel serum and urine markers for pediatric appendicitis

Novel serum and urine markers for pediatric appendicitis 22221321 2012 01 18 2012 05 10 2016 10 25 1553-2712 19 1 2012 Jan Academic emergency medicine : official journal of the Society for Academic Emergency Medicine Acad Emerg Med Novel serum and urine markers for pediatric appendicitis. 56-62 10.1111/j.1553-2712.2011.01251.x The objective was to describe the association between two novel biomarkers, calprotectin and leucine-rich alpha glycoprotein-1 (LRG), and appendicitis in children (...) . This was a prospective, cross-sectional study of children 3 to 18 years old presenting to a pediatric emergency department (ED) with possible appendicitis. Blood and urine samples were assayed for calprotectin and LRG via enzyme-linked immunosorbent assay (ELISA). Final diagnosis was determined by histopathology or telephone follow-up. Biomarker levels were compared for subjects with and without appendicitis. Recursive partitioning was used to identify thresholds that predicted appendicitis. Of 176 subjects, mean

EvidenceUpdates2012 Full Text: Link to full Text with Trip Pro

52. Meta-analysis of the results of randomized controlled trials that compared laparoscopic and open surgery for acute appendicitis

Meta-analysis of the results of randomized controlled trials that compared laparoscopic and open surgery for acute appendicitis Meta-analysis of the results of randomized controlled trials that compared laparoscopic and open surgery for acute appendicitis Meta-analysis of the results of randomized controlled trials that compared laparoscopic and open surgery for acute appendicitis Ohtani H, Tamamori Y, Arimoto Y, Nishiguchi Y, Maeda K, Hirakawa K CRD summary The review concluded that compared (...) with open appendectomy, laparoscopic appendectomy for suspected appendicitis was associated with a longer operative time, but earlier resumption of liquid and solid intake, shorter duration of postoperative hospital stay, and reduction in dose numbers of parenteral and oral analgesics. The authors’ conclusions reflect the evidence presented but given the methodological limitations their reliability is unclear. Authors' objectives To compare laparoscopic and open surgery for the treatment of patients

DARE.2012

53. An Evaluation of the Alvarado Score as a Diagnostic Tool for Appendicitis in Children

An Evaluation of the Alvarado Score as a Diagnostic Tool for Appendicitis in Children BestBets: An Evaluation of the Alvarado Score as a Diagnostic Tool for Appendicitis in Children An Evaluation of the Alvarado Score as a Diagnostic Tool for Appendicitis in Children Report By: John Heineman - - Search checked by David Drake - Institution: Oregon Health & Science University, Oregon, USA and Central Manchester University Hospitals NHS Foundation Trust respectively Date Submitted: 25th August (...) 2011 Date Completed: 15th April 2013 Last Modified: 15th April 2013 Status: Green (complete) Three Part Question In [children with suspected appendicitis] is [the Alvarado scoring system] [sufficiently sensitive and specific to enable rule in and/or rule out of acute appendicitis])? Clinical Scenario A 10-year-old girl presents to the emergency department (ED) with pain in her right lower quadrant. She states that the pain started 2 days ago when it was diffuse across her lower abdomen. She has had

BestBETS2012

54. Low-dose abdominal CT for evaluating suspected appendicitis.

Low-dose abdominal CT for evaluating suspected appendicitis. 22533576 2012 04 26 2012 04 27 2016 11 25 1533-4406 366 17 2012 Apr 26 The New England journal of medicine N. Engl. J. Med. Low-dose abdominal CT for evaluating suspected appendicitis. 1596-605 10.1056/NEJMoa1110734 Computed tomography (CT) has become the predominant test for diagnosing acute appendicitis in adults. In children and young adults, exposure to CT radiation is of particular concern. We evaluated the rate of negative (...) (unnecessary) appendectomy after low-dose versus standard-dose abdominal CT in young adults with suspected appendicitis. In this single-institution, single-blind, noninferiority trial, we randomly assigned 891 patients with suspected appendicitis to either low-dose CT (444 patients) or standard-dose CT (447 patients). The median radiation dose in terms of dose-length product was 116 mGy·cm in the low-dose group and 521 mGy·cm in the standard-dose group. The primary end point was the percentage of negative

NEJM2012

55. Laparoscopic versus open appendectomy for acute appendicitis: a metaanalysis

Laparoscopic versus open appendectomy for acute appendicitis: a metaanalysis Laparoscopic versus open appendectomy for acute appendicitis: a metaanalysis Laparoscopic versus open appendectomy for acute appendicitis: a metaanalysis Wei B, Qi CL, Chen TF, Zheng ZH, Huang JL, Hu BG, Wei HB CRD summary The review concluded that although laparoscopic appendectomy had a longer operating time than open appendectomy, it resulted in less postoperative pain, faster postoperative rehabilitation, a shorter (...) hospital stay and fewer postoperative complications in patients with acute appendicitis. Concerns about the appropriateness of meta-analysis and potential biases within the review mean that caution is warranted when interpreting the authors’ conclusions. Authors' objectives To assess the efficacy and safety of laparoscopic appendectomy compared with open appendectomy for acute appendicitis. Searching PubMed, EMBASE and Current Contents were searched from January 1992 to February 2010 for articles

DARE.2011

56. Discriminative accuracy of novel and traditional biomarkers in children with suspected appendicitis adjusted for duration of abdominal pain

Discriminative accuracy of novel and traditional biomarkers in children with suspected appendicitis adjusted for duration of abdominal pain 21676053 2011 06 16 2011 12 13 2016 10 25 1553-2712 18 6 2011 Jun Academic emergency medicine : official journal of the Society for Academic Emergency Medicine Acad Emerg Med Discriminative accuracy of novel and traditional biomarkers in children with suspected appendicitis adjusted for duration of abdominal pain. 567-74 10.1111/j.1553-2712.2011.01095.x (...) The objective was to assess the accuracy of novel and traditional biomarkers in patients with suspected appendicitis as a function of duration of symptoms. This was a prospective cohort study, conducted in a tertiary care emergency department (ED). The authors enrolled children 3 to 18 years old with acute abdominal pain of less than 96 hours and measured serum levels of interleukin-6 (IL-6), interleukin-8 (IL-8), C-reactive protein (CRP), white blood cell (WBC) count, and absolute neutrophil count (ANC

EvidenceUpdates2011 Full Text: Link to full Text with Trip Pro

57. Single incision versus conventional multi-incision appendicectomy for suspected appendicitis.

Single incision versus conventional multi-incision appendicectomy for suspected appendicitis. BACKGROUND: Appendicectomy is a well established surgical procedure used in the management of acute appendicitis. The operation can be performed with minimally invasive surgery (laparoscopic) or as an open procedure. A recent development in appendicectomy has been the introduction of less invasive single incision laparoscopic surgery, using a single multi-luminal port or multiple mono-luminal ports (...) , through a single skin incision. There are yet unanswered questions regarding the efficacy of this new and novel technique including: patient benefit and satisfaction, complications, long-term outcomes, and survival. OBJECTIVES: The aim of this review is to perform meta-analysis using data from available trials comparing single incision with conventional multi-incision laparoscopic appendicectomy for appendicitis, in order to ascertain any differences in outcome. SEARCH STRATEGY: We searched

Cochrane2011

58. Diagnostic performance of multidetector computed tomography for suspected acute appendicitis.

Diagnostic performance of multidetector computed tomography for suspected acute appendicitis. BACKGROUND: Use of preoperative computed tomography for suspected acute appendicitis has dramatically increased since the introduction of multidetector CT (MDCT) scanners. OBJECTIVE: To evaluate the diagnostic performance of MDCT for suspected acute appendicitis in adults. DESIGN: Analysis of MDCT findings and clinical outcomes of consecutive adults referred for MDCT for suspected appendicitis from (...) January 2000 to December 2009. SETTING: Single academic medical center in the United States. PATIENTS: 2871 adults. MEASUREMENTS: Interpretation of nonfocused abdominopelvic MDCT scans by radiologists who were aware of the study indication. Posttest assessment of diagnostic performance of MDCT for acute appendicitis, according to the reference standard of final combined clinical, surgical, and pathology findings. RESULTS: 675 of 2871 patients (23.5%) had confirmed acute appendicitis. The sensitivity

Annals of Internal Medicine2011

59. Perioperative hyperoxygenation and wound site infection following surgery for acute appendicitis: a randomized, prospective, controlled trial

Perioperative hyperoxygenation and wound site infection following surgery for acute appendicitis: a randomized, prospective, controlled trial 21502457 2011 04 19 2011 06 09 2013 11 21 1538-3644 146 4 2011 Apr Archives of surgery (Chicago, Ill. : 1960) Arch Surg Perioperative hyperoxygenation and wound site infection following surgery for acute appendicitis: a randomized, prospective, controlled trial. 464-70 10.1001/archsurg.2011.65 To assess the influence of hyperoxygenation on surgical site (...) infection by using the most homogeneous study population. A randomized, prospective, controlled trial. Department of surgery in a government hospital. A total of 210 patients who underwent open surgery for acute appendicitis. In the study group, patients received 80% oxygen during anesthesia, followed by high-flow oxygen for 2 hours in the recovery room. The control group received 30% oxygen, as usual. Open appendectomy via incision in the right lower quadrant of the abdomen. Surgical site infection

EvidenceUpdates2011

60. Cohort study: Ultrasound scan for suspected appendicitis in children: risk of diagnostic inaccuracy increases with BMI at or above 85th percentile and clinical probability of appendicitis of 50% or lower

Cohort study: Ultrasound scan for suspected appendicitis in children: risk of diagnostic inaccuracy increases with BMI at or above 85th percentile and clinical probability of appendicitis of 50% or lower Ultrasound scan for suspected appendicitis in children: risk of diagnostic inaccuracy increases with BMI at or above 85th percentile and clinical probability of appendicitis of 50% or lower | 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 Ultrasound scan for suspected appendicitis in children: risk of diagnostic inaccuracy increases with BMI at or

Evidence-Based Medicine (Requires free registration)2011