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

61. 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

62. 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

63. Amoxicillin plus clavulanic acid versus appendicectomy for treatment of acute uncomplicated appendicitis: an open-label, non-inferiority, randomised controlled trial.

Amoxicillin plus clavulanic acid versus appendicectomy for treatment of acute uncomplicated appendicitis: an open-label, non-inferiority, randomised controlled trial. 21550483 2011 05 09 2011 07 06 2016 11 25 1474-547X 377 9777 2011 May 07 Lancet (London, England) Lancet Amoxicillin plus clavulanic acid versus appendicectomy for treatment of acute uncomplicated appendicitis: an open-label, non-inferiority, randomised controlled trial. 1573-9 10.1016/S0140-6736(11)60410-8 Researchers have (...) suggested that antibiotics could cure acute appendicitis. We assessed the efficacy of amoxicillin plus clavulanic acid by comparison with emergency appendicectomy for treatment of patients with uncomplicated acute appendicitis. In this open-label, non-inferiority, randomised trial, adult patients (aged 18-68 years) with uncomplicated acute appendicitis, as assessed by CT scan, were enrolled at six university hospitals in France. A computer-generated randomisation sequence was used to allocate patients

Lancet2011

64. Discovery and validation of urine markers of acute pediatric appendicitis using high-accuracy mass spectrometry

Discovery and validation of urine markers of acute pediatric appendicitis using high-accuracy mass spectrometry 19556024 2010 02 01 2010 03 15 2017 02 20 1097-6760 55 1 2010 Jan Annals of emergency medicine Ann Emerg Med Discovery and validation of urine markers of acute pediatric appendicitis using high-accuracy mass spectrometry. 62-70.e4 10.1016/j.annemergmed.2009.04.020 Molecular definition of disease has been changing all aspects of medical practice, from diagnosis and screening (...) to understanding and treatment. Acute appendicitis is among many human conditions that are complicated by the heterogeneity of clinical presentation and shortage of diagnostic markers. Here, we sought to profile the urine of patients with appendicitis, with the goal of identifying new diagnostic markers. Candidate markers were identified from the urine of children with histologically proven appendicitis by using high-accuracy mass spectrometry proteome profiling. These systemic and local markers were used

EvidenceUpdates2010 Full Text: Link to full Text with Trip Pro

65. Clinical policy: critical issues in the evaluation and management of emergency department patients with suspected appendicitis

Clinical policy: critical issues in the evaluation and management of emergency department patients with suspected appendicitis 20116016 2010 02 01 2010 03 15 2016 11 25 1097-6760 55 1 2010 Jan Annals of emergency medicine Ann Emerg Med Clinical policy: Critical issues in the evaluation and management of emergency department patients with suspected appendicitis. 71-116 10.1016/j.annemergmed.2009.10.004 This clinical policy from the American College of Emergency Physicians is an update of a 2000 (...) clinical policy on the evaluation and management of patients presenting with nontraumatic acute abdominal pain.1 A writing subcommittee reviewed the literature to derive evidence-based recommendations to help clinicians answer the following critical questions: (1)Can clinical findings be used to guide decision making in the risk stratification of patients with possible appendicitis? (2) In adult patients with suspected acute appendicitis who are undergoing a computed tomography scan, what is the role

EvidenceUpdates2010

66. A meta-analysis comparing conservative treatment versus acute appendectomy for complicated appendicitis (abscess or phlegmon)

A meta-analysis comparing conservative treatment versus acute appendectomy for complicated appendicitis (abscess or phlegmon) A meta-analysis comparing conservative treatment versus acute appendectomy for complicated appendicitis (abscess or phlegmon) A meta-analysis comparing conservative treatment versus acute appendectomy for complicated appendicitis (abscess or phlegmon) Simillis C, Symeonides P, Shorthouse AJ, Tekkis PP CRD summary The review concluded that conservative treatment appeared (...) to be a safer option than acute appendectomy in patients with complicated appendicitis; further research was required. The authors' cautious conclusion is likely to be reliable. Authors' objectives To determine the efficacy of conservative treatment compared with acute appendectomy in patients with complicated appendicitis. Searching MEDLINE, EMBASE and The Cochrane Library were searched without language restriction up to June 2008; search terms were reported. References of relevant articles were checked

DARE.2010

67. Laparoscopic versus open appendectomy in adults with complicated appendicitis: systematic review and meta-analysis

Laparoscopic versus open appendectomy in adults with complicated appendicitis: systematic review and meta-analysis Laparoscopic versus open appendectomy in adults with complicated appendicitis: systematic review and meta-analysis Laparoscopic versus open appendectomy in adults with complicated appendicitis: systematic review and meta-analysis Markides G, Subar D, Riyad K CRD summary This review concluded that when compared with open appendectomy, laparoscopic appendectomy may have a lower (...) incidence of surgical site infections in complicated appendicitis, with no significant risk of intra-abdominal abscess (based on moderate to poor quality evidence). These conclusions reflect the data presented, but should be interpreted taking into consideration the possibility of language and publication bias (missed studies). Authors' objectives To evaluate the effectiveness of laparoscopic appendectomy compared with open appendectomy in patients with complicated acute appendicitis. Searching PubMed

DARE.2010

68. Diagnostic accuracy of noncontrast computed tomography for appendicitis in adults: a systematic review

Diagnostic accuracy of noncontrast computed tomography for appendicitis in adults: a systematic review Diagnostic accuracy of noncontrast computed tomography for appendicitis in adults: a systematic review Diagnostic accuracy of noncontrast computed tomography for appendicitis in adults: a systematic review Hlibczuk V, Dattaro JA, Jin Z, Falzon L, Brown MD CRD summary This well-conducted review concluded that non-enhanced computed tomography (CT) had high sensitivity and specificity (...) for the diagnosis of acute appendicitis in the adult population and was adequate for clinical decision making in the Emergency Department. The authors’ conclusions reflected the data presented and are likely to be reliable. Authors' objectives To assess the accuracy of non-contrast computed tomography (CT) for diagnosing acute appendicitis in adults in the emergency department setting. Searching MEDLINE, EMBASE, the Cochrane Library, DARE, HTA, the American College of Physicians Journal Club, and Emergency

DARE.2010

69. Antibiotic therapy versus appendectomy for acute appendicitis: a meta-analysis

Antibiotic therapy versus appendectomy for acute appendicitis: a meta-analysis Antibiotic therapy versus appendectomy for acute appendicitis: a meta-analysis Antibiotic therapy versus appendectomy for acute appendicitis: a meta-analysis Varadhan KK, Humes DJ, Neal KR, Lobo DN CRD summary This review concluded that, although antibiotics may be used as primary treatment for selected patients with suspected uncomplicated appendicitis, appendectomy should remain the gold standard therapy (...) for patients with acute appendicitis based on available evidence. These conclusions should be interpreted with some caution as they are based on a small number of trials with methodological limitations. Authors' objectives To compare antibiotic therapy alone with surgery (appendectomy) for acute appendicitis. Searching MEDLINE, EMBASE and the Cochrane Library were searched from 1966 to June 2009 for published studies. Search terms were reported. No language restrictions were applied. Study selection

DARE.2010

70. Prospective Validation of the Pediatric Appendicitis Score in a Canadian Pediatric Emergency Department

Prospective Validation of the Pediatric Appendicitis Score in a Canadian Pediatric Emergency Department 19549016 2009 08 20 2009 12 07 2009 08 20 1553-2712 16 7 2009 Jul Academic emergency medicine : official journal of the Society for Academic Emergency Medicine Acad Emerg Med Prospective validation of the pediatric appendicitis score in a Canadian pediatric emergency department. 591-6 10.1111/j.1553-2712.2009.00445.x Clinical scoring systems attempt to improve the diagnostic accuracy (...) of pediatric appendicitis. The Pediatric Appendicitis Score (PAS) was the first score created specifically for children and showed excellent performance in the derivation study when administered by pediatric surgeons. The objective was to validate the score in a nonreferred population by emergency physicians (EPs). A convenience sample of children, 4-18 years old presenting to a pediatric emergency department (ED) with abdominal pain of less than 3 days' duration and in whom the treating physician

EvidenceUpdates2009

71. Is Magnetic Resonance Imaging useful for suspected appendicitis in pregnant patients

Is Magnetic Resonance Imaging useful for suspected appendicitis in pregnant patients BestBets: Is Magnetic Resonance Imaging useful for suspected appendicitis in pregnant patients Is Magnetic Resonance Imaging useful for suspected appendicitis in pregnant patients Report By: Kevin Chiu, MD - Emergency Medicine Resident Search checked by Jerry Ray Baskerville, MD, FACEP - Institution: Christus Spohn Memorial Hospital / Texas A&M University Date Submitted: 23rd March 2009 Date Completed: 1st June (...) 2009 Last Modified: 1st June 2009 Status: Green (complete) Three Part Question In [pregnant patients with suspected appendicitis], how useful is [abdominal MRI] in [ruling in or ruling out acute appendicitis]? Clinical Scenario You suspect appendicitis when a 20 year old female, 25 weeks pregnant, presents with right lower quadrant abdominal pain, vomiting, and low grade fever. An abdominal ultrasound is performed, but the appendix was not visualized, and the study is read as inconclusive. Knowing

BestBETS2009

72. Appendicitis, mesenteric lymphadenitis, and subsequent risk of ulcerative colitis: cohort studies in Sweden and Denmark.

Appendicitis, mesenteric lymphadenitis, and subsequent risk of ulcerative colitis: cohort studies in Sweden and Denmark. OBJECTIVE: To determine whether the repeatedly observed low risk of ulcerative colitis after appendicectomy is related to the appendicectomy itself or the underlying morbidity, notably appendicitis or mesenteric lymphadenitis. DESIGN: Nationwide cohort studies. SETTING: Sweden and Denmark. PARTICIPANTS: 709 353 Swedish (1964-2004) and Danish (1977-2004) patients who had (...) was not associated with reduced risk (standardised incidence ratio 1.04, 95% confidence interval 0.95 to 1.15). Before the age of 20, however, appendicectomy for appendicitis (0.45, 0.39 to 0.53) or mesenteric lymphadenitis (0.65, 0.46 to 0.90) was associated with significant risk reduction. A similar pattern was seen in those with affected relatives, whose overall risk of ulcerative colitis was clearly higher than the background risk (1404 observed v 446 expected; standardised incidence ratio 3.15, 2.99 to 3.32

BMJ2009 Full Text: Link to full Text with Trip Pro

73. Diagnosis of acute appendicitis during pregnancy: a systematic review

Diagnosis of acute appendicitis during pregnancy: a systematic review Diagnosis of acute appendicitis during pregnancy: a systematic review Diagnosis of acute appendicitis during pregnancy: a systematic review Basaran A, Basaran M CRD summary This review evaluated the performance of computed tomography (CT) and magnetic resonance imaging (MRI) for the diagnosis of appendicitis in pregnancy. It concluded that MRI and CT appeared to be highly sensitive and specific and should be considered when (...) ultrasonography is normal or inconclusive and appendicitis is suspected. These conclusions are representative of the limited data available. Authors' objectives To evaluate the performance of computed tomography (CT) and magnetic resonance imaging (MRI) for the diagnosis of appendicitis during pregnancy. Searching MEDLINE (1950 to August 2008) and MEDION were searched for studies published in English. Search terms were reported. Bibliographies of included studies and review articles were screened

DARE.2009

74. Acute appendicitis in young children: cost-effectiveness of US versus CT in diagnosis - a Markov decision analytic model

Acute appendicitis in young children: cost-effectiveness of US versus CT in diagnosis - a Markov decision analytic model Acute appendicitis in young children: cost-effectiveness of US versus CT in diagnosis - a Markov decision analytic model Acute appendicitis in young children: cost-effectiveness of US versus CT in diagnosis - a Markov decision analytic model Wan MJ, Krahn M, Ungar WJ, Caku E, Sung L, Medina LS, Doria AS Record Status This is a critical abstract of an economic evaluation (...) that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary This study compared the cost-effectiveness of ultrasonography, computed tomography, and ultrasonography followed by computed tomography, for the diagnosis of paediatric acute appendicitis. The authors concluded that computed tomography, and ultrasonography

NHS Economic Evaluation Database.2009

75. The Paediatric Appendicitis Score (PAS) was useful in children with acute abdominal pain

The Paediatric Appendicitis Score (PAS) was useful in children with acute abdominal pain The Paediatric Appendicitis Score (PAS) was useful in children with acute abdominal pain | 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 The Paediatric Appendicitis Score (PAS) was useful in children with acute abdominal pain Article Text Clinical prediction guide The Paediatric Appendicitis Score (PAS) was useful in children with acute abdominal pain Statistics from Altmetric.com No Altmetric data available for this article. R D Goldman Dr R D Goldman

Evidence-Based Medicine (Requires free registration)2009

77. Prospective validation of the pediatric appendicitis score

Prospective validation of the pediatric appendicitis score 18534219 2008 07 21 2008 08 13 2016 08 03 1097-6833 153 2 2008 Aug The Journal of pediatrics J. Pediatr. Prospective validation of the pediatric appendicitis score. 278-82 10.1016/j.jpeds.2008.01.033 To prospectively validate the Pediatric Appendicitis Score (PAS), developed on a cohort of children with abdominal pain suggestive of appendicitis, in unselected children with abdominal pain who present to the emergency department. Over (...) to verify final outcome. Sensitivity, specificity, and the receiver operating characteristic curve of the PAS with respect to diagnosis of appendicitis were calculated. We collected data on 849 children. 123 (14.5%) had pathologic study-proven appendicitis. Mean (median, range) score for children with appendicitis and without appendicitis was 7.0 (7, 2-10) and 1.9 (1, 0-9), respectively. If a cutoff PAS of

EvidenceUpdates2008

78. Appendicitis in Three Courses

Appendicitis in Three Courses Appendicitis in Three Courses « Sinai EM Journal Club Emergency Medicine Discussion Forum Appendicitis in Three Courses Fearless chief Ted has organized the first of our Tuesday Night Journal Clubs (with apologies to ). The goal of these meetings is to informally discuss several relevant and provocative papers on a certain topic of interest in EM. Particularly, we wanted to give attendees a foundation in the literature, and some ammunition when dealing with other (...) , vomiting, fever and anorexia had relatively unimpressive positive and negative LR’s. Having ‘no similar pain previously’ gave a negative LR of 0.32. The main course and desert follows below! Our main course featured two papers on dealing with contrast CT in diagnosing appendicitis: .” Mittal, Goliath et al. in Arch Surg 2004 (139) p495-500 (PMID ). The authors found the sensitivity, specificity, PPV and NPV were comparable in the triple-contrast vs. rectal-contrast groups. The rectal contrast group

Sinai EM Journal Club2008

79. Perforated and nonperforated appendicitis: defect in enhancing appendiceal wall--depiction with multi-detector row CT.

Perforated and nonperforated appendicitis: defect in enhancing appendiceal wall--depiction with multi-detector row CT. 18096535 2007 12 21 2008 01 25 2016 11 24 1527-1315 246 1 2008 Jan Radiology Radiology Perforated and nonperforated appendicitis: defect in enhancing appendiceal wall--depiction with multi-detector row CT. 142-7 To retrospectively evaluate the accuracy of multi-detector row helical computed tomography (CT) with intravenous contrast material and without oral contrast material (...) for depiction of perforated appendicitis. This study was approved by the institutional review board; informed consent was waived. CT images in 102 patients (60 male patients, 42 female patients; age range, 4-82 years; mean age, 37.3 years) with surgically and pathologically proved appendicitis who were examined between January 2000 and December 2002 were retrospectively reviewed. Original transverse sections at 3- or 2-mm collimation and 1.5- or 1.0-mm intervals were viewed by using cine mode observation

EvidenceUpdates2008

80. Cost-effectiveness of computed tomography and ultrasound in the diagnosis of appendicitis

Cost-effectiveness of computed tomography and ultrasound in the diagnosis of appendicitis Cost-effectiveness of computed tomography and ultrasound in the diagnosis of appendicitis Cost-effectiveness of computed tomography and ultrasound in the diagnosis of appendicitis Romero J, Sanabria A, Angarita M, Varon JC Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results (...) and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary The objective was to evaluate the cost-effectiveness of diagnostic imaging techniques for appendicitis. The authors concluded that computed tomography (CT) and ultrasound were more cost-effective than physician examination and that CT achieved the best cost-effectiveness in both health plan systems. The study appears to have been well conducted and the authors’ conclusions

NHS Economic Evaluation Database.2008