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Radiology 2019 Feb 12:190056. Epub 2019 Feb 12.

From the Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229; and Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, Ohio.

JAMA Pediatr 2019 Feb 18. Epub 2019 Feb 18.

Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California.

Importance: Efforts to combat medical overuse have gained traction in recent years, but success has been intermittent and shortcomings have been recognized. A commitment to a strong evidence base is needed to more broadly engage clinicians and reduce overuse.

Observations: A structured MEDLINE search and a manual review of tables of contents from selected high-impact journals was performed to identify original research published in 2017 relevant to pediatric overuse. Read More

Case Rep Surg 2019 15;2019:6508642. Epub 2019 Jan 15.

Department of Radiology, Midland Regional Hospital Mullingar, Longford Road, Mullingar, Co-Westmeath, Ireland.

A 46-year-old female presented to our emergency department (ED) with a 2-day history of right lower abdominal pain which was associated with nausea and anorexia. Abdominal examination revealed tenderness in the right iliac fossa (RIF) with rebound tenderness and a localized guarding. Urine dipstick was normal, and the pregnancy test was negative. Read More

Gastroenterol Hepatol Bed Bench 2018 ;11(Suppl 1):S92-S97

Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Aim: Introducing possible suitable compound as diagnostic agent in appendicitis is aim of this investigation.

Background: Appendicitis diagnosis is a difficult step in treatment of disease due to complex abdominal pain signal which may be refer to the non-appendicitis pain.

Methods: Gene expression profiles of children with non-preforated appendicitis in comparison with the samples with non- appendicitis abdominal pain are analysis via protein - protein interaction (PPI) and the critical compounds are introduced by STITCH. Read More

Int J Surg Pathol 2019 Feb 17:1066896919830213. Epub 2019 Feb 17.

1 Georgetown University Hospital, Washington, DC, USA.

IgG4-related disease is a recent entity that has been described in a wide variety of organ systems. A 46-year-old female presented with acute appendicitis accompanied by a mass-forming lesion, raising a concern for neoplasm, and therefore, hemicolectomy was performed. The lesion revealed a dense lymphoplasmacytic infiltrate accompanied by storiform fibrosis and obliterative phlebitis. Read More

Biol Trace Elem Res 2019 Feb 15. Epub 2019 Feb 15.

Emergency Department of Shenzhen University General Hospital, Shenzhen, China.

Copper (Cu) and zinc (Zn) are involved in inflammatory process. This study was to investigate the clinical significance of Cu and Zn homeostasis alterations in acute appendicitis (AA). One hundred twenty-two AA patients and 102 healthy controls were enrolled in this study. Read More

J Surg Res 2019 Feb 12;238:113-118. Epub 2019 Feb 12.

Division of Acute Care Surgery, Department of Surgery, University of Arizona, Tucson, Arizona.

Background: Numerous factors contribute to advanced disease or increased complications in patients with acute appendicitis (AA). This study aimed to identify risk factors associated with AA perforation, including the effect of system time (ST) delay, after controlling for patient time (PT) delay. In this study, PT was controlled (to less than or equal to 24 h) to better understand the effect of ST delay on AA perforation. Read More

Wideochir Inne Tech Maloinwazyjne 2019 Jan 24;14(1):70-78. Epub 2018 Jul 24.

2 Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland.

Introduction: According to meta-analyses laparoscopic appendectomy is associated with many benefits. However, in comparison to open surgery an increased rate of intraabdominal abscesses (IAA) has been reported. Identification of predictive factors for this complication may help to identify patients with higher risk of IAA. Read More

Int J Colorectal Dis 2019 Feb 14. Epub 2019 Feb 14.

Department of Accident and Emergency, St Helens and Knowsley Hospitals NHS Trust, Prescot, UK.

ANZ J Surg 2019 Feb 12. Epub 2019 Feb 12.

Department of Colorectal Surgery, Division of Surgery, Princess Alexandra Hospital, Brisbane, Queensland, Australia.

Background: Acute appendicitis is the most common non-obstetric surgical presentation during pregnancy. There were concerns that laparoscopic appendicectomy increases the risk of foetal loss compared to an open approach. Therefore, with recent advances in perioperative care, it is likely the risk has changed. Read More

Am Surg 2018 Oct;84(10):1684-1690

Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.

Nonoperative management of acute appendicitis is becoming widespread, but recurrence and the potential for a complicated course are important concerns. An admission report-based institutional database was created to monitor appendicitis treatment outcomes. Complications and complexity of surgery were recorded based on manual chart review. Read More

Am Surg 2018 Nov;84(11):e490-e491

Radiology 2019 Feb 12:181959. Epub 2019 Feb 12.

From the Departments of Medical Imaging (R.M., S.M.D., F.M., D.G., S.V., B.K., D.R.M., U.K.U.), Pediatrics (G.G.), and Pediatric Emergency Medicine (A.L.), University of Arizona College of Medicine, 1501 N Campbell Ave, Tucson, AZ 85724.

Background Advances in abdominal MRI have enabled rapid, free-breathing imaging without the need for intravenous or oral contrast material. The use of MRI as the primary imaging modality for suspected appendicitis has not been previously studied. Purpose To determine the diagnostic performance of MRI as the initial imaging modality in children suspected of having acute appendicitis. Read More

Acta Chir Belg 2019 Feb 12:1-8. Epub 2019 Feb 12.

a 2nd Department of General Surgery , Jagiellonian University Medical College , Kraków , Poland.

Background: In general, the three main options for stump closure in laparoscopic appendectomy are clips, endoscopic staplers and endoloops. However, there is no gold standard, especially regarding complicated acute appendicitis which is generally associated with worse outcomes.

Objectives: We aimed to assess the outcomes of different stump closure techniques during laparoscopic appendectomies for complicated appendicitis Methods: Our multicenter observational study of 18 surgical units assessed the outcomes of 1269 laparoscopic appendectomies for complicated appendicitis that used the three main stump closure techniques: clips, staplers and endoloops. Read More

Ulus Travma Acil Cerrahi Derg 2019 Jan;25(1):12-19

Department of General Surgery, Medical Park Fatih Hospital, İstanbul-Turkey.

Background: Clinical scoring systems have been used to reduce negative appendectomy rate for several decades. However, the use of these systems has been questioned due to differences in their diagnostic accuracies. The aim of this prospective study was to develop a new clinical scoring system using a combination of all previously described variables for the diagnosis of acute appendicitis (AA). Read More

Trauma Surg Acute Care Open 2019 24;4(1):e000243. Epub 2019 Jan 24.

Division of General Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.

A 57-year-old woman with morbid obesity (body mass index [BMI] of 43), systemic lupus on steroids, type 2 insulin-dependent diabetes, peripheral vascular disease, unprovoked pulmonary embolism on rivaroxaban, and hypertension presented with 3 days of worsening abdominal pain and nausea. She had an extensive surgical history including a cesarean section, multiple laparotomies for small bowel obstructions (one complicated by bowel perforation requiring resection), and a double-barrelled ileostomy, which had been since reversed. As a result, she had a massive incisional hernia (figure 1). Read More

J Pak Med Assoc 2019 Feb;69(Suppl 1)(1):S12-S16

Nevill Hall Hospital, Brecon Road, Abergavenny NP7 7EG.

Objective: To compare the accuracy of Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) and modified Alvarado scores with that of non-contrast computed tomography scan and ultrasound of abdomen and pelvis.

Methods: The observational correlational study was conducted at Manipal Hospital, Bengaluru, India, from April 1, 2014, to April 30, 2016, and comprised patients aged 18-60 years presenting with right lower quadrant pain to the emergency department. Modified Alvarado, RIPASA scores and ultrasound of abdomen and pelvis with optional non-contrast computed tomography scan reports were collected. Read More

Niger J Clin Pract 2019 Feb;22(2):270-275

Department of Pathology, Erzincan University, Faculty of Medicine, Erzincan, Turkey.

Background: Parasitic infestation of the appendix is uncommon. Parasitic infections can cause inflammation in the appendix and can imitate acute appendicitis clinically. Enterobius vermicularis and Taenia species are among the most common parasitic agents causing acute appendicitis. Read More

Ann Afr Med 2019 Jan-Mar;18(1):36-41

Department of Surgery, Faculty of Clinical Sciences, College of Medicine, General Surgery Unit, University of Lagos, Idi-Araba, Lagos, Nigeria.

Background: Acute perforation of the appendix is one of the complications of appendicitis that is associated with increased morbidity and mortality and hence regarded as a surgical emergency. Risk factors for perforated appencidicits include extremes of age, male sex, pregnancy, immunosuppression, comorbid medical conditions and previous abdominal surgery.

Objectives: This study focuses on the pattern of presentation, risk factors, morbidity and mortality of patients managed for perforated appendicitis in our centre. Read More

J Paediatr Child Health 2019 Feb 5. Epub 2019 Feb 5.

Department of Emergency Medicine, Ufuk University Faculty of Medicine, Ankara, Turkey.

Aim: The differential diagnosis of paediatric patients admitted to the emergency department presenting with acute abdominal pain may be difficult. This study aims to investigate the diagnostic value of ischaemia-modified albumin (IMA) in the differential diagnosis of acute abdominal pain in children and in distinguishing surgical from non-surgical cases.

Methods: The study was conducted with a total of 152 subjects who provided informed consent, including 112 patients admitted to the paediatric emergency department and paediatric surgical clinic and 40 healthy control subjects. Read More

Ann Surg 2019 Jan 31. Epub 2019 Jan 31.

Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

MINI: The present meta-analysis demonstrates that, although limited by a lower efficacy compared to surgery, NOM with antibiotics could be considered a safe option for adults and pediatric patients with uncomplicated appendicitis, as it is successful in almost 75% of cases, and does not statistically increase the perforation rate.

Objective: The aim of this meta-analysis was to summarize the current available evidence on nonoperative management (NOM) with antibiotics for uncomplicated appendicitis, both in adults and children.

Summary Background Data: Although earlier meta-analyses demonstrated that NOM with antibiotics may be an acceptable treatment strategy for patients with uncomplicated appendicitis, evidence is limited by conflicting results. Read More

J Laparoendosc Adv Surg Tech A 2019 Feb 5. Epub 2019 Feb 5.

2 Division of Pediatric Surgery, Children's National Health System, Washington, District of Columbia.

Enterobius vermicularis associated appendiceal colic and acute appendicitis are rarely encountered in the United States. The 9-year-old patient described in this case presented with right lower quadrant abdominal pain, nausea, and vomiting consistent with acute appendicitis and was brought to the operating room for an appendectomy. Intraoperatively a pinworm, E. Read More

Emerg Radiol 2019 Feb 4. Epub 2019 Feb 4.

Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH, 44106, USA.

Oncologic emergencies have a high rate of morbidity and mortality. This review covers several scenarios of gastrointestinal malignancies presenting emergently as various acute abdominal pathologies. Radiologists should be familiar with the typical imaging findings, clinical presentations, and laboratory values which may suggest a background neoplasm, particularly when encountered in the context of an acute inflammatory state. Read More

Am J Emerg Med 2019 Jan 26. Epub 2019 Jan 26.

Department of Emergency Medicine/Alameda County Medical Center, Highland General Hospital, Oakland, CA 94602-1018, USA.

The ultrasound-guided transversus abdominis plane (TAP) block or TAP block is a well-established regional anesthetic block used by anesthesiologists for peri-operative pain control of the anterior abdominal wall. Multiple studies have demonstrated its utility to control pain for a range of procedures from inguinal hernia repair, laparoscopic cholecystectomies to cesarean sections [1-3]. There are no cases describing the efficacy of the ultrasound-guided TAP block in the emergency department as a part of a multimodal pain pathway for patients diagnosed with acute appendicitis. Read More

Surg Obes Relat Dis 2019 Jan 11. Epub 2019 Jan 11.

Department of Surgery, Queen's University, Kingston, Ontario, Canada. Electronic address:

Background: An incidental finding of intestinal nonrotation at the time of bariatric surgery poses the following 2 dilemmas: (1) which operation to perform, and (2) whether an appendectomy should be performed concurrently.

Objectives: To review the experience of 2 Bariatric Centers of Excellence with laparoscopic sleeve gastrectomy (LSG) in patients with intestinal nonrotation, and to perform a systematic review of the literature on this topic.

Setting: Two Bariatric Centers of Excellence as designated by the Ontario Bariatric Network. Read More

BMC Surg 2019 Feb 4;19(1):17. Epub 2019 Feb 4.

Department of Hepatobiliary Surgery, the Second Affiliated Hospital, Nanchang University, No. 1, mingde road, Nanchang, Jiang xi, China.

Background: Hepatic portal vein gas (HPVG) is a rare acute abdomen, which is not an independent disease. Meanwhile, HPVG combined with appendicitis has been rarely reported. We found only a similar report by looking for literature, but no intestinal necrosis occurred. Read More

Int J Surg Case Rep 2019 Jan 29;55:103-106. Epub 2019 Jan 29.

Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan.

Introduction: Perforating appendicitis and abscess-forming appendicitis may cause septic disseminated intravascular coagulation (DIC). However, non-perforating acute appendicitis with septic DIC is extremely rare.

Presentation Of Case: A 67-year-old man was referred to our hospital one day after starting oral antibiotic treatment for acute appendicitis. Read More

Eur J Trauma Emerg Surg 2019 Feb 2. Epub 2019 Feb 2.

Department of General Surgery, Kishiwada Tokushukai Hospital, 4-27-1 Kamoricho, Kishiwada, Osaka, 596-0042, Japan.

Background: Appendectomy is one of the most common operations. Laparoscopic appendectomy (LA) is considered first-line treatment, but the use of LA for treatment of complicated appendicitis remains controversial. Here, we performed a retrospective analysis to compare clinical outcomes between patients treated with LA and those who underwent open appendectomy (OA). Read More

Surg Case Rep 2019 Feb 1;5(1):15. Epub 2019 Feb 1.

Department of Surgery, Redcliffe Hospital, Anzac Avenue, Redcliffe, QLD, 4020, Australia.

Background: Meckel's diverticulum (MD) is the most common congenital abnormality of the gastrointestinal (GI) tract. Most of the people remain asymptomatic during their lifetime, but some can develop complications such as inflammation, haemorrhage or obstruction. Perforation of Meckel's diverticulum is very rare, and we present a case of perforation by a chicken bone. Read More

Indian J Pathol Microbiol 2019 Jan-Mar;62(1):169-170

Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalaya, New Delhi, India.

World J Clin Cases 2019 Jan;7(2):209-214

Department of Pathology, E-Da Cancer Hospital, I-Shou University, Kaohsiung City 82445, Taiwan.

Background: Colonic lipomas are rare, slow-growing benign tumors. Colonic lipomas are generally asymptomatic and are found incidentally. Although cases of cecal lipoma have been sporadically reported in the literature, the disease has not been systematically reviewed. Read More

World J Gastrointest Surg 2019 Jan;11(1):19-26

Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya 44280, Turkey.

Background: Incidental appendectomy can be defined as the removal of a clinically normal appendix during another surgical procedure unrelated to appendicitis or other appendicular diseases.

Aim: To compare the demographic, biochemical, and histopathological features of the patients who underwent incidental and standard appendectomy.

Methods: The demographic, biochemical, and histopathological data of 72 patients (Incidental App group) who underwent incidental appendectomy during living donor hepatectomy at our Liver Transplant Center between June 2009 and December 2016 were compared with data of 288 patients (Acute App group) who underwent appendectomy for presumed acute appendicitis. Read More

Zhonghua Wei Chang Wai Ke Za Zhi 2019 Jan;22(1):49-58

Department of General Surgery, Medical School of Nanjing University, Jinling Hospital, Jiangsu Nanjing 210002,

Objective: To analyze the current status of diagnosis and management of acute appendicitis (AA) in China.

Methods: Questionnaire survey was used to retrospectively collect data of hospitalized patients with AA from 43 medical centers nationwide in 2017 (Sort by number of cases provided: Jinling Hospital of Medical School of Nanjing University, The First Affiliated Hospital of Xinjiang Medical University, Lu'an People's Hospital, Tengzhou Central People's Hospital, Dalian Central Hospital, The Affiliated Hospital of Xuzhou Medical University, Dongying People's Hospital, Jinjiang Hospital of Traditional Chinese Medicine, Huangshan Shoukang Hospital, Xuyi People's Hospital, Nanjing Jiangbei People's Hospital, Lanzhou 940th Hospital of PLA, Heze Municipal Hospital, The First College of Clinical Medical Science of China Three Gorges University, Affiliated Jiujiang Hospital of Nanchang University, The Second People's Hospital of Hefei, Affiliated Central Hospital of Shandong Zaozhuang Mining Group, The Third People's Hospital of Kunshan City, Xuzhou First People's Hospital, The 81st Group Army Hospital of PLA, Linyi Central Hospital, The General Hospital of Huainan Eastern Hospital Group, The 908th Hospital of PLA, Liyang People's Hospital, The 901th Hospital of Joint Logistic Support Force, The Third Affiliated Hospital of Chongqing Medical University, The Fourth Hospital of Jilin University, Harbin Acheng District People's Hospital, The First Affiliated Hospital of Zhengzhou University, Nanjing Luhe People's Hospital, Taixing Municipal People's Hospital, Baotou Central Hospital, The Affiliated Hospital of Nantong University, Linyi People's Hospital, The 72st Group Army Hospital of PLA, Zaozhuang Municipal Hospital, People's Hospital of Dayu County, Taixing City Hospital of Traditional Chinese Medicine, Suzhou Municipal Hospital, Beijing Guang'anmen Hospital, Langxi County Hospital of Traditional Chinese Medicine, Nanyang Central Hospital, The Affiliated People's Hospital of Inner Mongolia Medical University).The diagnosis and management of AA were analyzed through unified summary. Read More

Zhonghua Wei Chang Wai Ke Za Zhi 2019 Jan;22(1):17-21

Department of General Surgery, Jinling Hospital, Nanjing Medical School of Nanjing University, Nanjing 210002, China.

The published clinical research in 2018 in surgical infection are changing current opinions in the management of acute appendicitis, antibiotics usage, resuscitation of septic shock, and choice of nutritional therapy in critically ill patients. In the management of uncomplicated acute appendicitis, antibiotic therapy can be successful in selected patients who wish to avoid surgery. Delayed primary wound closure can not reduce superficial surgical site infection rates compared to primary wound closure for complicated appendicitis. Read More

Medicine (Baltimore) 2019 Feb;98(5):e14104

Department of Surgery, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, South Korea.

Rationale: The horseshoe anomaly of the vermiform appendix is extremely rare. Preoperative confirmation of this anomaly is difficult; therefore, routine procedures, such as appendectomy, may become unexpectedly challenging when such anomalies are encountered during the surgical process.

Patient Concerns: A 33-year-old man presented with abdominal pain in the right lower abdomen owing to acute appendicitis confirmed via computed tomography. Read More

J Coll Physicians Surg Pak 2019 Feb;29(2):175-177

Department of General Surgery, Faculty of Medicine, University of Beykent, Istanbul, Turkey.

Solitary cecal diverticulum was first described by Potier in 1912. Although it is a rare condition, however, there is an increased prevalence in Asian populations. The cecal diverticula are usually asymptomatic, however, 10-20% of the cases become symptomatic due to complications. Read More

J Pak Med Assoc 2019 Feb;69(Suppl 1)(1):S12-S16

Nevill Hall Hospital, Brecon Road, Abergavenny NP7 7EG.

Objective: To compare the accuracy of Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) and modified Alvarado scores with that of non-contrast computed tomography scan and ultrasound of abdomen and pelvis.

Methods: The observational correlational study was conducted at Manipal Hospital, Bengaluru, India, from April 1, 2014, to April 30, 2016, and comprised patients aged 18-60 years presenting with right lower quadrant pain to the emergency department. Modified Alvarado, RIPASA scores and ultrasound of abdomen and pelvis with optional non-contrast computed tomography scan reports were collected. Read More

Gan To Kagaku Ryoho 2018 Dec;45(13):2105-2107

Dept. of Surgery, Tohoku Rosai Hospital.

We report a resected case of cancer at the ileum of the blind loop. An 81-year-old male underwent an appendectomy for acute appendicitis and an ileotransverse colostomy for postoperative obstruction when he was 14 years old. He underwent radiation therapy for prostate cancer when he was 75 years old. Read More

J Surg Res 2019 Mar 1;235:237-243. Epub 2018 Nov 1.

Department of Surgery, Johns Hopkins University, Baltimore, Maryland. Electronic address:

Background: Acute appendicitis is currently one of the most common surgical emergencies. Intra-abdominal abscesses (IAA) are a fearsome complication, which may occur. Irrigation during the appendectomy is one of the factors suggested to affect the rates of IAA. Read More

Korean J Gastroenterol 2019 Jan;73(1):45-49

Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea.

A 49-year-old man visited the emergency room of Korea University Ansan Hospital with hematochezia starting the day before the visit. Recently, he was on anti-platelet medication due to hypertension. The patient had no definite symptoms other than hematochezia. Read More

Radiologe 2019 Feb;59(2):114-125

Klinik und Poliklinik für Radiologie, Klinikum der Ludwig-Maximilians-Universität München, Campus Grosshadern, Marchioninistr. 15, 81377, München, Deutschland.

Clinical/methodical Issue: Diagnostic imaging plays a crucial role in the assessment and stratification of pathologic conditions causing acute abdomen. This report provides information on etiology, clinical manifestations and therapeutic options for six common diseases resulting in acute abdomen-appendicitis, cholecystitis, bowel obstruction, diverticulitis, acute pancreatitis, and viscus perforation.

Performance: Besides initial ultrasound, CT scans often represent the imaging gold standard for the diagnostic evaluation of acute abdomen. Read More

Trauma Surg Acute Care Open 2018 30;3(1):e000222. Epub 2018 Dec 30.

Department of Surgery, Acute Care Surgery, College of Medicine, University of Kentucky, Lexington, Kentucky, USA.

Background: Laparoscopic appendectomy can be performed on a fast-track, short-stay, or outpatient basis with high success rates, low morbidity, low readmission rates, and shorter length of hospital stay. Cost savings from outpatient appendectomy have not been well described. We hypothesize that outpatient laparoscopic appendectomy is associated with cost savings. Read More

Case Rep Gastroenterol 2018 Sep-Dec;12(3):765-772. Epub 2018 Dec 20.

Department of Pathology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan.

Pulse granuloma is a rare pathologic condition considered to be a benign inflammatory reaction to foreign materials originated from ingested legume matter. As for pulse granulomas of the gastrointestinal tract, association with diverticular diseases is relatively common, but only a few pulse granuloma cases associated with appendicitis have been reported. This report presents histopathologic findings of pulse granuloma lesions observed in two appendectomy cases, with some histochemical examinations of cellulose matter which is reportedly a major component to provoke pulse granuloma reaction. Read More

J Pediatr Surg 2018 Dec 28. Epub 2018 Dec 28.

Department of Surgery, Zucker School of Medicine at Hofstra Northwell, Cohen Children's Medical Center, 269-1 76th Ave, Queens, NY 11040, United States.

Introduction: Negative appendectomy rate (NAR) is a quality metric used in the surgical management of appendicitis. The rates of negative appendectomy (NA) in children range anywhere from 1% to 40% in the literature. Many reports do not provide clear pathological definitions for either appendicitis or NA on which they base their calculation of NAR. Read More

Surg Infect (Larchmt) 2019 Jan 24. Epub 2019 Jan 24.

1 Department of Surgery, MetroHealth Medical Center, Cleveland, Ohio.

Background: After publication of the Study to Optimize Peritoneal Infection Therapy (STOP IT) trial, we sought to determine if we were implementing study findings into practice appropriately. We had three objectives: evaluate antibiotic usage; evaluate patient outcomes; and delineate differences in antibiotic usage between general surgeons (GS) and trauma/acute care surgery trained surgeons (TACS).

Patients And Methods: This was an analysis of patients with complicated intra-abdominal infection admitted via the emergency department from February 2014 through May 2017. Read More

Visc Med 2018 Dec 24;34(6):453-458. Epub 2018 Nov 24.

Medizinische Klinik II, Diakonissenkrankenhaus Mannheim, Mannheim, Germany.

Background: Ever since the first appendectomy has been performed, surgery has been the standard of care for acute appendicitis, with antibiotic therapy being reserved for special situations. Recent studies have shown the feasibility of antibiotic therapy for uncomplicated appendicitis.

Methods: This clinical therapeutic review is based both on author expertise and a selective literature survey in PubMed based on the term 'appendicitis', combined with the terms 'acute', 'complicated', 'conservative', 'non-operative', 'therapy', 'surgery', and 'strategy'. Read More

Int J Colorectal Dis 2019 Jan 22. Epub 2019 Jan 22.

Helios Klinikum Schleswig, Schleswig, Germany.

Introduction: The aim of this study was to evaluate the effectiveness of initially conservative therapy compared to immediate appendectomy for acute appendicitis with abscess in terms of medical and economic outcomes.

Methods: Of all the patients treated for appendicitis from January 2009 to December 2017 in five German hospitals, 240 were included in the study. Fifty-three patients received conservative (CON) and 195 patients received surgical (SUR) therapy as initial treatment. Read More

Int J Colorectal Dis 2019 Jan 21. Epub 2019 Jan 21.

Department of Minimally Invasive Digestive Surgery, Antoine-Beclere Hospital, AP-HP, 92140, Clamart, France.

Purpose: We report an unusual case of endometriosis of the appendix with simultaneous invasion of the sigmoid colon.

Methods: Clinical, radiological, surgical, and histological data of the patient were reviewed, as well as the current literature on gastrointestinal endometriosis.

Results: A 41-year-old woman presented to the emergency department of our hospital with acute right lower quadrant pain, pronounced tenderness elevated white blood cell count, and increased C-reactive protein. Read More

Emerg Med Australas 2019 Jan 21. Epub 2019 Jan 21.

Emergency Department, Princess Margaret Hospital for Children, Perth, Western Australia, Australia.

Objective: Abdominal pain is a common paediatric presentation to the ED. Accurate diagnosis of acute appendicitis is challenging, with the best-performing clinical scoring systems having sensitivities between 72% and 100%. The aim of this study is to assess the diagnostic accuracy of clinician gestalt according to seniority in diagnosing paediatric acute appendicitis in ED. Read More

Turk J Surg 2018 Dec 1;34(4):340-341. Epub 2018 Dec 1.

Clinic of Gastroenterology, Minasera Aldan Hospital, Ankara, Turkey.

Colonoscopy is commonly performed for diagnostic and therapeutic purposes and has a relatively low morbidity rate. Nevertheless, it is necessary for operators to be aware of the rare complications of colonoscopy due to a large number of procedures performed in daily practice. Acute appendicitis is an unusually rare occurrence after colonoscopy, with no clear association being found between the colonoscopy and acute appendicitis. Read More