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Ugeskr Laeger 2018 Nov;180(48)

Appendicitis is a common condition, which is often seen by the general practitioners as well as in the emergency departments. It is normally treated with laparoscopic appendectomy. This review gives an overview of the long-term surgical complications ileus and incisional hernia and of the impact of appendicitis and appendectomy on female fertility. Read More

Pediatr Surg Int 2018 Dec 3. Epub 2018 Dec 3.

Department of Surgery, Children's Mercy Hospital, 2401 Gillham Road, 64108, Kansas City, MO, USA.

Background: Post-operative intra-abdominal abscess (PIAA) is the most common complication after appendectomy for perforated appendicitis (PA). Typically, intravenous antibiotics by a peripherally inserted venous catheter are utilized to treat the abscess. We sought to evaluate the role of oral antibiotics in this population. Read More

Ann Med Surg (Lond) 2018 Dec 9;36:168-172. Epub 2018 Nov 9.

UCL Medical School, UCL, Research Department of Medical Education, Room GF/664, Royal Free Campus, Hampstead, London, NW3 2PR, UK.

Background: Appendicitis is a medical condition that causes painful inflammation of the appendix. For acute appendicitis, appendectomy is immediately required as any delay may lead to serious complications such as gangrenous or perforated appendicitis with or without localized abscess formation. Patients who had appendectomy for complicated appendicitis are more prone to develop post-operative complications such as peritoneal abscess or wound infection. Read More

J Pak Med Assoc 2018 Dec;68(12):1854-1858

Jinnah Sindh Medical University, Karachi.

Pheochromocytoma, a rare tumour, arises mainly in the adrenal gland. It consists of chromaffin cells or sympathetic para-ganglia if extra-adrenal. It is an occurrence of rare nature with an incidence of two to eight cases per million annually. Read More

Gynecol Obstet Fertil Senol 2018 Nov 28. Epub 2018 Nov 28.

Clinique Tivoli-Ducos, 33000 Bordeaux, France. Electronic address:

J Surg Res 2019 Jan 26;233:8-19. Epub 2018 Jul 26.

Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.

Background: Transferred emergency general surgery (EGS) patients have increased morbidity, mortality, and costs, yet little is known about the characteristics of such transfers. Increasing specialization and a decreasing general surgery workforce have led to concerns about access to care, which may lead to increased transfers. We sought to evaluate the reasons for and timing of transfers for EGS diagnoses. Read More

J Surg Res 2019 Jan 17;233:100-103. Epub 2018 Aug 17.

Department of Surgery, The Children's Mercy Hospital, Kansas City, Missouri. Electronic address:

Background: In some institutions, urinary catheters (UCs) have been placed in all patients receiving opioid patient-controlled analgesia (PCA) because of the increased incidence of urinary retention. Our institutional data demonstrated no UC replacements in 48 children who had PCA for perforated appendicitis who had their catheters removed before discontinuation of the PCA. As part of a quality improvement initiative, we discontinued the practice of requiring UC with PCA for perforated appendicitis. Read More

J Pediatr Surg 2018 Nov 7. Epub 2018 Nov 7.

Division of General, Thoracic and Fetal Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA. Electronic address:

Aim Of The Study: Pediatric surgery trainees at our program are allowed to perform unsupervised laparoscopic appendectomies during their last year of training to promote independent operative decision-making skills. We reviewed the outcomes of laparoscopic appendectomies done by senior trainees without supervision and compared them to experienced pediatric surgeons.

Methods: We reviewed 500 laparoscopic appendectomies performed without supervision by the last 10 pediatric surgery trainees during their last year of training (first 50 cases of each trainee). Read More

PLoS One 2018 5;13(12):e0208151. Epub 2018 Dec 5.

Department of Molecular Biology, Division of Biological Sciences, University of California at San Diego, La Jolla, CA, United States of America.

The communities of beneficial bacteria that live in our intestines, the gut microbiome, are important for the development and function of the immune system. Bacteroides species make up a significant fraction of the human gut microbiome, and can be probiotic and pathogenic, depending upon various genetic and environmental factors. These can cause disease conditions such as intra-abdominal sepsis, appendicitis, bacteremia, endocarditis, pericarditis, skin infections, brain abscesses and meningitis. Read More

J Trauma Acute Care Surg 2018 Dec 3. Epub 2018 Dec 3.

Professor of Medicine and Emergency Medicine, Department of Emergency Medicine (and Department of Medicine, Division of Infectious Diseases), Olive View-UCLA Medical Center, 14445 Olive View Drive, North Annex, Sylmar, CA 91342.

Background: Meta-analyses and a recent guideline acknowledge that conservative management of uncomplicated appendicitis with antibiotics can be successful for patients who wish to avoid surgery. However, guidance as to specific management does not exist.

Methods: PUBMED and EMBASE search of trials describing methods of conservative treatment was conducted according to PRISMA guidelines. Read More

Ulus Travma Acil Cerrahi Derg 2018 Nov;24(6):557-562

Department of General Surgery, Okmeydanı Training and Research Hospital, İstanbul-Turkey.

Background: The Alvarado score (AS) and the Appendicitis Inflammatory Response score (AIRS) were developed to diagnose acute appendicitis (AA). The aim of this study was to evaluate the severity of AA using the AS and the AIRS tools.

Methods: Patients who presented between January 2016 and December 2017 and underwent surgery for AA and who had a preoperative AS and AIRS value were evaluated retrospectively. Read More

Ulus Travma Acil Cerrahi Derg 2018 Nov;24(6):552-556

Department of General Surgery, İstanbul University İstanbul Faculty of Medicine, İstanbul-Turkey.

Background: The aim of this study was to compare the obstetric and surgical outcomes of laparoscopic appendectomy (LA) and open appendectomy (OA) performed for pregnant women at a single center. It was the hypothesis of this study that there would be no significant difference in the results.

Methods: The medical records of 57 consecutive pregnant women who underwent an appendectomy between January 2009 and September 2018 were reviewed retrospectively. Read More

Ulus Travma Acil Cerrahi Derg 2018 Nov;24(6):545-551

Department of General Surgery, Sakarya University Training and Research Hospital, Sakarya, Turkey.

Background: The Karaman score is a novel diagnostic scoring system consisting of 6 parameters. The aim of the present study was to assess the diagnostic performance of the Karaman score in comparison with the Alvarado score.

Methods: A total of 200 patients who underwent an appendectomy were enrolled in the study (research registry number: 2290). Read More

Ulus Travma Acil Cerrahi Derg 2018 Nov;24(6):539-544

Department of Emergency, University of Health Sciences, Haseki Training and Research Hospital, İstanbul-Turkey.

Background: The aim of this study was to investigate the prognostic value of irisin by examining the serum level of this smooth muscle protein in patients presenting at the emergency department (ED) with acute abdominal pain.

Methods: This research was performed as a single-center, prospective, cross-sectional study. In all, 213 adult patients presenting at the ED with acute abdominal pain and 140 healthy controls were enrolled. Read More

ANZ J Surg 2018 Dec;88(12):1222-1223

Department of Surgery, The University of Queensland, Princess Alexandra Hospital, Brisbane, Queensland, Australia.

Surg Endosc 2018 Dec 4. Epub 2018 Dec 4.

Department of General Surgery, Shaare Zedek Medical Center, Jerusalem, Israel.

Background: Accurate and timely diagnoses of acute appendicitis (AA) during pregnancy avoids maternal and fetal morbidity and mortality. We present our experience of using an initial transabdominal ultrasound (US) performed at presentation to diagnose AA in pregnant patients as well as the value of a delayed repeat study in those who remain equivocal. We explore the sensitivity and specificity of this algorithm as well as the maternal and fetal safety of this approach. Read More

Mater Sociomed 2018 Oct;30(3):215-220

King Abdulaziz University, Medical School, Jeddah, Saudi Arabia.

Introduction: Acute Appendicitis is the most common emergent abdominal surgery worldwide. diagnosis based on clinical assessment, laboratory and radiological investigations and appendectomy is the treatment of choice. Removing a normal appendix is a relatively common surgical issue, defined as negative appendectomy (NA). Read More

Int J Surg Case Rep 2018 Nov 16;54:34-38. Epub 2018 Nov 16.

Department of Surgery, Palmetto Healthcare System, University of South Carolina Medical School, 2 Medical Park Road, Columbia, SC 29203, United States. Electronic address:

Introduction: A colonic metastasis from infiltrating breast ductal carcinoma is a rare phenomenon in the literature, especially in a male.

Presentation Of Case: We present a rare case of a 55-year-old male with a past medical history of breast cancer who presented with signs and symptoms of appendicitis. A computed tomography (CT) scan revealed acute appendicitis in addition to a 2. Read More

Ann Ital Chir 2018 Nov 29;7. Epub 2018 Nov 29.

Purpose: In this study, we compared the endocrine and cytokine reaction of the patients which laparoscopic and conventional appendectomy was done for acute appendicitis.

Materials And Method: 50 patients who were operated for acute appendicitis in Ankara Atatürk Research and Training Hospital between the dates December 2013 and February 2014 were enrolled and grouped as either laparoscopic or conventional. Serum ACTH, IL-6 and CRP levels were obtained at induction of anesthesia and postoperative 6th hour. Read More

Ann Med Surg (Lond) 2018 Dec 20;36:239-241. Epub 2018 Nov 20.

Caboolture Hospital, 120 McKean Street, 4510, Queensland, Australia.

Introduction: Acute appendicitis in older adults is relatively uncommon and could be the first presentation of an underlying colorectal carcinoma. Colonoscopy in these individuals affords the opportunity for earlier diagnosis and treatment. The finding of increased rates of colorectal cancer (CRC) with older patients who have had appendicitis was supported by a number of small studies and case reports in the early 1980s. Read More

Am J Surg 2018 Nov 27. Epub 2018 Nov 27.

Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland. Electronic address:

Background: The aim of this study was to assess outcomes of octogenarians undergoing emergency abdominal surgery (EAS).

Methods: Octogenarians undergoing EAS 12/2011-12/2016 were retrospectively analysed. The outcomes were assessed by univariable and multivariable regression analysis. Read More

Medicine (Baltimore) 2018 Nov;97(48):e13294

Department of Laboratory, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Rationale: The presence of purpura is a compulsory criteria for the diagnosis of Henoch-Schönlein purpura (HSP). Typical purpura of HSP is distributed symmetrically over the extensor surfaces of the lower limbs, buttocks, and forearms with the occasional involvement of trunk and face in children. It occurs only involving the bottom of the feet has never been reported. Read More

BMJ Paediatr Open 2018 9;2(1):e000341. Epub 2018 Nov 9.

Division of Pediatric Surgery, Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Introduction: Many children with acute abdominal pain and suspicion of appendicitis are diagnosed with constipation. Nevertheless, it can be difficult to differentiate between acute constipation and acute appendicitis because of similar symptoms and lack of diagnostic criteria. Consequently, constipation is often missed despite repeated consultations at the emergency department. Read More

ANZ J Surg 2018 Nov 29. Epub 2018 Nov 29.

Department of General Surgery, Singapore General Hospital, Singapore.

J Cancer Res Ther 2018 Oct-Dec;14(6):1355-1360

Department of Radiology, Health Science University, Umraniye Education and Research Hospital, Istanbul, Turkey.

Aims: Appendiceal mucocele (AM) is a rare pathology, and its reported incidence is 0.3% in all appendectomy specimens. Here, we report a case series of AM and make a brief review of literature. Read More

Cochrane Database Syst Rev 2018 11 28;11:CD001546. Epub 2018 Nov 28.

Institute for Research in Operative Medicine (IFOM) - Department for Evidence-based Health Services Research, University Witten/Herdecke, Ostmerheimer Str. 200 (Building 38), Cologne, Germany, 51109.

Background: The removal of the acute appendix is one of the most frequently performed surgical procedures. Open surgery associated with therapeutic efficacy has been the treatment of choice for acute appendicitis. However, in consequence of the evolution of endoscopic surgery, the operation can also be performed with minimally invasive surgery. Read More

JAMA Surg 2018 Nov 28. Epub 2018 Nov 28.

Department of Surgery, VA Boston Healthcare System, West Roxbury, Massachusetts.

JAMA Surg 2018 Nov 28. Epub 2018 Nov 28.

Division of Digestive Surgery and Urology, Turku University Hospital, Turku, Finland.

Importance: The step after conservative treatment of periappendicular abscess arouses controversy, ranging from recommendations to abandon interval appendectomy based on low recurrence rates of the precipitating diagnosis to performing routine interval appendectomy owing to novel findings of increased neoplasm risk at interval appendectomy. To our knowledge, there are no randomized clinical trials with sufficient patient numbers comparing these treatments.

Objective: To compare interval appendectomy and follow-up with magnetic resonance imaging after initial successful nonoperative treatment of periappendicular abscess. Read More

J Gastrointest Cancer 2018 Nov 28. Epub 2018 Nov 28.

Pathology Department, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt.

Objectives: Mucinous appendiceal tumors (MATs) constitute 0.2-0.3% of appendectomies. Read More

Iran J Microbiol 2018 Aug;10(4):208-214

Nizam's Institute of Medical Sciences Panjagutta, Hyderabad, Telangana, India.

Background And Objectives: Intra-abdominal infections (IAIs) include a wide spectrum of pathological conditions, ranging from uncomplicated appendicitis to fecal peritonitis .The resulting infections should be diagnosed early and treated based on the organism isolated and its susceptibility. In this study the bacteriological profile and antimicrobial resistance pattern of intra-abdominal infections was analyzed. Read More

J Pediatr Surg 2018 Nov 7. Epub 2018 Nov 7.

Department of Surgery, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4L8, Canada; Division of General Surgery, St. Joseph's Healthcare, 50 Charlton Avenue East, Hamilton, Ontario, L8N 4A6, Canada. Electronic address:

Background/purpose: Appendiceal perforation significantly impacts the outcomes of pediatric appendicitis. While socioeconomic status affects perforation risk in the United States, these effects should dissipate in a universal healthcare system. The specific spatial patterns associated with perforation have also never been delineated. Read More

Int J Surg Case Rep 2018 Nov 13;53:377-380. Epub 2018 Nov 13.

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

Introduction: Neurofibromas are a characteristic of the autosomal dominant disorder Neurofibromatosis type 1 (NF1), also known as von Recklinghausen's disease. Appendiceal neurofibromas are extremely rare, and low-grade appendiceal mucinous neoplasms (LAMNs) have not previously been reported in NF1.

Presentation Of Case: A 62-year-old man with NF1 was scheduled for elective surgical treatment of an asymptomatic, enlarged and diffusely thickened appendix that remained after curative antimicrobial treatment of acute appendicitis. Read More

J West Afr Coll Surg 2017 Oct-Dec;7(4):120-127

Assistant Professor Histopathology, Shifa International Hospital, Islamabad, Pakistan.

Mucocele of the appendix is an uncommon disease in which there is cystic dilatation of the appendix caused by mucus secretion and usually associated with benign or malignant causes. Preoperative diagnosis is difficult as the patient presents with non-specific clinical symptoms. We report a case of mucocele of the appendix with elevated serum carcinoembryonic antigen (CEA) - a condition sparsely reported in literature. Read More

Turk J Surg 2018 Nov 20:1-3. Epub 2018 Nov 20.

Department of Surgery, Hamadan University of Medical Sciences, Hamadan, Iran.

Objective: Despite the recent use of computed tomography scan and diagnostic laparoscopy, acute appendicitis is still highly misdiagnosed. Timely diagnosis of acute appendicitis is more crucial in children and elderly patients because of vague symptoms and rapid progression to perforation in these age groups, which may result in high rates of morbidity and mortality. The aim of the present study was to find the diagnostic values of procalcitonin and interleukin 6 (IL-6) for diagnosing acute appendicitis in our center. Read More

Turk J Surg 2018 Nov 20:1-5. Epub 2018 Nov 20.

Department of General Surgery, Bursa Yüksek İhtisas Training and Research Hospital, İstanbul, Turkey.

Objective: Appendiceal tumors are rare and mostly present as acute appendicitis. Its estimated lifetime prevalence has been reported as 8%, and the annual incidence is approximately 0.1% in Western countries. Read More

Am J Emerg Med 2018 Nov 17. Epub 2018 Nov 17.

Department of Surgery, University of Pamukkale, Denizli, Turkey.

Simple bone cyst (SBC) also known as unicameral bone cyst is a benign, radiolucent bone lesion that is seen commonly in childhood. These lesions are usually found incidentally although pain and swelling can be seen. The most common complication is a pathological fracture, and this is often the cause of presentation. Read More

Crit Ultrasound J 2018 Nov 23;10(1):31. Epub 2018 Nov 23.

Anesthesiology and Critical Care Department, Toulouse University Hospital, University Toulouse III Paul Sabatier, Toulouse, France.

Background: Right iliac fossa abdominal pain is a common reason for emergency ward admissions, its etiology is difficult to diagnose. It can be facilitated by an imaging examination, such as a Computerized Tomography scan which exposes the patient to ionizing radiation and implies delays. A bedside ultrasound performed by emergency physicians could avoid these issues. Read More

Ann Ital Chir 2018 Nov 19;7. Epub 2018 Nov 19.

Aim: Although still debatable, appendicectomy during laparoscopy in patients with abdominal pain is often performed even if the appendix seems normal. The study's aim is to compare the postoperative outcomes of laparoscopic appendicectomies with appendix proven to be histologically normal to those with proven appendicitis, adding evidence on whether a normal appendix should be removed.

Methods: All consecutive patients who underwent laparoscopic appendicectomy in a one-year period in a single centre were retrospectively studied. Read More

Pediatric Health Med Ther 2018 26;9:135-145. Epub 2018 Oct 26.

Department of Surgery, Harbor-UCLA Medical Center, Torrance, CA, USA,

Perforated appendicitis, as defined by a visible hole in the appendix or an appendicolith free within the abdomen, carries significant morbidity in the pediatric population. Accurate diagnosis is challenging as there is no single symptom or sign that accurately predicts perforated appendicitis. Younger patients and those with increased duration of symptoms are at higher risk of perforated appendicitis. Read More

J Surg Res 2018 Dec 3;232:63-71. Epub 2018 Jul 3.

Department of Surgery, Harbor-UCLA Medical Center, Torrance, California; Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, California; Los Angeles Biomedical Research Institute, Torrance, California. Electronic address:

Background: Variations in the management of pediatric patients at children's hospitals (CHs) and non-CHs (NCHs) have been well described, especially within the trauma literature. However, little is known about the outcomes and costs of common general surgical procedures at NCHs. The purpose of this study was to evaluate the effect of CH designation on the outcomes and costs of appendectomy and cholecystectomy. Read More

J Surg Res 2018 Dec 18;232:346-350. Epub 2018 Jul 18.

Department of Surgery, Children's Mercy Hospital, Kansas City, Missouri. Electronic address:

Background: The evolving demands of our current health care system for enhanced efficiency and safety while decreasing hospital length of stay has led to our institutional protocol for same-day discharge (SDD) after laparoscopic appendectomy. We have previously demonstrated a 28% rate of SDD in children with nonperforated appendicitis. The purpose of our study is to assess the effectiveness of a mature protocol for SDD by evaluating discharge success, duration of hospital stay, and readmission rates. Read More

J Surg Res 2018 Dec 30;232:33-38. Epub 2018 Jun 30.

Heart Center, Turku University Hospital, Turku, Finland; Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.

Background: We aimed to investigate the trends in occurrence and the treatment approaches of appendicitis in Finnish children.

Material And Methods: All patients aged <16 y hospitalized for appendicitis in Finland in 2004-2014 were included. Data were retrospectively collected from the Finnish Care Register for Health Care and Statistics Finland. Read More

J Dtsch Dermatol Ges 2018 Dec 21;16(12):1443-1449. Epub 2018 Nov 21.

Department of Oto-Rhino-Laryngology Head and Neck Surgery, Ulm University Medical Center, Germany.

Background: Hereditary angioedema (HAE) is a rare genetic disorder that leads to recurrent development of mucosal and dermal swelling. It is mediated by bradykinin, and can affect virtually any part of the human body, including the gastrointestinal tract, the extremities, and the laryngeal and pharyngeal regions. Safe and potent drugs are available for acute and prophylactic treatment of HAE. Read More

Rev Col Bras Cir 2018 Nov 14;45(5):e19. Epub 2018 Nov 14.

Universidade Federal de Pelotas, Faculdade de Medicina, Pelotas, RS, Brasil.

Objective: to evaluate the main risk factors for postoperative complications in patients undergoing appendectomy for acute appendicitis.

Methods: we retrospectively analyzed 1241 patients undergoing open or laparoscopic appendectomy. Patients were allocated to four groups: Group 1, without postoperative complications, and Groups 2, 3, and 4, with postoperative complications defined according to their severity, following Clavien-Dindo classification (I, II, and ≥III, respectively). Read More

Chirurg 2018 Nov 19. Epub 2018 Nov 19.

Klinik und Poliklinik für Allgemein‑, Viszeral‑, Gefäß- und Kinderchirurgie, Universitätsklinikum Würzburg, Oberduerrbacherstr. 6, 97080, Würzburg, Deutschland.

Tumors of the appendix are not a uniform group but differ significantly in terms of their origin/histology and metastatic behavior. Furthermore, tumors of the appendix are often diagnosed as incidental findings after appendectomy for acute appendicitis. A subgroup of these neoplasms are low-grade appendiceal mucinous neoplasms (LAMN). Read More

Clin Case Rep 2018 Nov 28;6(11):2160-2162. Epub 2018 Sep 28.

Division of Gastroenterology, Hepatology and Nutrition Jeanne de Flandre Children Hospital CHU-Lille Univ. Lille Lille France.

Acute appendicitis is the most common surgical condition encountered in the pediatric age group but the clinical presentation could be misleading. This highlights the importance of exploratory laparotomy even in the absence of systemic manifestations in order not to miss a serious underlying pathology such as intestinal tuberculosis. Read More

Am J Surg 2018 Nov 13. Epub 2018 Nov 13.

Department of Surgery, University of Illinois College of Medicine, Peoria, IL, USA; Children's Hospital of Illinois at OSF Saint Francis Medical Center, Peoria, IL, USA. Electronic address:

Background: With similar effectiveness of ultrasonography, our institution replaced CT imaging with ultrasound for diagnosing appendicitis in children. An unexpected consequence was the overutilization of ultrasound. Our objective was to establish measures that could help prevent this overuse. Read More

Am Surg 2018 Sep;84(9):e439-e440

Am Surg 2017 Dec;83(12):e490-e492

Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.

Am Surg 2017 Dec;83(12):e471-e473

Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.