781 results match your criteria Pediatrics Appendicitis


Delayed Diagnosis of Pediatric Appendicitis during the COVID-19 Pandemic.

Acta Paediatr 2020 May 27. Epub 2020 May 27.

Department of Pediatrics C, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.

Aim: To present seven pediatric patients with appendicitis, all with late diagnosis resulting from different aspects of the fear from the current global COVID-19 pandemic.

Methods: Cases were collected from three pediatric surgical wards. Comparison between complicated appendicitis rates in the COVID-19 era and similar period in previous year was performed. Read More

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http://dx.doi.org/10.1111/apa.15376DOI Listing

Clinical Prediction Scores for Pediatric Appendicitis.

Eur J Pediatr Surg 2020 May 26. Epub 2020 May 26.

Department of Clinical Sciences, Pediatrics, Lund University, Lund, Sweden.

Introduction:  The rate of misdiagnosis of appendicitis in children is a challenge and clinical prediction scores could be part of the solution. However, the pediatric appendicitis score (PAS) and the Alvarado score have shown disappointing diagnostic accuracy in pediatric validation studies, while the appendicitis inflammatory response (AIR) score and the novel pediatric appendicitis risk calculator (pARC) have not yet been validated thoroughly. Therefore, the aim of the present study was to evaluate these four prediction scores prospectively in children with suspected appendicitis. Read More

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http://dx.doi.org/10.1055/s-0040-1710534DOI Listing

Antibiotic therapy in pediatric acute appendicitis: Compliance with local protocol to reduce antibiotic overuse.

Arch Pediatr 2020 May 11. Epub 2020 May 11.

Department of Pediatric Surgery, CHU d'Amiens-Picardie, Site Sud, 80054 Amiens, France. Electronic address:

Purpose: Acute appendicitis is one of the commonest surgical emergencies in pediatrics. Treatment usually consists of a combination of surgery and antibiotics. The present study was designed to assess compliance with our local antibiotic protocol and analyse the consequences of non-compliance. Read More

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http://dx.doi.org/10.1016/j.arcped.2020.04.001DOI Listing

Post operative pediatric appendicitis nurse-driven discharge: Patient outcomes and nursing perspectives.

Am J Surg 2020 Apr 20. Epub 2020 Apr 20.

Swedish Medical Center, First Hill Campus, Department of Pediatrics, Pediatric Surgery 1101 Madison St #800, Seattle, WA, 98104, USA. Electronic address:

Background: Nurse-driven discharge pathways following pediatric appendectomies have proven effective in children's hospitals; studies in general hospital settings are lacking. Additionally, despite the central role of nursing in such pathways, nursing perspectives aren't investigated in the literature.

Methods: Data from all pediatric acute uncomplicated appendicitis patients who underwent laparoscopic appendectomy in the 12 months following institution of a nurse-driven discharge pathway (intervention, n = 67) were compared to those treated in the preceding year (control, n = 64). Read More

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http://dx.doi.org/10.1016/j.amjsurg.2020.02.063DOI Listing
April 2020
2.291 Impact Factor

The importance of visualization of appendix on abdominal ultrasound for the diagnosis of appendicitis in children: A quality assessment review.

World J Emerg Med 2020 ;11(3):140-144

Brantford General Hospital, Brantford, ON, Canada.

Background: Ultrasound has the first line investigation role in the diagnosis of acute appendicitis in children. The purpose of this study was to perform a quality assessment review on the visualization rate of appendix on ultrasound in children in the community hospital setting.

Methods: A retrospective chart review of the abdominal ultrasound findings for the visualization of the appendix was performed on paediatric patients ranging from 5 to 18 years. Read More

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http://dx.doi.org/10.5847/wjem.j.1920-8642.2020.03.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7183919PMC
January 2020

High-risk Pediatric Emergencies.

Emerg Med Clin North Am 2020 May;38(2):383-400

Department of Pediatrics, Division of Pediatric Emergency Medicine, Boston University School of Medicine, 4th floor, 801 Albany Street, Boston, MA, 02119, USA.

More than half of pediatric malpractice cases arise from emergency departments, primarily due to missed or delayed diagnoses. All providers who take care of children in emergency departments should be aware of this risk and the most common diagnoses associated with medicolegal liability. This article focuses on diagnosis and management of high-risk diagnoses in pediatric patients presenting to emergency departments, including meningitis, pneumonia, appendicitis, testicular torsion, and fracture. Read More

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http://dx.doi.org/10.1016/j.emc.2020.01.004DOI Listing

Should single-incision laparoscopic appendectomy be the new standard for pediatric appendicitis?

Pediatr Neonatol 2020 Apr 6. Epub 2020 Apr 6.

Division of Pediatric Surgery, Department of Surgery, Shuang Ho Hospital, New Taipei City, Taiwan; Department of Surgery, School of Medicine, Taipei Medical University, Taipei, Taiwan. Electronic address:

Background: To compare single-incision laparoscopic appendectomy (SILA) with conventional (CLA) and transumbilical laparoscopic appendectomy (TULA).

Methods: This is a retrospective cohort study. Patients were divided into three groups, SILA, CLA, and TULA. Read More

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http://dx.doi.org/10.1016/j.pedneo.2020.03.013DOI Listing

Brief Report: Association of Complicated Appendicitis in Children with Autism Spectrum Disorders.

J Autism Dev Disord 2020 Apr 15. Epub 2020 Apr 15.

Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.

Appendicitis is the most common surgical emergency in children and can lead to significant complications. The aim of our study was to determine whether children with autism spectrum disorders (ASD) are at increased risk for appendicitis and its complications compared to neurotypical (NT) peers. From 2000 to 2013, 292,572 children were included (n = 48,762 ASD). Read More

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http://dx.doi.org/10.1007/s10803-020-04499-zDOI Listing

Influence of age on clinical presentation, diagnosis delay and outcome in pre-school children with acute appendicitis.

BMC Pediatr 2020 Apr 6;20(1):151. Epub 2020 Apr 6.

Department of Pediatrics, University Hospital Liège, Liège, Belgium.

Background: Unusual clinical presentation of acute appendicitis in preschool children leads to misdiagnosis and complications. We aimed to analyze the influence of age on clinical presentation, laboratory findings and complications in preschool children with acute appendicitis.

Methods: From January 2012 until December 2017, 29 children younger than 6 years of age (median 50 months) with acute appendicitis were enrolled in this retrospective study. Read More

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http://dx.doi.org/10.1186/s12887-020-02053-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7133018PMC

Case report on a misleading case of appendiceal perforation presented with severe generalized convulsion.

Transl Pediatr 2020 Feb;9(1):81-85

Department of Gastroenterology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710000, China.

Appendicitis and convulsions are two common pathologies among children. Though appendicitis has some certain symptoms, they might present with atypical symptoms in young ages. Here we present a misleading case of a perforated appendix that presented with severe generalized convulsion, no significant abdominal symptoms and had a recent history of mild gastrointestinal problems. Read More

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http://dx.doi.org/10.21037/tp.2020.02.01DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7036636PMC
February 2020

Point-of-Care Ultrasound for Undifferentiated Abdominal Pain in a Pediatric Patient: A Proposed Algorithm.

Pediatr Emerg Care 2020 Mar 6. Epub 2020 Mar 6.

Departments of Emergency Medicine and Pediatrics, Alpert Medical School of Brown University, Hasbro Children's Hospital/Rhode Island Hospital, Providence, RI.

Abdominal pain is a common presentation in the pediatric emergency department and may pose a diagnostic challenge to the physician. Although most abdominal pain is benign, the presence of abdominal pain may represent a surgical emergency. We present an atypical presentation of perforated appendicitis in a child with 2 weeks of abdominal pain, in whom point-of-care ultrasound expedited diagnosis and patient disposition. Read More

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http://dx.doi.org/10.1097/PEC.0000000000002033DOI Listing

Incidence Trends, Comorbidities and Outcomes of Pyogenic Liver Abscess Among Children. A Nationwide Population-Based Analysis.

J Pediatr Gastroenterol Nutr 2020 Mar 5. Epub 2020 Mar 5.

Department of Pediatric Gastroenterology, Cleveland Clinic Children's hospital, Cleveland, OH.

Objectives: Population based analysis of incidence, comorbid conditions, microbiological characteristics and outcomes of pyogenic liver abscess (PLA) in children.

Methodology: Retrospective analysis of National Inpatient Sample (NIS) and Kids Inpatient database (KID) database from 2003 to 2014 and included patients between 1 and 20 years of age. Using ICD 9 codes, we identified all hospitalizations with PLA and compared them with 1:10 age and gender matched controls. Read More

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http://dx.doi.org/10.1097/MPG.0000000000002700DOI Listing

Nonsurgical Management of Acute Appendicitis in Sickle Cell Disease.

J Pediatr Hematol Oncol 2020 Mar 3. Epub 2020 Mar 3.

Department of Pediatrics, SUNY Downstate Health Sciences University, Brooklyn, NY.

A 9-year-old child with sickle cell disease (sickle beta zero thalassemia) was diagnosed to have acute appendicitis during a hospitalization for pain, acute chest syndrome, and exacerbation of asthma. Because of his high surgical risk, his appendicitis was treated nonsurgically, successfully deferring his appendectomy. He remains well after 1 year. Read More

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http://dx.doi.org/10.1097/MPH.0000000000001774DOI Listing

Minimizing Ionizing Radiation in Evaluating Suspected Appendicitis in Children Before and After the Release of the ACEP Clinical Policy.

Pediatr Emerg Care 2020 Feb 24. Epub 2020 Feb 24.

George Washington University School of Medicine and Health Sciences, Washington, DC.

Study Objective: The aim of this study was to examine the impact of the ACEP (American College of Emergency Physicians) clinical policy regarding diagnosis of suspected appendicitis on changing practice in the pediatric emergency department (ED) in the absence of a formal departmental protocol.

Methods: This was a retrospective chart review in a pediatric ED in which patients aged 2 to 18 years were evaluated for appendicitis via ultrasound, computed tomography (CT), or both, over a 7-year study period. We compared rates of CT utilization in the period before the release of the ACEP clinical policy regarding diagnosis and treatment of appendicitis (2008-2009) and the period after (2010-2014). Read More

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http://dx.doi.org/10.1097/PEC.0000000000002068DOI Listing
February 2020

Time course response of inflammatory markers in pediatric appendicitis.

Pediatr Surg Int 2020 Apr 22;36(4):493-500. Epub 2020 Feb 22.

Department of Pediatric Surgery, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore.

Purpose: We aim to evaluate the diagnostic value and time course response of the triple inflammatory markers: white blood cell count (WBC), neutrophil percentage (Neu), and C-reactive protein (CRP) in pediatric acute appendicitis.

Methods: A retrospective review of clinical data pertaining to 1391 patients admitted with suspicion for pediatric appendicitis from 2012 to 2017 was conducted. Triple inflammatory markers were acquired upon admission. Read More

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http://dx.doi.org/10.1007/s00383-020-04620-4DOI Listing

Appendicitis in Neutropenic Pediatric Oncology Patients: A Case Series and Review of the Literature.

J Pediatr Hematol Oncol 2020 Feb 19. Epub 2020 Feb 19.

Division of Pediatric Hematology-Oncology, University of Virginia School of Medicine, Charlottesville, VA.

Appendicitis is the most common reason for which pediatric patients require emergent surgery. Although surgical removal of the appendix is the standard of care for appendicitis, neutropenic patients require special consideration as optimal management for these patients remains controversial. We present a case series of 3 neutropenic patients with appendicitis, all of whom were managed differently according to the circumstances unique to each case. Read More

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http://dx.doi.org/10.1097/MPH.0000000000001762DOI Listing
February 2020

Improving the diagnostic accuracy of appendicitis using a multidisciplinary pathway.

J Pediatr Surg 2020 May 31;55(5):889-892. Epub 2020 Jan 31.

Department of Surgery, University of British Columbia, Vancouver, Canada. Electronic address:

Background/purpose: Improvement opportunities exist in the accuracy and timeliness of the diagnosis of childhood appendicitis. The purpose of our study was to conduct a post-implementation audit of a diagnostic pathway for children with suspected appendicitis presenting to our pediatric emergency department.

Methods: We adopted a diagnostic pathway that utilized a validated risk of appendicitis stratification tool (Alvarado Score) with protocolized use of abdominal ultrasound for moderate risk patients. Read More

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http://dx.doi.org/10.1016/j.jpedsurg.2020.01.040DOI Listing

An infected urachal cyst presenting as acute abdominal pain in a child: A case report.

Medicine (Baltimore) 2020 Jan;99(5):e18884

Department of Pediatrics, Cathay General Hospital, Taipei, Taiwan.

Introduction: Urachal cyst is an exceptionally rare disease in children caused by the incomplete obliteration of the urachal remnant. Urachal cysts seldom cause symptoms unless a secondary infection occurs. The symptoms of an infected urachal cyst are nonspecific and may be similar to acute appendicitis or other acute abdominal conditions. Read More

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http://dx.doi.org/10.1097/MD.0000000000018884DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004625PMC
January 2020

Use of Lumen-apposing Metal Stents for Endoscopic Drainage of Intra-abdominal Fluid Collections in Pediatric Patients.

J Pediatr Gastroenterol Nutr 2020 Feb;70(2):258-260

Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Children's Hospital at Montefiore.

Introduction: Intraabdominal fluid collections that previously required surgical intervention can now be drained with less invasive techniques. The use of lumen-apposing metal stents (LAMS) to treat pancreatic pseudocysts and perirectal abscesses has been shown to be a safe and effective technique in adults. We aim to evaluate the indications, outcomes, and complications of the use of LAMS in pediatric patients at our institution. Read More

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http://dx.doi.org/10.1097/MPG.0000000000002538DOI Listing
February 2020

Cost-effectiveness of Imaging Protocols for Suspected Appendicitis.

Pediatrics 2020 02 21;145(2). Epub 2020 Jan 21.

Departments of Pediatrics and.

Background: Inaccurate diagnosis of appendicitis leads to increased costs and morbidity. Ultrasound costs less than computed tomography (CT) or MRI but has lower sensitivity and may not visualize the appendix.

Methods: We conducted a cost-effectiveness analysis using a decision-analytic model of 10 imaging strategies for suspected appendicitis in a hypothetical cohort of patients: no imaging with discharge or surgery; CT only; MRI only; or staged approach with CT or MRI after 1) negative ultrasound result or ultrasound without appendix visualization, 2) ultrasound without appendix visualization, or 3) ultrasound without appendix visualization but with secondary signs of inflammation. Read More

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http://dx.doi.org/10.1542/peds.2019-1352DOI Listing
February 2020

Reverend Bayes and Appendicitis.

Pediatrics 2020 02 21;145(2). Epub 2020 Jan 21.

Children's Mercy Hospital Kansas City, Kansas City, Missouri.

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http://dx.doi.org/10.1542/peds.2019-3349DOI Listing
February 2020

Can mean platelet volume, Neutrophil-to-Lymphocyte, Lymphocyte-to-Monocyte, Platelet-to-Lymphocyte ratios be favourable predictors for the differential diagnosis of appendicitis?

J Pak Med Assoc 2019 May;69(5):647-654

Department of Pediatric Surgery, Medical Faculty, Afyon Kocatepe University, Afyon karahisar, Turkey.

Objective: To investigate whether some ratios obtained from complete blood count could be favourable predictors in differentiating appendicitis from mesenteric lymphadenitis, appendicitis and familial Mediterranean fever.

Methods: The retrospective cross-sectional study was conducted at AfyonKocatepe University Medical Faculty, Afyonkarahisar, Turkey, from January 1, 2014, to December 31, 2016, and comprised data of patients who presented to the department of paediatric surgery and paediatrics with symptoms of acute abdomen. Mean platelet volume, neutrophil/lymphocyte ratio, lymphocyte/monocyte ratio, and platelet/lymphocyte ratio of the patients calculated at the time of admission were analysed. Read More

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Systematic Review of Disparities in Care and Outcomes in Pediatric Appendectomy.

J Surg Res 2020 May 6;249:42-49. Epub 2020 Jan 6.

Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois. Electronic address:

Background: The impact of social, racial, and economic inequities on health and surgical outcomes for children is poorly described.

Methods: A systematic review using search terms related to disparities in care of pediatric appendicitis identified 20 titles and narrowed to 11 full texts. Nine retrospective studies were analyzed, representing 350,408 cases treated across the United States from 1983 to 2010. Read More

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http://dx.doi.org/10.1016/j.jss.2019.12.018DOI Listing

Diagnostic Performance of a Staged Pathway for Imaging Acute Appendicitis in Children.

Pediatr Emerg Care 2020 Jan 6. Epub 2020 Jan 6.

Department of Medical Imaging, University of Toronto, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada.

Introduction: The objective of this work is to assess the performance of our staged diagnostic pathway in the evaluation of suspected appendicitis cases in children. The pathway consisted of clinical assessment by the emergency physician, performing initial ultrasound (US), consultation, and clinical reevaluation by the surgery team followed by a repeat focused US scan in inconclusive cases. Computed tomography (CT) was limited to cases where the repeat US remained inconclusive and the clinical reassessment indicated persistent concerns for appendicitis. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001964DOI Listing
January 2020

A 2-year-old with a hepatic abscess secondary to an ascending retrocecal appendicitis: case report and review of the literature.

Int J Emerg Med 2019 Dec 19;12(1):41. Epub 2019 Dec 19.

D.O. Assistant Clinical Professor, Beaumont Hospital, Botsford Campus, Teaching hospital of Michigan State University, Department of Emergency Medicine, Farmington Hills, MI, USA.

Background: Diagnosing appendicitis within the pediatric population can be challenging, whether it be a neonate with irritability or a toddler with flank pain. Symptoms may mimic a viral illness, constipation, urinary tract infection, or intussusception, all of which are more common in this age group when compared with appendicitis. While a ruptured appendicitis can result in an intra-abdominal abscess, peritonitis, and/or shock, the development of a pyogenic hepatic abscess is extremely rare. Read More

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http://dx.doi.org/10.1186/s12245-019-0260-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6923966PMC
December 2019

Are Postoperative Intravenous Antibiotics Indicated After Laparoscopic Appendicectomy for Simple Appendicitis? A Prospective Double-blinded Randomized Controlled Trial.

Ann Surg 2019 Dec 9. Epub 2019 Dec 9.

Department of Pediatric Surgery, Urology & Surgical Simulation, Monash Children's Hospital, Melbourne, Australia.

Background: There is limited evidence for the use of postoperative antibiotics for simple appendicitis (SA) in children. Our aim was to conduct a prospective double-blinded randomized controlled trial to investigate this after a laparoscopic appendicectomy.

Methods: Following ethical approval, children (≤16 years) undergoing appendicectomy were recruited at a single institution. Read More

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http://dx.doi.org/10.1097/SLA.0000000000003732DOI Listing
December 2019

Colon stenosis due to acute neonatal appendicitis in a preterm baby: a case report.

BMC Pediatr 2019 12 12;19(1):492. Epub 2019 Dec 12.

Department of Neonatology, Osaka Red Cross Hospital, 5-30, Fudegasakicho, Tennoji Ward, Osaka, Japan.

Background: Colon stenosis and acute appendicitis are rare diseases among premature babies. To the best of our knowledge, no study has identified both the conditions in preterm babies.

Case Presentation: Here we report a case of a preterm Japanese male baby who developed ascending colon stenosis and appendicitis. Read More

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http://dx.doi.org/10.1186/s12887-019-1873-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6907132PMC
December 2019

Is Ischemia-Modified Albumin a Reliable Marker in Accurate Diagnosis of Appendicitis in Children?

World J Surg 2020 Apr;44(4):1309-1315

Department of Pediatrics, Division of Pediatric Emergency Care, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.

Background: Acute appendicitis is one of the most common abdominal emergencies. Despite all improvements in diagnostic techniques, there are still ongoing problems as proper diagnosis, misdiagnosis and perforated appendicitis. The aim of this study is to demonstrate the clinical value of IMA in patients with appendicitis and to determine the accurate diagnosis of appendicitis in clinically suspected patients. Read More

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http://dx.doi.org/10.1007/s00268-019-05323-1DOI Listing

Down the Rabbit Hole-Considerations for Ingested Foreign Bodies.

Pediatr Gastroenterol Hepatol Nutr 2019 Nov 7;22(6):619-623. Epub 2019 Nov 7.

Department of Pediatric Gastroenterology and Nutrition, Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA.

We report the case of a seven-year-old boy with an ingested foreign body, which was retained within the appendix for a known duration of ten months, ultimately requiring appendectomy. The ingested foreign body was incidentally discovered by abdominal x-ray at an emergency room visit for constipation. Despite four bowel cleanouts, subsequent x-rays showed persistence of the foreign body in the right lower quadrant. Read More

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http://dx.doi.org/10.5223/pghn.2019.22.6.619DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6856502PMC
November 2019

Correlation of white cell count and CRP in acute appendicitis in paediatric patients.

S Afr J Surg 2019 Dec;57(4):40

Department of Paediatric Surgery, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Chris Hani Baragwanath Academic Hospital, South Africa.

Background: Ten per cent of children who present with abdominal pain at an emergency department are diagnosed with acute appendicitis. The diagnosis of which relies on clinical acumen, but addition of tests such as measurement of the white cell count (WCC) and C-reactive protein (CRP) are needed to decrease the morbidity associated with inappropriate surgical management. This study evaluates the sensitivity, specificity and accuracy of the WCC and CRP separately and when used in combination and evaluates whether an increased WCC and CRP are associated with complicated appendicitis. Read More

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December 2019

Assessing surgical care delivery at facilities caring for higher volumes of minority children utilizing the pediatric quality indicator for perforated appendicitis: a propensity-matched analysis.

Pediatr Surg Int 2020 Mar 26;36(3):407-414. Epub 2019 Nov 26.

Department of General and Thoracic Surgery, Children's National Health System, Washington, DC, USA.

Introduction: The pediatric quality indicator (PDI) measures released by the Agency for Healthcare Research and Quality (AHRQ) provide an impetus for benchmarking quality of care in children. The PDI-17, aimed at studying perforation in appendicitis, is one such measure that this study aims to utilize to assess surgical care delivery and outcomes in children managed at majority-minority hospitals.

Methods: The Kid Inpatient Database (2000-2012) was queried for pediatric patients (< 18 years) with a diagnosis of appendicitis, with and without perforation. Read More

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http://dx.doi.org/10.1007/s00383-019-04604-zDOI Listing

Mesenteric venous thrombosis as a complication of appendicitis in an adolescent: A case report and literature review.

Medicine (Baltimore) 2019 Nov;98(48):e18002

Division of Pediatric Emergency Medicine, Department of Pediatrics, Severance Children's Hospital.

Rationale: Mesenteric venous thrombosis is an uncommon but potentially fatal condition that can cause bowel ischemia. It results from a systemic hypercoagulable state or abdominal infection draining into the portal venous system. Several cases regarding portomesenteric venous thrombosis as a complication of appendicitis were reported in adults, but there are far fewer reports in pediatric patients. Read More

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http://dx.doi.org/10.1097/MD.0000000000018002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6890307PMC
November 2019

Near Real-Time Surveillance to Assess the Safety of the 9-Valent Human Papillomavirus Vaccine.

Pediatrics 2019 12 18;144(6). Epub 2019 Nov 18.

Marshfield Clinic Research Institute, Marshfield, Wisconsin.

Background And Objectives: Human papillomavirus is the most common sexually transmitted infection in the United States and causes certain anogenital and oropharyngeal cancers. The 9-valent human papillomavirus vaccine (9vHPV) provides protection against additional types not included in the quadrivalent vaccine. We conducted near real-time vaccine safety surveillance for 24 months after the vaccine became available in the Vaccine Safety Datalink. Read More

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http://dx.doi.org/10.1542/peds.2019-1808DOI Listing
December 2019

Evaluation of concordance among surgeons and pathologists regarding the diagnosis and classification of acute appendicitis in children.

J Pediatr Surg 2019 Oct 26. Epub 2019 Oct 26.

Resident of Pediatrics, Department of Pediatrics, Faculty of Medicine, Universidad Nacional de Colombia, Colombia.

Acute appendicitis is the most frequent urgent abdominal surgical pathology in children. Therapeutic decisions in patients who have undergone an appendectomy are made based on the macroscopic findings at the moment of surgery. There is high variability between surgical and histopathological findings. Read More

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http://dx.doi.org/10.1016/j.jpedsurg.2019.09.025DOI Listing
October 2019

Calculated decisions: Pediatric appendicitis risk calculator (pARC)

Pediatr Emerg Med Pract 2019 Sep 2;16(9):CD5-CD6. Epub 2019 Sep 2.

Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, NY

The pediatric appendicitis risk calculator quantifies appendicitis risk in pediatric patients with abdominal pain, possibly better than the pediatric appendicitis score. Read More

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September 2019

Calculated decisions: Pediatric appendicitis score (PAS)

Authors:
Jamie Lovell

Pediatr Emerg Med Pract 2019 Sep 2;16(9):CD1-CD2. Epub 2019 Sep 2.

Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA

The pediatric appendicitis score predicts the likelihood of a diagnosis of appendicitis in pediatric patients with abdominal pain. Read More

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September 2019

[Clinical features and etiology of abdominal distension in children].

Zhongguo Dang Dai Er Ke Za Zhi 2019 Oct;21(10):1022-1027

Department of Gastroenterology, Children's Hospital of Chongqing Medical University/National Clinical Medical Research Center of Children's Health and Diseases/Ministry of Education Key Laboratory of Child Development and Disorders/China International Science and Technology Cooperation Base of Child Development and Critical Disorders/Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.

Objective: To study the clinical features and etiology of abdominal distension in children with different ages.

Methods: A retrospective analysis was performed for the clinical data of 1 561 children who were admitted due to abdominal distension from January 2013 to October 2016, including clinical manifestations, radiological examination, pathological results, and disease diagnosis.

Results: Among the 1 561 children, there were 823 neonates (aged <28 days), 307 infants (aged 28 days to 1 year), 186 toddlers (aged 1-3 years), 120 preschool children (aged 3-6 years), 106 school-aged children (aged 6-12 years), and 19 adolescents (aged 12-17 years). Read More

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October 2019

Pediatric Appendicitis-Factors Associated With Surgical Approach, Complications, and Readmission.

J Surg Res 2020 02 16;246:395-402. Epub 2019 Oct 16.

Department of Pediatrics, University of Mississippi Medical Center, Jackson, Mississippi.

Background: Laparoscopic appendectomy is a preferred approach in children with appendicitis. Patient characteristics associated with open appendectomy are poorly characterized, although such information can help optimize the care.

Material And Methods: To characterize the factors associated with open appendectomy, we performed a retrospective analysis using the 2014 Nationwide Readmissions Database, capturing 49. Read More

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http://dx.doi.org/10.1016/j.jss.2019.09.031DOI Listing
February 2020
1 Read

Unusual localization and coexistence of primary hydatid cyst: a case report.

Turk Pediatri Ars 2019 25;54(3):192-195. Epub 2019 Sep 25.

Department of Radiology, Konya Training and Research Hospital, Konya, Turkey.

Hydatid cysts are zoonotic parasitic infections caused by . Although witnessed in all body parts, the first and most important locations for this parasite are the liver and lungs. Unusually, hydatid cysts are rarely located in the pelvic region. Read More

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http://dx.doi.org/10.5152/TurkPediatriArs.2018.6200DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6776457PMC
September 2019
7 Reads

Accuracy of automated identification of delayed diagnosis of pediatric appendicitis and sepsis in the ED.

Emerg Med J 2019 Dec 9;36(12):736-740. Epub 2019 Oct 9.

Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA.

Background: Delayed diagnoses of serious emergency conditions can lead to morbidity in children, but are challenging to identify and measure. We developed and piloted an automated tool for identifying delayed diagnosis of two serious conditions commonly seen in the ED using administrative data.

Methods: We identified cases with a final diagnosis of appendicitis or sepsis in a freestanding children's hospital from 2008 to 2018, with any hospital ED encounter within the preceding 7 days. Read More

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http://dx.doi.org/10.1136/emermed-2019-208841DOI Listing
December 2019
1 Read

Acute eosinophilic appendicitis after generalized skin reaction due to unknown cause in a child: Case report and literature review.

Clin Pract 2019 Aug 16;9(3):1177. Epub 2019 Sep 16.

Department of Radiology, Democritus University of Thrace, University Hospital of Alexandroupolis, Dragana, Alexandroupolis, Greece.

Acute eosinophilic appendicitis (AEA) is a rare variant of appendix inflammation possibly linked to allergy. Histopathological evidence of eosinophilic infiltration of the and edema separating the muscle fibers is the gold standard for the diagnosis. Here, we report a case of a young boy with AEA following a skin reaction of possible allergic origin. Read More

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http://dx.doi.org/10.4081/cp.2019.1177DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6763710PMC
August 2019
1 Read

Perforation in pediatric non-complicated appendicitis treated by antibiotics: the real incidence.

Pediatr Surg Int 2020 Jan 1;36(1):69-74. Epub 2019 Oct 1.

Department of Pediatric General and Urogenital Surgery, Juntendo University Hospital, 3-1-3 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan.

Purpose: The incidence of perforation during antibiotic therapy (AT) of children triaged as non-complicated acute appendicitis (NC-Ap) was investigated.

Methods: Abdominal ultrasonography (US) and/or computed tomography (CT) scans from cases of perforation identified at appendectomy for failed AT were reassessed blindly by a panel of board-certified specialists for any evidence of pre-AT morbidity suggestive of perforation.

Results: Of 521 cases triaged as NC-Ap, symptoms resolved with AT in 452 cases (86. Read More

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http://dx.doi.org/10.1007/s00383-019-04574-2DOI Listing
January 2020
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Multifocal Appendiceal Carcinoid Tumor in an Adolescent: A Case Report and Review of the Literature.

J Pediatr Hematol Oncol 2019 10;41(7):568-570

Department of Surgery, Division of Pediatric Surgery.

Appendiceal carcinoid tumors in children and adolescents are rare. This report describes a case of a multifocal appendiceal carcinoid tumor identified incidentally following appendectomy in an adolescent. In this report, we describe the staging process and surgical management for focal and locally invasive appendiceal carcinoid tumors and highlight the rarity of multifocality in this location. Read More

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http://dx.doi.org/10.1097/MPH.0000000000001331DOI Listing
October 2019
3 Reads

Microbiota of Children With Complex Appendicitis: Different Composition and Diversity of The Microbiota in Children With Complex Compared With Simple Appendicitis.

Pediatr Infect Dis J 2019 10;38(10):1054-1060

From the Department of Paediatric Surgery, Emma Children's Hospital.

Background: Two types of appendicitis are hypothesized, simple and complex, with potential different treatment strategies. To improve differentiation, underlying pathogeneses need to be further unraveled.

Aim: To determine if the microbial composition in the appendix differs between children with simple and complex appendicitis. Read More

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http://dx.doi.org/10.1097/INF.0000000000002434DOI Listing
October 2019
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Imaging Acute Non-Traumatic Abdominal Pathologies in Pediatric Patients: A Pictorial Review.

J Radiol Case Rep 2019 Jul 31;13(7):29-43. Epub 2019 Jul 31.

Department of Radiology, American University of Beirut Medical Center, Beirut, Lebanon.

The dilemma of acute non-traumatic abdominal pathologies in the pediatric population depends on the age of the patients and symptoms. Surgical etiologies in patients younger than 2 years of age include intussusception, pyloric stenosis, malrotation and midgut volvulus. In older patients, considerations become closer to differential etiologies in adults including acute appendicitis. Read More

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http://dx.doi.org/10.3941/jrcr.v13i7.3443DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6738493PMC
July 2019
4 Reads

Does peritoneal lavage influence the rate of complications following pediatric Laparoscopic Appendicectomy in Children with Complicated Appendicitis? A Prospective Randomized Clinical Trial.

J Pediatr Surg 2019 Dec 30;54(12):2524-2527. Epub 2019 Aug 30.

Department of Paediatric Surgery, Urology & Surgical Simulation, Monash Children's Hospital, Melbourne, Australia.

Background: There is ongoing debate concerning the use of peritoneal irrigation in the setting of complicated appendicitis (CA) in children. Our aim was to conduct a prospective randomized controlled trial for the treatment of CA during a laparoscopic appendicectomy in children.

Methods: Following ethical approval (REC10138B), pediatric patients (≤16 years old) were recruited from a single institution over a 3-year time period (2015-2018). Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00223468193057
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http://dx.doi.org/10.1016/j.jpedsurg.2019.08.039DOI Listing
December 2019
6 Reads

Inflammatory bowel disease in Nigerian children: case series and management challenges.

Paediatr Int Child Health 2019 Sep 9:1-5. Epub 2019 Sep 9.

Department of Pharmacology and Therapeutics, Lagos State University College of Medicine , Ikeja , Lagos , Nigeria.

Inflammatory bowel disease (IBD) is rare in sub-Saharan Africa. Five cases in Nigerian children are presented to highlight the occurrence, pattern of clinical presentation and management challenges. The patients were identified following a retrospective review of all diagnosed cases of IBD between 1 January 2011 and 31 December 2018 seen at the Paediatric Gastroenterology, Hepatology and Nutrition Unit of Lagos State University Teaching Hospital. Read More

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http://dx.doi.org/10.1080/20469047.2019.1662658DOI Listing
September 2019
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[Utility of Pediatric Appendicitis Score and abdominal ultrasound in the diagnostic process of acute appendicitis].

Cir Pediatr 2019 Jul 29;32(3):128-134. Epub 2019 Jul 29.

Servicio Pediatría. Hospital Arnau de Vilanova. Lleida.

Introduction: Pain in the right iliac fossa is a frequent reason for consultation and the diagnosis of appendicitis remains a challenge. The Pediatric Appendicitis Score (PAS) stratifies the risk of suffering appendicitis, and abdominal ultrasound provides information without irradiation. This study aims to correlate the score and the ultrasound with the screening of appendicitis and evaluate its efficiency. Read More

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July 2019
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Appendicitis or non-specific abdominal pain in pre-school children: When to request abdominal ultrasound?

J Paediatr Child Health 2020 Mar 4;56(3):367-371. Epub 2019 Sep 4.

Rare Diseases and Pediatric Medicine Research Group, Galicia Sur Health Research Institute, Vigo, Spain.

Aim: The aim of this study is to determine the most useful diagnostic tools to differentiate appendicitis from non-specific abdominal pain (NSAP) in pre-school children.

Methods: We prospectively evaluated all children aged 5 years or younger admitted for suspected appendicitis at a paediatric emergency department during 5 years. Cases of NSAP and appendicitis were enrolled according to inclusion and exclusion criteria. Read More

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http://dx.doi.org/10.1111/jpc.14617DOI Listing
March 2020
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Case 4: Two Children with Presumed Inguinal Hernias.

Pediatr Rev 2019 Sep;40(9):491-493

Department of Pediatric Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, TX.

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http://dx.doi.org/10.1542/pir.2017-0138DOI Listing
September 2019