703 results match your criteria Pediatrics Appendicitis


Abdominal Lymphoma Presenting as Terminal Ileitis: A Case Report.

J Emerg Med 2019 Apr 16. Epub 2019 Apr 16.

Department of Emergency Medicine, Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.

Background: Most pediatric patients with lymphoma do not have classic symptoms of fever, night sweats, and weight loss. Lymphoma can present as vague symptoms and may mimic common pediatric abdominal emergencies. In this case report, we present a child who presented with abdominal pain and who was initially misdiagnosed as having a surgical emergency. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07364679193013
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http://dx.doi.org/10.1016/j.jemermed.2019.03.004DOI Listing
April 2019
2 Reads

Fast-track surgery for acute appendicitis in children: a systematic review of protocol-based care.

ANZ J Surg 2019 Apr 15. Epub 2019 Apr 15.

Department of Paediatric Surgery, Women's and Children's Hospital, Adelaide, South Australia, Australia.

Background: 'Fast-track' surgery protocols aim to standardize and rationalize post-operative care, with evidence of safety and efficacy in both uncomplicated and complicated childhood appendicitis. Generalization for broader adoption has been limited by variation in protocol design, including specific antibiotic choice, discharge criteria, post-operative monitoring and patient selection.

Methods: A systematic review of the literature was performed to evaluate the current evidence underpinning fast-track protocols for childhood appendicitis and identify areas of consensus and controversy. Read More

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http://dx.doi.org/10.1111/ans.15125DOI Listing
April 2019
3 Reads

Diagnostic accuracy of pediatric atypical appendicitis: Three case reports.

Medicine (Baltimore) 2019 Mar;98(13):e15006

Department of Pediatrics, Integrated Traditional Chinese and Western Medicine, Tianjin Nankai Hospital.

Rationale: Acute appendicitis is one of the most common causes of acute abdomen in children, yet it is difficult to diagnose in young children because its clinical manifestations may be atypical. Here, 3 atypical clinical cases associated with appendicitis in children are reported.

Patient Concern: The 1st case corresponds to a 5-year-old male patient who presented with abdominal discomfort, intermittent fevers, and vomiting, have increased white blood cell (WBC) count and C-reactive protein (CRP). Read More

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http://dx.doi.org/10.1097/MD.0000000000015006DOI Listing
March 2019
3 Reads

Cytokines and Chemokines in Pediatric Appendicitis: A Multiplex Analysis of Inflammatory Protein Mediators.

Mediators Inflamm 2019 21;2019:2359681. Epub 2019 Feb 21.

Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary AB, Canada.

Objectives: We aimed to demonstrate the potential of precision medicine to describe the inflammatory landscape present in children with suspected appendicitis. Our primary objective was to determine levels of seven inflammatory protein mediators previously associated with intra-abdominal inflammation (C-reactive protein-CRP, procalcitonin-PCT, interleukin-6 (IL), IL-8, IL-10, monocyte chemoattractant protein-1-MCP-1, and serum amyloid A-SAA) in a cohort of children with suspected appendicitis. Subsequently, using a multiplex proteomics approach, we examined an expansive array of novel candidate cytokine and chemokines within this population. Read More

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http://dx.doi.org/10.1155/2019/2359681DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6409077PMC
February 2019
1 Read

Disparities in Care: Do Children with Autism Spectrum Disorder Experience Differential Medication Receipt In The Emergency Department?

J Dev Behav Pediatr 2019 Apr;40(3):170-175

Nurse Scientist Consultant, Ambler, PA.

Objective: The primary objective of this study was to describe analgesia administration between neurotypical (NT) individuals and those with autism spectrum disorder (ASD) diagnosed with appendicitis or long bone fractures in the emergency department (ED). A secondary objective was to compare the rates of complicated appendicitis as a proxy for delayed diagnosis between the groups.

Methods: This is a retrospective cohort study using the Pediatric Health Information System database. Read More

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http://dx.doi.org/10.1097/DBP.0000000000000650DOI Listing
April 2019
1 Read

Sepsis after non-perforated acute appendicitis.

Clin Case Rep 2019 Mar 6;7(3):520-523. Epub 2019 Feb 6.

Faculty of Medicine, Department of Pediatrics Lorestan University of Medical Sciences Khorramabad Iran.

Appendicitis is a worm-like appendage whose base is located on the posterior side of the inner cecum. Acute appendicitis is uncommon in children younger than 5 years old. The patient was a 1. Read More

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http://dx.doi.org/10.1002/ccr3.2030DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406223PMC
March 2019
1 Read

Comparative Effectiveness of Ceftriaxone plus Metronidazole versus Anti-Pseudomonal Antibiotics for Perforated Appendicitis in Children.

Surg Infect (Larchmt) 2019 Mar 15. Epub 2019 Mar 15.

2 Department of Pediatrics and Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Background: Appendicitis is the most common pediatric surgical emergency and one of the most common indications for antibiotic use in hospitalized children. The antibiotic choice differs widely across children's hospitals, and the optimal regimen for perforated appendicitis remains unclear.

Methods: We conducted a retrospective cohort study comparing initial antibiotic regimens for perforated appendicitis at a large tertiary-care children's hospital. Read More

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http://dx.doi.org/10.1089/sur.2018.234DOI Listing
March 2019
1 Read

Early appendectomy vs. conservative management in complicated acute appendicitis in children: A meta-analysis.

J Pediatr Surg 2019 Feb 25. Epub 2019 Feb 25.

General and Emergency Surgery dept, Bufalini Hospital, Cesena, Italy.

Background: No consensus exists among surgeons regarding the optimal treatment of complicated acute appendicitis in children (CAA). Existing studies present heterogeneity of data and only few studies analyzed free perforated appendicitis (FPA) separately from appendicular abscess (AAb) and appendicular phlegmon (AP).

Method: Studies which have been judged eligible for this systematic review and consequent meta-analysis are those comparing non-operative management (NOM) with operative management (OM) in children with CAA. Read More

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http://dx.doi.org/10.1016/j.jpedsurg.2019.01.065DOI Listing
February 2019

Diagnosis of appendicitis in the paediatric emergency department: an update.

Curr Opin Pediatr 2019 Feb 14. Epub 2019 Feb 14.

Emergency Department, Sunshine Hospital.

Purpose Of Review: Concern regarding appendicitis is a common reason for presentation to the paediatric emergency department. We review recent progress in the use of biomarkers, imaging and clinical scoring systems in improving diagnostic accuracy in suspected appendicitis in children.

Recent Findings: Use of ultrasound, often performed at the bedside, is becoming more widespread with a parallel reduction in computed tomography (CT) use. Read More

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http://dx.doi.org/10.1097/MOP.0000000000000749DOI Listing
February 2019

2018 Update on Pediatric Medical Overuse: A Review.

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

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http://dx.doi.org/10.1001/jamapediatrics.2018.5550DOI Listing
February 2019
1 Read

Does appendicitis in a child with a ventriculoperitoneal shunt necessitate shunt revision?

Arch Dis Child 2019 Feb 15. Epub 2019 Feb 15.

Department of Paediatrics, University of Oxford, Oxford, UK.

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http://dx.doi.org/10.1136/archdischild-2018-316265DOI Listing
February 2019
1 Read

Vomiting and Dehydration in a 2-Year-Old.

Pediatrics 2019 Mar 12;143(3). Epub 2019 Feb 12.

Divisions of Emergency Medicine and.

A 2-year-old girl with a past medical history of cutaneous mastocytosis and eczema presented with 1 day of yellow-green, nonbloody vomiting, bradycardia, and listlessness. She was evaluated by her pediatrician and sent to the emergency department because of concern for dehydration. In the emergency department, she improved with fluid rehydration but still had decreased energy and bradycardia. Read More

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http://dx.doi.org/10.1542/peds.2018-0504DOI Listing
March 2019
7 Reads

First-Line Diagnostic Evaluation with MRI of Children Suspected of Having Acute Appendicitis.

Radiology 2019 Apr 12;291(1):170-177. 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

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http://dx.doi.org/10.1148/radiol.2019181959DOI Listing
April 2019
6 Reads

The diagnostic value of ischaemia-modified albumin in acute abdominal pain.

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

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https://onlinelibrary.wiley.com/doi/abs/10.1111/jpc.14394
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http://dx.doi.org/10.1111/jpc.14394DOI Listing
February 2019
15 Reads

The Impact of Pediatric Surgical Specialty Meetings: A 5-year Analysis of Presented Abstracts.

J Surg Res 2019 Jun 2;238:16-22. Epub 2019 Feb 2.

Yale School of Medicine, Department of Surgery, Section of Pediatric Surgery, New Haven, Connecticut. Electronic address:

Background: Abstracts presented at the American Academy of Pediatrics Section on Surgery (AAP) and American Pediatric Surgical Association (APSA) meetings can be taken as a reasonable representation of academic activity in pediatric surgery. We sought to assess ongoing trends in pediatric surgical research by analyzing the scientific content of each association's yearly meeting.

Methods: Abstracts presented at AAP and APSA between 2009 and 2013 were identified from the final printed programs (n = 910). Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00224804183082
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http://dx.doi.org/10.1016/j.jss.2018.11.034DOI Listing
June 2019
11 Reads

Adult emergency department referrals from urgent care centers.

Am J Emerg Med 2019 Jan 17. Epub 2019 Jan 17.

Department of Emergency Medicine, Penn State Hershey Medical Center, 500 University Drive, Hershey, PA 17033, USA; Department of Pediatrics, Penn State Hershey Medical Center, 500 University Drive, Hershey, PA 17033, USA. Electronic address:

Background: Although urgent care centers (UCCs) can often evaluate and treat minor injuries/illnesses, patients may present with life threatening conditions that require immediate recognition, stabilization, and transfer to a higher level of care, beyond the capabilities of most UCCs.

Objective: To describe adult ED referrals from UCCs and to determine the percentage of referrals considered critical, complex, and simple.

Methods: A prospective study was conducted between 8/2016-8/2017 on patients >18 years referred directly to our ED from surrounding UCCs. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.029DOI Listing
January 2019
24 Reads

Accuracy of clinician gestalt in diagnosing appendicitis in children presenting to the emergency department.

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

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http://dx.doi.org/10.1111/1742-6723.13220DOI Listing
January 2019
6 Reads

Risk of Appendicitis in IgE-Mediated Allergy-Reply.

JAMA Pediatr 2019 Jan 7. Epub 2019 Jan 7.

Department of Pediatric Surgery, Children's Hospital, Skåne University Hospital, Lund, Sweden.

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http://dx.doi.org/10.1001/jamapediatrics.2018.4857DOI Listing
January 2019

Appendicitis: Role of MRI.

Authors:
Manoj K Mittal

Pediatr Emerg Care 2019 Jan;35(1):63-66

Attending Physician, Pediatric Emergency Medicine, Children's Hospital of Philadelphia; Associate Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.

The diagnosis of pediatric appendicitis can be difficult, with a substantial proportion misdiagnosed based on clinical features and laboratory tests alone. Accordingly, advanced imaging with ultrasound (US), computed tomography (CT), and/or magnetic resonance imaging has become routine for most children undergoing diagnostic evaluation for appendicitis. There is increasing interest in the use of US as the primary imaging modality and reserving CT as a secondary diagnostic modality in equivocal cases. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001710DOI Listing
January 2019
2 Reads

Utility of applying white blood cell cutoffs to non-diagnostic MRI and ultrasound studies for suspected pediatric appendicitis.

Am J Emerg Med 2018 Dec 18. Epub 2018 Dec 18.

Division of Emergency Medicine, Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA. Electronic address:

Background: Non-contrast magnetic resonance imaging (MRI) and ultrasound studies in pediatric patients with suspected appendicitis are often non-diagnostic. The primary objective of this investigation was to determine if combining these non-diagnostic imaging results with white blood cell (WBC) cutoffs improves their negative predictive values (NPVs).

Methods: A retrospective chart review was conducted including patients ≤18 years old with suspected appendicitis who had MRI performed with or without a preceding ultrasound study in a pediatric emergency department. Read More

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http://dx.doi.org/10.1016/j.ajem.2018.12.029DOI Listing
December 2018
3 Reads

Laparoscopic appendectomy - Outcomes of senior trainees operating without supervision versus experienced pediatric surgeons.

J Pediatr Surg 2019 Feb 7;54(2):276-279. 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

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http://dx.doi.org/10.1016/j.jpedsurg.2018.10.092DOI Listing
February 2019
5 Reads

Outcomes and Costs of Common Surgical Procedures at Children's and Nonchildren's Hospitals.

J Surg Res 2018 12 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

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http://dx.doi.org/10.1016/j.jss.2018.06.021DOI Listing
December 2018
19 Reads

Tuberculous colon perforation mimicking acute appendicitis: A case report and review of the literature.

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

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http://doi.wiley.com/10.1002/ccr3.1795
Publisher Site
http://dx.doi.org/10.1002/ccr3.1795DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6230600PMC
November 2018
16 Reads

Importance of Compliance Audits for a Pediatric Complicated Appendicitis Clinical Practice Guideline.

J Med Syst 2018 Nov 7;42(12):257. Epub 2018 Nov 7.

Division of Pediatric Surgery, Department of Surgery, Emory University School of Medicine, Children's Healthcare of Atlanta, 1405 Clifton Road, Atlanta, GA, 30322, USA.

Clinical practice guidelines (CPG) have been shown to decrease practice variation, reduce resource use, and improve patient outcomes. The purpose of this study was to audit compliance of a pediatric complicated appendicitis CPG to identify areas for continued improvement. A comprehensive complicated appendicitis CPG was implemented in a children's hospital system. Read More

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http://dx.doi.org/10.1007/s10916-018-1117-0DOI Listing
November 2018
2 Reads

Outcomes and costs of pediatric appendectomies at rural hospitals.

J Pediatr Surg 2019 Jan 5;54(1):103-107. Epub 2018 Oct 5.

Department of Surgery, Harbor-UCLA Medical Center, 1000 West Carson Street, Box 461, Torrance, CA 90502, USA; Department of Pediatrics, Harbor-UCLA Medical Center, 1000 West Carson Street, Box 461, Torrance, CA 90502, USA; Los Angeles Biomedical Research Institute, 1124 West Carson Street, Torrance, CA 90502, USA; Division of Pediatric Surgery, UCLA, 10833 Le Conte Ave, Box 709818, Los Angeles, CA 90095, USA. Electronic address:

Background/purpose: Despite policy efforts to support rural hospitals, little is known about the quality and safety of pediatric surgical care in geographically remote areas. Our aim was to determine the outcomes and costs of appendectomies at rural hospitals.

Methods: The Kids' Inpatient Database (2003-2012) was queried for appendectomies in children <18 years at urban and rural hospitals. Read More

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http://dx.doi.org/10.1016/j.jpedsurg.2018.10.018DOI Listing
January 2019

Assessing outcomes and costs of appendectomies performed at rural hospitals.

Am J Surg 2018 Oct 28. Epub 2018 Oct 28.

Department of Surgery, Harbor-UCLA Medical Center, 1000 West Carson Street, Box 461, Torrance, CA, 90502, USA; Department of Pediatrics, Harbor-UCLA Medical Center, 1000 West Carson Street, Box 461, Torrance, CA, 90502, USA; Los Angeles Biomedical Research Institute, 1124 West Carson Street, Torrance, CA, 90502, USA. Electronic address:

Background: The purpose of our study was to assess the outcomes and costs of appendectomies performed at rural and urban hospitals.

Methods: The National Inpatient Sample (2001-2012) was queried for appendectomies at urban and rural hospitals. Outcomes (disease severity, laparoscopy, complications, length of stay (LOS), and cost) were analyzed. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2018.10.038DOI Listing
October 2018
2 Reads

Paediatric appendiceal ultrasound: a survey of Australasian sonographers' opinions on examination performance and sonographic criteria.

J Med Radiat Sci 2018 Dec 28;65(4):267-274. Epub 2018 Oct 28.

Science and Engineering Faculty, Queensland University of Technology, Brisbane, Queensland, Australia.

Introduction: The objectives of this study were to identify knowledge gaps and/or perceived limitations in the performance of paediatric appendiceal ultrasound by Australasian sonographers. We hypothesised that: sonographers' confidence in visualising the appendix in children was poor, particularly outside predominantly paediatric practice; workplace support for prolonging examinations to improve visualisation was limited; and the sonographic criteria applied in diagnosis did not reflect contemporary literature.

Methods: A cross-sectional survey of Australasian sonographers regarding paediatric appendicitis was conducted using a mixed methods approach (quantitative and qualitative data). Read More

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http://dx.doi.org/10.1002/jmrs.310DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6275268PMC
December 2018
3 Reads

The Diagnostic Value of Irisin in Pediatric Patients with Acute Abdominal Pain.

Emerg Med Int 2018 24;2018:3296535. Epub 2018 Sep 24.

Department of Emergency Medicine, Bagcilar Research and Education Hospital, Istanbul, Turkey.

Objectives: Diagnosis of pediatric patients presenting to the Emergency Department with acute abdominal pain is not always easy. The purpose of this study was to investigate the effectiveness of irisin, a peptide hormone with reactivity shown in the appendix and neutrophils, in the differential diagnosis of pediatric patients with acute abdominal pain.

Methods: 162 subjects consenting to participate, including 112 patients presenting to the Pediatric Emergency and Pediatric Surgery clinics with acute abdominal pain and 50 controls, were enrolled in the study. Read More

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http://dx.doi.org/10.1155/2018/3296535DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6174778PMC
September 2018
6 Reads

Hidden diagnosis behind viral infection: the danger of anchoring bias.

BMJ Case Rep 2018 Oct 21;2018. Epub 2018 Oct 21.

Department of General Pediatrics and Interdisciplinary Medicine, National Center for Child Health and Development, Tokyo, Japan.

Anchoring bias is one of the most common diagnostic biases that may lead to closed-minded thinking and could result in unnecessary tests, inappropriate patient management and even misdiagnosis. A 4-year-old boy was brought to the emergency department because of shaking chills. On the basis of bilateral swollen preauricular areas, high level of serum amylase and the prevalence of mumps, he initially received a diagnosis of mumps in spite of the shaking chills. Read More

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http://dx.doi.org/10.1136/bcr-2018-226613DOI Listing
October 2018
7 Reads

Association of meteorological factors with pediatric acute appendicitis in China: A 7-year retrospective analysis.

Medicine (Baltimore) 2018 Oct;97(42):e12913

Laboratory of Stem Cell Biology and Therapy, Children's Hospital of Chongqing Medical University, 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.

Acute appendicitis (AA) affects between 7% and 8% of the world population and is one of the most common general surgical emergencies. The concept of seasonal patterns in the incidence of AA remains controversial. Thus, this study aimed to investigate whether meteorological factors are related to variations in the rate of pediatric AA cases at the Children's Hospital in Chongqing, China. Read More

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http://dx.doi.org/10.1097/MD.0000000000012913DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6211853PMC
October 2018
15 Reads

Reliability of ultrasonography and the Alvarado scoring system in acute appendicitis.

Turk J Pediatr 2018 ;60(2):173-179

Departments of Pediatrics, The University of Health Sciences, Umraniye Research and Training Hospital, İstanbul,Turkey.

Yazar AS, Erdoğan S, Şahin C, Güven Ş. Reliability of ultrasonography and the Alvarado scoring system in acute appendicitis. Turk J Pediatr 2018; 60: 173-179. Read More

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http://www.turkishjournalpediatrics.org/doi.php?doi=10.24953
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http://dx.doi.org/10.24953/turkjped.2018.02.009DOI Listing
January 2018
14 Reads

Implementing a surgeon-reported categorization of pediatric appendicitis severity.

Pediatr Surg Int 2018 Dec 13;34(12):1281-1286. Epub 2018 Oct 13.

Division of Pediatric Surgery, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Surgical Outcomes and Quality Improvement Center (SOQIC), Northwestern University Feinberg School of Medicine, 633 N. St. Clair Street, 20th Floor, Chicago, IL, 60611, USA.

Purpose: The purpose of this study was to implement a novel surgeon-reported categorization (SRC) for pediatric appendicitis severity and determine if SRC was associated with outcomes.

Methods: We conducted a retrospective review of appendectomies by 15 surgeons within a single center from January to December 2016. The SRC was defined as: simple (category 1), gangrenous or adherent (category 2A), perforation with localized abscess (category 2B), and perforation with gross contamination (category 2C). Read More

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http://link.springer.com/10.1007/s00383-018-4364-8
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http://dx.doi.org/10.1007/s00383-018-4364-8DOI Listing
December 2018
10 Reads

Gene Expression Signatures Can Aid Diagnosis of Sexually Transmitted Infection-Induced Endometritis in Women.

Front Cell Infect Microbiol 2018 20;8:307. Epub 2018 Sep 20.

Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.

Sexually transmitted infection (STI) of the upper reproductive tract can result in inflammation and infertility. A biomarker of STI-induced upper tract inflammation would be significant as many women are asymptomatic and delayed treatment increases risk of sequelae. Blood mRNA from 111 women from three cohorts was profiled using microarray. Read More

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https://www.frontiersin.org/article/10.3389/fcimb.2018.00307
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http://dx.doi.org/10.3389/fcimb.2018.00307DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6158555PMC
September 2018
7 Reads

Assessment of proadrenomedullin as diagnostic or prognostic biomarker of acute appendicitis in children with acute abdominal pain.

Am J Emerg Med 2018 Sep 26. Epub 2018 Sep 26.

Pediatric Emergency Department, General and University Hospital of Tajo, Avenida Amazonas Central, s/n, 28300 Aranjuez, Madrid, Spain.

Background: Acute appendicitis (AA) is one of the most frequent surgical pathologies in pediatrics.

Objectives: To investigate the utility of proadrenomedullin (pro-ADM) for the diagnosis of AA.

Methods: Prospective, analytical, observational, and multicenter study conducted in 6 pediatric emergency departments. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07356757183079
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http://dx.doi.org/10.1016/j.ajem.2018.09.038DOI Listing
September 2018
25 Reads

Perforated appendicitis in children: antimicrobial susceptibility and antimicrobial stewardship.

J Glob Antimicrob Resist 2019 Mar 27;16:159-161. Epub 2018 Sep 27.

Department of Microbiology, Bezmialem Vakif University Medical Faculty, Istanbul, Turkey.

Objectives: For perforated appendicitis in children, microbiological cultures should always be sought if an adequate sample is available. Knowledge of local epidemiology is important for optimal selection of antimicrobial therapy. The aim of this study was to evaluate the aetiology and susceptibility of pathogens in paediatric patients with perforated appendicitis. Read More

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http://dx.doi.org/10.1016/j.jgar.2018.09.015DOI Listing
March 2019
5 Reads

Pediatric Conditions Requiring Interfacility Transport From Emergency Departments: A Statewide Study of Regionalization.

Pediatr Emerg Care 2018 Sep 11. Epub 2018 Sep 11.

Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.

Objectives: Pediatric care is increasingly regionalized, increasing rates of interfacility transport (IFT). However, it is unknown what conditions most frequently require IFT. This study's objective was to identify high-frequency pediatric conditions requiring IFT. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001578DOI Listing
September 2018
3 Reads

Pediatric Malpractice Claims in the Emergency Department and Urgent Care Settings From 2001 to 2015.

Pediatr Emerg Care 2018 Sep 11. Epub 2018 Sep 11.

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

Objectives: This study aimed to provide an assessment of medical malpractice claims involving pediatric patients cared for in emergency department and urgent care settings.

Methods: We performed a retrospective review of all closed malpractice claims involving children (0-17 years old) originating from emergency department or urgent care centers from the Physician Insurers Association of America's Data Sharing Project database for a 15-year period (2001-2015). Reported data collected include medical specialty involved, medical diagnoses, chief medical factors, severity of resulting injury, claim disposition, average indemnity, and average defense costs. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001602DOI Listing
September 2018
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Utilization of Imaging to Identify a Benign Condition Mimicking Acute Appendicitis in a Child.

J Investig Med High Impact Case Rep 2018 Jan-Dec;6:2324709618797989. Epub 2018 Aug 31.

Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA.

One of the most concerning causes of abdominal pain affecting children is acute appendicitis. However, there are benign conditions that can closely mimic appendicitis in children. In this article, we present a case of a child admitted for possible acute appendicitis and determined to have a condition known as omental infarction. Read More

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http://dx.doi.org/10.1177/2324709618797989DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6120172PMC
August 2018
4 Reads

Empyema Due to Thoracic Migrating Appendicolith.

Indian Pediatr 2018 07;55(7):603-604

Department of Paediatrics, CHILDS Trust Medical Research Foundation, Kanchi Kamakoti CHILDS Trust Hospital, Chennai, India.

Background: Retained appendicolith following appendicectomy, and can cause recurrent abscess in the abdomen and retroperitoneum.

Case Characteristics: 11-yr-old boy who presented with subpulmonic abscess and pneumonia following appendicectomy for perforated appendicitis.

Observation: Thoracotomy revealed a thick walled subpulmonic abscess surrounding an appendicolith along with a rent in the posterolateral aspect of the diaphragm. Read More

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July 2018
5 Reads

Immediate surgery or conservative treatment for complicated acute appendicitis in children? A meta-analysis.

J Pediatr Surg 2018 Jul 27. Epub 2018 Jul 27.

Department of Paediatric Surgery, Attikon University General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.

Purpose: This study carried out a meta-analysis to compare immediate surgery (IS) with conservative treatment (CT) of complicated acute appendicitis (CAA) in children.

Methods: Systematic literature research was performed for relevant studies published from 1969 to date. Trials of IS compared with CT were included. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00223468183047
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http://dx.doi.org/10.1016/j.jpedsurg.2018.07.017DOI Listing
July 2018
7 Reads

Improving imaging strategies in pediatric appendicitis: a quality improvement initiative.

J Surg Res 2018 10 25;230:131-136. Epub 2018 May 25.

Division of Pediatric Surgery, Department of Surgery, University of Alabama at Birmingham, Children's of Alabama, Birmingham, Alabama. Electronic address:

Background: Data from the American College of Surgeons National Surgical Quality Improvement Program identified our hospital as an outlier for preoperative computed tomography (CT) use in the diagnosis of acute appendicitis in children. We performed a quality improvement project to reduce this utilization in favor of ultrasound-based diagnoses (ultrasonography [US]) through creation and implementation of an evidence-based appendicitis algorithm.

Methods: Over a 2-y period (1 y preceding and 1 y following institution of the algorithm), the clinical information of all pediatric patients operated on for suspicion of acute appendicitis following imaging studies in our institution was collated. Read More

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http://dx.doi.org/10.1016/j.jss.2018.04.043DOI Listing
October 2018
2 Reads

Association of IgE-Mediated Allergy With Risk of Complicated Appendicitis in a Pediatric Population.

JAMA Pediatr 2018 Oct;172(10):943-948

Department of Pediatric Surgery, Children's Hospital, Skåne University Hospital, Lund, Sweden.

Importance: Childhood appendicitis is commonly complicated by gangrene and perforation, yet the causes of complicated appendicitis and how to avoid it remain unknown.

Objective: To investigate whether children with IgE-mediated allergy have a lower risk of complicated appendicitis.

Design, Setting, And Participants: This retrospective cohort study included all consecutive patients younger than 15 years (hereinafter referred to as children) who underwent appendectomy for acute appendicitis at a tertiary pediatric surgery center in Sweden between January 1, 2007, through July 31, 2017. Read More

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http://dx.doi.org/10.1001/jamapediatrics.2018.1634DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6233766PMC
October 2018
26 Reads

Effects of ambient air pollution exposure on frequency of hospital admissions for appendicitis in Taipei, Taiwan.

J Toxicol Environ Health A 2018 26;81(17):854-860. Epub 2018 Jul 26.

b Department of Public Health, College of Health Sciences , Kaohsiung Medical University , Kaohsiung , Taiwan.

The relationship between exposure to ambient air pollutants and hospital admissions for appendicitis is not known. This study examined whether an association existed between air contaminant levels and frequency of hospital admissions for appendicitis in Taipei, Taiwan. Ambient air pollution and hospital admission data for Taipei were obtained for 2009-2013. Read More

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http://dx.doi.org/10.1080/15287394.2018.1498276DOI Listing
July 2018
15 Reads

Ascaridial Volvulus: An Uncommon Cause of Ileal Perforation.

Iran J Med Sci 2018 Jul;43(4):432-435

Department of Pediatrics, CSI Kalyani Multispeciality Hospital, Mylapore, Chennai, India.

Ascariasis is a common worm infestation in developing and under-developed countries. It is caused by the ingestion of food contaminated with Ascaris eggs from faeces and is more common in places with poor sanitation. Almost 25% of the world population is infested by Ascaris lumbricoides. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6055212PMC
July 2018
11 Reads

Improving the value of ultrasound in children with suspected appendicitis: a prospective study integrating secondary sonographic signs.

Ultrasonography 2019 Jan 7;38(1):67-75. Epub 2018 May 7.

Science and Engineering Faculty, Queensland University of Technology, Brisbane, Australia.

Purpose: The purpose of this study was to determine whether the awareness and inclusion of secondary sonographic signs of appendicitis, in combination with a structured evaluation as part of engagement and training for sonographers, improved appendix visualization rates and reduced equivocal findings in children with suspected acute appendicitis.

Methods: This was a prospective study of 230 children at a tertiary children's hospital in Australia referred for an ultrasound examination of suspected appendicitis. The ultrasound findings, radiology reports, histology, clinical results, and follow-up were collated. Read More

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http://dx.doi.org/10.14366/usg.17062DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6323308PMC
January 2019
9 Reads

Diagnostic performance of CT for pediatric patients with suspected appendicitis in various clinical settings: a systematic review and meta-analysis.

Emerg Radiol 2018 Dec 12;25(6):627-637. Epub 2018 Jul 12.

Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.

Objective: To assess the diagnostic performance of CT for pediatric patients with suspected appendicitis in various clinical settings and the proportion of acute appendicitis on final diagnosis among equivocal CT findings.

Methods: MEDLINE and EMBASE databases were searched until October 21, 2017, for studies investigating diagnostic performance of CT for acute appendicitis in pediatric patients confirmed by histopathologic findings and/or clinical follow-up. Pooled estimates of sensitivity and specificity were calculated using a hierarchical logistic regression modeling. Read More

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http://dx.doi.org/10.1007/s10140-018-1624-9DOI Listing
December 2018
16 Reads

C-reactive protein expression in adipose tissue of children with acute appendicitis.

Pediatr Res 2018 10 10;84(4):564-567. Epub 2018 Jul 10.

Lipid Laboratory, IIS-Fundación Jiménez Díaz, UAM, Madrid, Spain.

Objective: The aim of this study is to gain insights into the role of visceral adipose tissue as a source of C-reactive protein (CRP) in acute inflammation and to explore the potential relationship of CRP expression with the severity of appendicitis.

Methods: A total of 20 pediatric patients undergoing appendectomy were included in the study. Patients were divided into two groups according to appendicitis severity (uncomplicated and complicated). Read More

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http://dx.doi.org/10.1038/s41390-018-0091-zDOI Listing
October 2018
21 Reads

Conversion from laparoscopic to open appendectomy: decreased risk at dedicated children's hospitals.

Pediatr Surg Int 2018 Aug 20;34(8):873-877. Epub 2018 Jun 20.

Phoenix Children's Hospital, Phoenix, AZ, USA.

Purpose: The advent of laparoscopy has revolutionized surgical practice within the last 30 years. Conversion to open surgery, however, remains necessary at times, even for the most experienced laparoscopic surgeon.

Methods: The kids' inpatient database was analyzed for 2006, 2009, and 2012 for patients who underwent laparoscopic appendectomy and conversion to open (CPT 470. Read More

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http://dx.doi.org/10.1007/s00383-018-4297-2DOI Listing
August 2018
4 Reads

Hospital type predicts computed tomography use for pediatric appendicitis.

J Pediatr Surg 2019 Apr 29;54(4):723-727. Epub 2018 May 29.

McGovern Medical School, University of Texas Health Sciences Center at Houston, Department of Pediatric Surgery, Houston, TX; Children's Memorial Hermann Hospital, Houston, TX; Center for Surgical Trials and Evidence-Based Practice (C-STEP), Houston, TX.

Background: Evidence-based guidelines recommend ultrasound (US) over computed tomography (CT) as the primary imaging modality for suspected pediatric appendicitis. Continued high rates of CT use may result in significant unnecessary radiation exposure in children. The purpose of this study was to evaluate variables associated with preoperative CT use in pediatric appendectomy patients. Read More

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http://dx.doi.org/10.1016/j.jpedsurg.2018.05.018DOI Listing
April 2019
5 Reads

Acute Appendicitis: A Meta-Analysis of the Diagnostic Accuracy of US, CT, and MRI as Second-Line Imaging Tests after an Initial US.

Radiology 2018 Sep 19;288(3):717-727. Epub 2018 Jun 19.

From the Department of Diagnostic Imaging (K.A.E., A.A., C.L., Y.K.L.), Hospital Library and Archives (T.A.W.), Division of Pediatric Emergency Medicine (S.S.), and Department of Diagnostic Imaging (A.S.D.), The Hospital for Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Departments of Family and Community Medicine (R.M.), Pediatrics (S.S.), and Medical Imaging (A.S.D.), University of Toronto, Toronto, Canada.

Purpose To evaluate the sensitivity, specificity, and diagnostic odds ratios of US, CT, and MRI as second-line imaging modalities after initial US for assessing acute appendicitis in children and adults. Materials and Methods A literature search was conducted in Medline and Embase to identify articles that used surgery or histopathologic examination alone or in combination with clinical follow-up or chart review to evaluate the diagnostic accuracy of second-line imaging modalities. The quality of articles was assessed by using the Quality Assessment of Diagnostic Accuracy Studies-2 and the Standards for Reporting of Diagnostic Accuracy tools. Read More

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http://dx.doi.org/10.1148/radiol.2018180318DOI Listing
September 2018
28 Reads