Acute appendicitis

Baird, D.; Simillis, Constantinos; Kontovounisios, Christos; Rasheed, Shahnawaz; Tekkis, Paris

doi:10.1136/bmj.j1703

Cited by 148 publications

(133 citation statements)

References 36 publications

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“…The patients' time of this new type of appendicitis was much longer (4.7 day on average for Tibetan students) than that of sporadic appendicitis. Some study showed that patients' time of 12, 24 and 36 hours increased relative risk for perforated appendicitis 23 .…”

Section: Discussionmentioning

confidence: 99%

“…9 The infectious etiology, differential diagnosis and management for perforated appendicitis and non-perforated appendicitis are current hot topics. [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] Since the appendix is connected to cecum which is exposed to the environment outside of human body, appendicitis can be caused by different etiologies. Therefore, appendicitis should not be only one entity, but a group of different entities.…”

Section: Introductionmentioning

confidence: 99%

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Demonstration of four entities of appendicitis in China through studying cluster/outbreak

Guo

Yang

et al. 2020

Preprint

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Objective:To differentiate different entities of appendicitis through studying cluster/outbreak, ascertain common setting of cluster/outbreak, and provide the epidemiological evidences of infectious etiology of appendicitis.Background: Differential diagnosis and management for perforated appendicitis and non-perforated appendicitis and the infectious etiology of appendicitis are current hot topics.Methods: Field investigation for Tibetan students were carried out and reports published in English and Chinese medical journals were reviewed. Results:The literature review included 473 patients in 7 cluster/outbreaks of appendicitis in 6 provinces and autonomous regions. All the clusters/outbreaks occurred in group living units. We found two classic entities of appendicitis with natural history from nonperforated appendicitis to perforated appendicitis and two entities of non-perforated appendicitis. In classic entities, one may represent majority of sporadic patients and the other may represent partial sporadic patients with obvious gastrointestinal manifestation.In entities of non-perforated appendicitis, one was identical to features of sporadic nonperforated appendicitis and the other one is identical to the following Tibetan students and associated with Fusobacterium.The field investigation for 120 Tibetan students with appendicitis showed that the resected appendices exhibited diffuse or focal hemorrhages and infiltration by eosinophils and by lymphocytes. Most patients had normal body temperature, white blood cell count and neutrophil count. This is a new entity of appendicitis.All rights reserved. No reuse allowed without permission.author/funder, who has granted medRxiv a license to display the preprint in perpetuity. : medRxiv preprint 3The clusters/outbreaks of appendicitis showed the features of infectious disease in epidemiology. The entity of perforated appendicitis was not found. Conclusion:Studying cluster/outbreak is a good method to differentiate different entities of appendicitis and infectious etiology.All rights reserved. No reuse allowed without permission.author/funder, who has granted medRxiv a license to display the preprint in perpetuity. : medRxiv preprint . Cluster/outbreak often results from common cause, therefore almost every patient in cluster/outbreak belongs to the same entity and appeared in certain stage of same entity.Connecting each stage, we can know full natural histories of different entities and accordingly demonstrate whether or not perforated appendicitis and non-perforated appendicitis are different entities. All rights reserved. No reuse allowed without permission. author/funder, who has granted medRxiv a license to display the preprint in perpetuity. : medRxiv preprint METHODS Epidemiological, Clinical and Pathological InvestigationField investigation of cluster/outbreak was carried out according to Reingold AL's methods 35 and literature review was carried out to find the other cluster/outbreak. All rights reserved. No reuse allowed without permission. author/funder, who...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Demonstration of four entities of appendicitis in China through studying cluster/outbreak

Guo

Yang

et al. 2020

Preprint

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“…This is particularly true where the appendix is retrocaecal or retroileal. 4 Delay in diagnosis and treatment results in increased rate of perforation, morbidity, mortality and hospital stay. 5 Moreover, radiological modalities like computerized tomography (CT) scan abdomen and ultrasonography (USG) abdomen are effective to supplement the diagnosis of acute appendicitis, both modalities have lower sensitivity in detecting perforated appendicitis.…”

Section: Introductionmentioning

confidence: 99%

Elevated serum bilirubin in acute appendicular perforation as a newer serum marker: a diagnostic validation test

Goudar

Kanchan

2020

Int Surg J

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Background: Acute appendicitis is the commonest cause of acute surgical abdomen. Appendicectomy is the most frequently performed urgent abdominal operation and is often the first major procedure performed by a surgeon in training. Delay in diagnosis and treatment results in increased rate of perforation, morbidity, mortality and hospital stay.Methods: A prospective study where a total of 100 patients with clinical, radiological and histopathological diagnosis of acute appendicitis or appendicular perforation were studied. The liver function tests were carried out in all the patients.Results: In a study group of 100 patients (74 males and 26 females); 59 cases were acute appendicitis and 41 cases were appendiceal perforation proven histopathological. Out of which 48 cases had elevated serum bilirubin levels i.e., 17 in acute appendicitis group and 31 in appendicular perforation group. The mean serum total bilirubin is 1±0.4 in acute appendicitis cases and 1.9±1.13 in the appendicular perforation cases. Similarly, the sensitivity and specificity of elevated serum bilirubin as a diagnostic marker in appendicular perforation was found to be 75.6% and 71.2% respectively.Conclusions: Elevated serum bilirubin levels appears to be a promising new supplemental diagnostic serum marker in Appendicular Perforation and perhaps be a decision-making investigation.

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“…Surgical appendectomy is needed for AA and non-operative conservative treatment, such as bowel rest and/or antibiotics is usually used for uncomplicated diverticulitis. [4][5][6][7] Nevertheless, ARCD is often misdiagnosed as AA and was revealed during invasive surgery. [3,8] Computer tomography (CT) or ultrasound can be used as a diagnostic imaging tool to avoid unnecessary surgical exploration or for ARCD mimicking AA, but it has the disadvantage of radiation exposure and cost.…”

Section: Introductionmentioning

confidence: 99%

Clinical difference between acute appendicitis and acute right-sided colonic diverticulitis

Song

Lee

et al. 2020

Preprint

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Background: The clinical presentations of acute appendicitis (AA) and acute right-sided colonic diverticulitis (ARCD) are similar, but the usual treatment for each disease differs between surgical and conservative management. This study aimed to identify the clinical differences between AA and ARCD.Method: We performed a single-center retrospective case-control study on adult patients with AA and ARCD confirmed by computed tomography who had visited an emergency department between March 2018 and February 2019. The clinical variables, including past medical history, presented symptoms and signs, and laboratory findings were compared between the two groups. We subsequently performed a logistic regression analysis for differentiating ARCD from AA based on the results of univariate analyses.Results: A total of 222 (79%) and 59 (21%) patients were enrolled in the AA and ARSD groups, respectively. Logistic regression analysis revealed that factors associated with ARCD were a past history of diverticulitis [OR 141.691 (95% CI: 12.222 – 1642.601), p < 0.001], ketonuria [OR 0.268 (95% CI: 0.099 – 0.726), p = 0.010], anorexia [OR 0.037 (95% CI: 0.007 – 0.207), p < 0.001], and neutrophilia [OR 0.179 (95% CI: 0.062 – 0.519), p = 0.002].Conclusion: Anorexia, neutrophilia, and ketonuria were predictors of AA and a history of diverticulitis was a predictor of ARCD.

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Acute appendicitis

Cited by 148 publications

References 36 publications

Demonstration of four entities of appendicitis in China through studying cluster/outbreak

Demonstration of four entities of appendicitis in China through studying cluster/outbreak

Elevated serum bilirubin in acute appendicular perforation as a newer serum marker: a diagnostic validation test

Clinical difference between acute appendicitis and acute right-sided colonic diverticulitis

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