Acute appendicitis in children: Emergency department diagnosis and management

Rothrock, Steven G.; Pagane, Joseph

doi:10.1067/mem.2000.105658

Cited by 346 publications

(317 citation statements)

References 134 publications

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“…In children CRP values aid in the diagnosis of perforated appendicitis. Whether LC may discriminate simple from perforated appendicitis in the pediatric population remains uncertain [9][10][11][12][13]. Despite previous investigations it remains unclear whether LC, CRP levels and Erythrocyte Sedimentation Rate (ESR) levels combined with body temperature and duration of abdominal pain have a predictive value in diagnosing a perforated appendicitis in unselected patient groups.…”

Section: Introductionmentioning

confidence: 99%

Comparative Study of Acute and Perforated Appendicitis

Akhil¹

2017

MOJS

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Introduction: The aim of this study was to create a model for the identification of a perforated appendicitis. Patients and Method:All consecutive patients who have undergone an appendectomy in the DY Patil Medical Hospital, Pune between January 1, 2015 and July 31, 2017 were included in a retrospective cohort study. Baseline patient characteristics, history and laboratory data were collected. Variables discriminating perforated from non-perforated appendicitis were identified using univariate and multivariable analyses. These items were used to create a model to predict perforation.Results: A total of 498 patients were included in the study. In the univariate analysis leukocyte count (LC), C-Reactive Protein levels (CRP), Erythrocyte Sedimentation Rate levels (ESR), days of symptoms and temperature were identified as predictors of perforated appendicitis. A predictive model was created using CRP, LC, ESR, duration of abdominal pain, and temperature. The predicted probability (P) of a perforated appendicitis can be calculated from the following model: (P) = 1 / (1+e (-(-2.788 + 0.012* CRP + 0.207* days with complaints))). Conclusion:Perforation of appendicitis can be predicted from the CRP level and the duration of abdominal pain. These findings might influence the choice between conservative or surgical treatment of appendicitis, and could provide guidance in the early start of antibiotics. Keywords:

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Section: Introductionmentioning

confidence: 99%

Comparative Study of Acute and Perforated Appendicitis

Akhil¹

2017

MOJS

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“…[4][5][6] The global incidence of appendicitis in children increases from 1-2 cases per 10,000 children aged less than 4 years to 25 cases per 10,000 in children between the ages of 10 and17 years. 7 In the United States of America, the annual incidence of appendicitis is 37 cases per 10,000 children aged between 0 and 14 years 8 with approximately 70,000 cases reported among all American children annually. 9 In the United Kingdom, acute appendicitis accounts for an estimated 34,000 hospital admissions among the general population with 20% of these cases (approximately 6,800) reported to be in children of 0-14 years of age.…”

Section: Introductionmentioning

confidence: 99%

Is magnetic resonance imaging a viable alternative to ultrasound as the primary imaging modality in the diagnosis of paediatric appendicitis? A systematic review

2016

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yesBackground: Appendicitis is the most common cause of acute abdominal pain requiring surgical intervention\ud in paediatric patients. Ultrasound is generally the diagnostic imaging modality of choice, followed\ud by CT, where paediatric appendicitis is suspected. However, high operator dependency and\ud diagnostic restrictions related to anatomical and clinical presentation may limit consistency of application.\ud This paper explores whether MRI is a viable alternative to ultrasound as the primary imaging\ud modality.\ud Method: A systematic review of the literature was undertaken. A search of Medline, Cinahl, PubMed\ud Central and Google Scholar was undertaken supplemented by a review of reference lists, author\ud searching and review of NICE evidence base for existing guidelines. Included studies were assessed for\ud bias using the QUADAS-2 quality assessment tool and data were extracted systematically using a purposefully\ud designed electronic data extraction proforma.\ud Results: Seven studies were included in final review. The age range of participants extended from 0 to 19\ud years. Only one study with a patient age range of 0e14 used sedation. Sensitivity estimates from the\ud included studies ranged from 92% to 100% while specificity ranged from 89% to 100%. A significant\ud variation in the number and type of sequences was noted between the studies.\ud Conclusion: MRI offers high sensitivity and specificity comparable to contrast enhanced CT and greater\ud than ultrasound as reported in the literature. Where accessibility is not a restriction, MRI is a viable\ud alternative to ultrasound in the assessment and diagnosis of paediatric appendicitis. Clinical practice\ud recommendations have been provided to facilitate the translation of evidence into practice.Funding info requested 17/03/201

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“…Trata-se da principal causa de cirurgia abdominal de urgência na infância e adolescência, sendo diagnosticada em aproximadamente 250 mil casos por ano nos Estados Unidos. Entre 8% de crianças que apresentam dor abdominal aguda, em 1% diagnostica-se a apendicite aguda (17) .…”

Section: Discussionunclassified

Estado nutricional de crianças e adolescentes hospitalizados em enfermaria de cirurgia pediátrica

Simões

Palchetti

Patin³

et al. 2010

Rev. paul. pediatr.

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OBJETIVO: Avaliar o estado nutricional, o tempo de internação e as especialidades clínicas de pacientes internados na enfermaria de Cirurgia Pediátrica do Hospital São Paulo da Unifesp-EPM. MÉTODOS: Estudo transversal retrospectivo, com 749 crianças e adolescentes de ambos os gêneros acompanhados por equipe interdisciplinar durante o período de agosto de 2007 a julho de 2008. Foram coletados dados antropométricos, dias de internação e procedimento cirúrgico segundo a especialidade. Para a classificação do estado nutricional, utilizou-se o escore Z do índice de massa corporal (Z IMC) e da estatura/idade (Z E/I) segundo a curva da Organização Mundial de Saúde (OMS, 2007). As crianças foram classificadas segundo diagnóstico estabelecido previamente à cirurgia. Utilizou-se o programa STATA 8.0 para análise dos dados e aplicou-se o teste ANOVA e comparações múltiplas de Bonferroni, considerando-se significante p<0,05. RESULTADOS: A mediana de idade foi sete anos (0 a 18), predominando o gênero masculino (59%) e as internações para cirurgia otorrinolaringológica (18%). Dos pacientes internados, 66% tinham estatura adequada para idade, 43% eutróficos e 31% obesos/sobrepeso. Os pacientes desnutridos permaneceram mais dias internados quando comparados aos obesos/sobrepeso (7,2 versus 4,1 dias; p=0,035). Os lactentes apresentaram maior tempo de internação (p=0,006) e menor valor de Z IMC, comparados aos outros grupos etários (p=0,001). Os lactentes com programação de cirurgia cardíaca apresentaram Z IMC menor em relação às demais especialidades (p=0,002). CONCLUSÕES: O perfil dos pacientes internados condiz com a atual transição nutricional, aumento da prevalência de obesidade concomitante à desnutrição. Entretanto, a desnutrição ainda constitui fator agravante para a permanência hospitalar

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Acute appendicitis in children: Emergency department diagnosis and management

Cited by 346 publications

References 134 publications

Comparative Study of Acute and Perforated Appendicitis

Comparative Study of Acute and Perforated Appendicitis

Is magnetic resonance imaging a viable alternative to ultrasound as the primary imaging modality in the diagnosis of paediatric appendicitis? A systematic review

Estado nutricional de crianças e adolescentes hospitalizados em enfermaria de cirurgia pediátrica

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