Akute Appendizitis - Wandel in Epidemiologie, Diagnostik und Therapie

Sahm, Maik; Pross, M.; Lippert, H.

doi:10.1055/s-0030-1247477

Cited by 32 publications

(18 citation statements)

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“…The perforation rate in the setting of acute appendicitis was 12.12%, which is similar to other studies published in Western Europe. 12 The main difference in demographics was the increased rate of perforation in men (14.64%) compared with females (9.52%). The ratio of acute appendicitis patients between genders was approximately 1:1.…”

Section: Discussionmentioning

confidence: 99%

The value of biochemical markers in predicting a perforation in acute appendicitis

McGowan

Sims

Zia

et al. 2012

ANZ Journal of Surgery

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Background: Acute appendicitis is the most common surgical diagnosis of abdominal pain. Perforated appendicitis can result in increased morbidity and mortality. Identifying a perforation early can reduce the impact on the patient. Bilirubin, C-reactive protein (CRP) and white cell count (WCC) have been shown to indicate perforation in appendicitis. This study aimed to identify whether these biochemical markers can be used to identify if patients are suitable for either a conservative or surgical approach. Methods: A retrospective post hoc analysis of all appendicectomies over a 6-year period investigating the association between preoperative bilirubin, CRP, WCC, and neutrophil count and the histological findings of either the presence or lack of a perforation. Results: One thousand two hundred seventy-one patients had appendicitis, 154 (12.12%) of which were perforated upon histological examination. All biochemical markers were significantly higher in perforation (P < 0.001). The greatest sum of sensitivity and specificity of CRP was at 34.6 mg/L (sensitivity 78.57%, specificity 63.01%), and for bilirubin was at 21.5 mmol/L (sensitivity 62.96%, specificity 88.31%). Combining CRP and bilirubin improved sensitivity and specificity, but this was reduced by further incorporating WCC and neutrophils. Logistic regression analysis identified CRP as the most sensitive marker of perforation (odds ratio (OR) = 1.064 (1.043-1.085) ) (P < 0.001), with bilirubin (OR = 1.005 (1.003-1.008) ) also significant (P < 0.001) for a 1-unit increase. Conclusion: Bilirubin and CRP are markers of perforation in appendicitis, but are not accurate enough to be diagnostic. In a patient with high clinical suspicion of acute appendicitis, a raised CRP and bilirubin suggests that a patient is not suitable for conservative treatment.

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Section: Discussionmentioning

confidence: 99%

The value of biochemical markers in predicting a perforation in acute appendicitis

McGowan

Sims

Zia

et al. 2012

ANZ Journal of Surgery

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“…Daher ist eine aktuelle Analyse des Verbreitungsgrades der klassischen und laparoskopischen Operationstechnik im klinischen Alltag ein interessanter Sachverhalt. Wie viele Erkrankungsbilder unterliegt auch die Appendizitis einem Wandel in der Epidemiologie, der Diagnostik und der Therapie [2]. Mc Burney implementierte 1894 den Wechselschnitt im rechten Unterbauch zur Appendektomie und stellte mit seinem operativen Zugang fast 100 Jahre einen bewährten Standard [3].…”

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Akute Appendizitis - Klinische Versorgungsforschung zur aktuellen chirurgischen Therapie

et al. 2012

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“…Therefore much interest exists in finding ways to diagnose and estimate the extent of acute appendicitis before relying on radiological test [11]. A simple cheap biochemical test that is specific for acute appendicitis useful in conjunction with clinical finding in predicting diagnosis of appendicitis or appendicitis with its complication needs to be evaluated for surgical decision [12,13].…”

Section: Inroductionmentioning

confidence: 99%

Liver function test as a marker for acute appendicitis

Yadav¹,

Chandra²

2016

Janaki Med. Coll. J. Med. Sci.

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Background and Objectives: Acute appendicitis is one of the commonest surgical emergencies of the abdomen worldwide. Even with the availability of current imaging investigation like USG , CT scan and MRI, the diagnosis is still a problem. Delay in diagnosis increases mortality and morbidity. Liver function test is one of the biochemical parameters being assessed as a marker of acute appendicitis and may also predict the severity of the inflammation. However the available literature is limited and views are conflicting. In this study, it is proposed to access the validity of using liver function test to predict the appendicitis and its severity. Material and Methods:This is a prospective study of 80 cases of operated patients of acute appendicitis in Universal College Of Medical Sciences, Bhairahawa, Nepal during the period from 6th May 2013 to 6th July 2014. Data were collected from the patient by their clinical history, examination and investigations, Liver function test and ultrasound. Post operative follow up was done to note for complications and histopathology findings. Data collection was compiled in a systemic way in preformed proforma and analyzed. Results:Out of 80 patients, 44(55%) were male and 36(45%) were female. Total serum bilirubin was elevated in 29 (36.25%) of the patients. Rise in serum bilirubin was mixed type with direct bilirubin Predominance. In Liver enzymes ALT, AST, ALP were raised in 32.5%, 28.75% and 82.5% respectively. Hyperbilirubinemia has the specificity (80 %) sensitivity (37.33%) with good positive predictive value of 96.55%. Similarly sensitivity and specificity of direct bilirubin (90.67%, 20.00%), Indirect bilirubin (16.00%, 80%), AST/SGOT (30.67%, 100%), ALT/SGPT (34.67%, 100%) ALP (84.00%, 40%) respectively. The positive predictive value for direct bilirubin, indirect bilirubin, AST/SGOT, ALT/SGPT and ALP are 94.44%,92.31%,100%,100% and 95.45% respectively. Conclusion:Liver function test is a marker for acute appendicitis and its complication with a good positive predictive value. Liver function test should be used together with clinical examination and other laboratory investigations in the assessment of patients with suspected acute Appendicitis. Key words: Acute appendicitis, Liver function test, Conclusion:Otomycosis is one of the most common presenting problems in otorhinolaryngology OPD. Females are affected more. Aspergillus niger implicated the most and ear itching is the most common presenting symptom.

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Akute Appendizitis - Wandel in Epidemiologie, Diagnostik und Therapie

Cited by 32 publications

References 18 publications

The value of biochemical markers in predicting a perforation in acute appendicitis

The value of biochemical markers in predicting a perforation in acute appendicitis

Akute Appendizitis - Klinische Versorgungsforschung zur aktuellen chirurgischen Therapie

Liver function test as a marker for acute appendicitis

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