Appendiceal phlegmon in adults: Do we know how to manage it yet?

Panahi, Pedram; Ibrahim, Rashid; Veeralakshmanan, Pushpa; Ackah, James; Coleman, Mark

doi:10.1016/j.amsu.2020.08.033

Cited by 4 publications

(3 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A conservative approach is the first option in patients with plastron appendicitis. However, the presence of tumors and inflammatory bowel diseases that can mimic appendicitis should be investigated with colonoscopy and computed tomography (CT) imaging in healed patients[ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Is omentectomy necessary in the treatment of benign or malignant abdominal pathologies? A systematic review

Atay¹,

Dılek²

2021

WJGS

View full text Add to dashboard Cite

BACKGROUND The omentum is an organ that is easily sacrificed during abdominal surgery. The scope of omentectomy and whether a routine omentectomy should be performed are still unknown. AIM To review the literature in order to determine the physiological functions of the omentum and the roles it plays in pathological events in order to reveal the necessity for removal and preservation of the omentum. METHODS A clinical review of the English language literature based on the MEDLINE (PubMed) database was conducted using the keywords: “abdomen”, “gastrointestinal”, “tumor”, “inflammation”, “omental flap”, “metastasis”, “omentum”, and “omentectomy”. In addition, reports were also identified by systematically reviewing all references in retrieved papers. RESULTS The omentum functions as a natural barrier in areas where pathological processes occur in the abdominal cavity. The omentum limits and controls inflammatory and infectious pathologies that occur in the abdomen. It also aids in treatment due to its cellular functions including lymphatic drainage and phagocytosis. It shows similar behavior in tumors, but it cannot cope with increasing tumor burden. The stage of the disease changes due to the tumor mass it tries to control. Therefore, it is considered an indicator of poor prognosis. Due to this feature, the omentum is one of the first organs to be sacrificed during surgical procedures. However, there are many unknowns regarding the role and efficacy of the omentum in cancer. CONCLUSION The omentum is a unique organ that limits and controls inflammatory processes, foreign masses, and lesions that develop in the abdominal cavity. Omental flaps can be used in all anatomical areas, including the thorax, abdomen, pelvis, and extremities. The omentum is an organ that deserves the title of the abdominal policeman. It is generally accepted that the omentum should be removed in cases where there is tumor invasion. However, the positive or negative contribution of omental resection in the treatment of abdominal pathologies should be questioned.

show abstract

Section: Discussionmentioning

confidence: 99%

Is omentectomy necessary in the treatment of benign or malignant abdominal pathologies? A systematic review

Atay¹,

Dılek²

2021

WJGS

View full text Add to dashboard Cite

show abstract

“…While cecal ligation and puncture (CLP) is a well-established model for sepsis [ 30 , 31 , 32 ], the information on cecal ligation model is still very scare. Indeed, ligation of the cecal appendix is an easy procedure to induce the retention of necrotic tissue inside the intra-abdominal space of mice which usually surround by the greater omentum (adipose tissue) as a mechanism for the control of infection similar to phlegmon appendicitis in patients [ 33 ]. Notably, both the human appendix (from the terminal end of the cecum) and the cecal appendage in rodents are located at the junction of the ileum and cecum; the human appendix is a narrow extension that is an evolutionary vestige, whereas the rodent cecal appendage is very large [ 34 ].…”

Section: Introductionmentioning

confidence: 99%

Lacticaseibacillus rhamnosus dfa1 Attenuate Cecal Ligation-Induced Systemic Inflammation through the Interference in Gut Dysbiosis, Leaky Gut, and Enterocytic Cell Energy

Tongthong

Kaewduangduen

Phuengmaung

et al. 2023

IJMS

View full text Add to dashboard Cite

Despite an uncommon condition, the clinical management of phlegmon appendicitis (retention of the intra-abdominal appendiceal abscess) is still controversial, and probiotics might be partly helpful. Then, the retained ligated cecal appendage (without gut obstruction) with or without oral Lacticaseibacillus rhamnosus dfa1 (started at 4 days prior to the surgery) was used as a representative model. At 5 days post-surgery, the cecal-ligated mice demonstrated weight loss, soft stool, gut barrier defect (leaky gut using FITC-dextran assay), fecal dysbiosis (increased Proteobacteria with reduced bacterial diversity), bacteremia, elevated serum cytokines, and spleen apoptosis without kidney and liver damage. Interestingly, the probiotics attenuated disease severity as indicated by stool consistency index, FITC-dextran assay, serum cytokines, spleen apoptosis, fecal microbiota analysis (reduced Proteobacteria), and mortality. Additionally, impacts of anti-inflammatory substances from culture media of the probiotics were demonstrated by attenuation of starvation injury in the Caco-2 enterocyte cell line as indicated by transepithelial electrical resistance (TEER), inflammatory markers (supernatant IL-8 with gene expression of TLR4 and NF-κB), cell energy status (extracellular flux analysis), and the reactive oxygen species (malondialdehyde). In conclusion, gut dysbiosis and leaky-gut-induced systemic inflammation might be helpful clinical parameters for patients with phlegmon appendicitis. Additionally, the leaky gut might be attenuated by some beneficial molecules from probiotics.

show abstract

“…Cuatro artículos describieron el tiempo hasta la cirugía, que osciló entre 52 y 78 días, con una media de 63 ± 11 días. (Karaca et al, 2001) (Panahi et al, 2020). Ningún paciente tenía una neoplasia apendicular diagnosticada antes de la operación y la incidencia general fue extremadamente baja.…”

Section: Introductionunclassified

Complicaciones tempranas, sistémicas y posquirúrgicas en masa apendicular

et al. 2023

View full text Add to dashboard Cite

El tratamiento quirúrgico de la masa apendicular es controversial. Objetivos: Estimar la prevalencia de las complicaciones postoperatorias y describir si hay o no relación de causalidad entre las técnicas quirúrgicas y las complicaciones posoperatorias en masa apendicular. Material y métodos: Estudio observacional descriptivo, prospectivo de corte trasversal, en donde se incluyeron pacientes con diagnóstico de masa apendicular sometidos a cirugía en el Hospital Regional ISSSTE Puebla durante 2020-2022. Resultados: Se diagnosticaron 486 pacientes con apendicitis aguda. La incidencia de masa apendicular fue de 20.9% (102/ 486), el manejo fue quirúrgico en el 100% de estos pacientes. La técnica quirúrgica que se asoció mayor mortalidad fue la Ileocequectomía con Ileostomía (2%) y la que se asoció con mayor complicación temprana, posquirúrgica y sistémica fue Cierre Primario Mas Parche De Epiplón (41 (40%), 36(35%); 28 (27%), respectivamente). La diferencia de frecuencias fue analizada con Chi cuadrada y los marcadores séricos y antropométricos fueron analizados con Prueba de Kruskal-Wallis. Conclusión: Las características cínicas y las técnicas quirúrgicas en la cirugía de masa apendicular se relacionan con determinadas complicaciones, así como mortalidad. Es necesario el abordaje personalizado para evaluar el tratamiento y para determinar el tipo de técnica quirúrgica.

show abstract

Appendiceal phlegmon in adults: Do we know how to manage it yet?

Cited by 4 publications

References 11 publications

Is omentectomy necessary in the treatment of benign or malignant abdominal pathologies? A systematic review

Is omentectomy necessary in the treatment of benign or malignant abdominal pathologies? A systematic review

Lacticaseibacillus rhamnosus dfa1 Attenuate Cecal Ligation-Induced Systemic Inflammation through the Interference in Gut Dysbiosis, Leaky Gut, and Enterocytic Cell Energy

Complicaciones tempranas, sistémicas y posquirúrgicas en masa apendicular

Contact Info

Product

Resources

About