Distinguishing between acute appendicitis and appendiceal mucocele: is this possible preoperatively?

Saylam, Barış; Güldoğan, Cem Emir; Çoşkun, Faruk; Vural, Veli; Çomçalı, Bülent; Tez, Mesut

doi:10.1007/s00068-013-0321-3

Cited by 8 publications

(9 citation statements)

References 22 publications

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“…Although it is reported that half of the patients are asymptomatic [12,13], our study reveals that clinical features on presentation included abdominal pain, abdominal distention, abdominal mass and hematochezia. A number of Appendiceal mucocele patients were misdiagnosed as acute appendicitis [14,15]. However, only 3 of 51 patients in our study was found to have tenderness and rebound pain typical of acute appendicitis.…”

Section: Discussioncontrasting

confidence: 57%

Analysis of Clinical Characteristics of Low-Grade Appendiceal Mucinous Neoplasm (LAMN): A Retrospective Cohort Study of 51 LAMN Patients

Xiao

Liu

2020

Journal of Investigative Surgery

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Introduction: Low-grade appendiceal mucinous neoplasm (LAMN) is a rare disorder. There is no consensus on the prognosis and management of LAMN. Materials and methods: We reviewed 51 consecutive patients with LAMN from 2013 to 2018. We divided our patients into two groups. The first is patients with an intact appendix. The second group comprises patients with the potential to develop a malignant condition. Comparisons of serum tumor markers between two groups were performed. Survival curves were estimated. Univariate and multivariate Cox proportional hazards were computed for 46 patients with median follow-up of 2.7 years. Results: Comparison of patients in two groups revealed significant differences in the mean level and abnormal ratio of CA125 (p < 0.001, p < 0.001), CA19-9 (p ¼ 0.04, p ¼ 0.04), and CEA (p ¼ 0.001, p ¼ 0.02). Eight patients had relapsed by the last follow-up in the second group. Patients with normal CEA had significantly longer disease-free survival (DFS) time than those with abnormal CEA (p ¼ 0.04). CA19-9 exhibited a significant association with DFS (HR ¼ 5.72, p ¼ 0.02) in the Univariate Cox proportional hazards. Discussion: The prognosis of LAMN is related to serum tumor markers, the surgical procedure and the pathology.

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Section: Discussioncontrasting

confidence: 57%

Analysis of Clinical Characteristics of Low-Grade Appendiceal Mucinous Neoplasm (LAMN): A Retrospective Cohort Study of 51 LAMN Patients

Xiao

Liu

2020

Journal of Investigative Surgery

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“…On this basis, the authors assigned a point to each of these factors (large appendiceal diameter, low WBC count and presence of microscopic haematuria) resulting in a predictive score and a stratification of patients into three groups (Score I: 0 points; Score II: 1 points; Score III: ≥2 points). The scoring system for patients with ≥2 points was proven to have an area under the curve (AUC) of 0.855 using a receiver-operating characteristic curve with a sensitivity of 73.33% and a specificity of 89.87% 6. Of note, the patient we presented had an appendiceal diameter of 40×60 mm (by CT scan), a WBC count of 9900/mm 3 and a preoperative urine sample documenting 4 erythrocytes/µL.…”

Section: Discussionmentioning

confidence: 89%

The appropriate management of an appendiceal mucocele

et al. 2015

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Appendicectomy is one of the most commonly performed surgical procedures. Appendiceal mucocele is a relative rare disease, but appropriate management is critical. Indeed, the intact removal of a mucocele represents a curative treatment; conversely, a rupture may result in the spread of epithelial cells throughout the peritoneal cavity (pseudomyxoma peritonei). We report a case of a 61-year-old woman, admitted to our department, who underwent resection of an appendiceal mucocele, focusing, in the discussion, on the clinical and surgical management of this disease.

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“…These findings suggest that treatment delays are predominantly influenced by factors within the healthcare system that can be further mitigated with improved professional education and streamlining of administrative processes. Considering the well-documented challenges involved in evaluation of peritoneal malignancies given their significant heterogeneity, varying nature of initial presentation and overall rare occurrence ( 14 , 15 , 17 , 31 – 34 ), healthcare professionals at large would benefit from better awareness on the initial presentations, appropriate evaluation strategies and treatment options for peritoneal malignancies. Additionally, treatment delays incurred here are also contributed at least in part by patients’ failure to recognize symptoms that suggest underlying peritoneal malignancies which resulted in delayed presentation to primary care.…”

Section: Discussionmentioning

confidence: 99%

Incidence and outcomes of delayed presentation and surgery in peritoneal surface malignancies

et al. 2023

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BackgroundPeritoneal surface malignancies (PSM) present insidiously and often pose diagnostic challenges. There is a paucity of literature quantifying the frequency and extent of therapeutic delays in PSM and its impact on oncological outcomes.MethodsA review of a prospectively maintained registry of PSM patients undergoing Cytoreductive Surgery and Hyperthermic Intra-peritoneal Chemotherapy (CRS-HIPEC) was conducted. Causes for treatment delays were identified. We evaluate the impact of delayed presentation and treatment delays on oncological outcomes using Cox proportional hazards models.Results319 patients underwent CRS-HIPEC over a 6-years duration. 58 patients were eventually included in this study. Mean duration between symptom onset and CRS-HIPEC was 186.0 ± 37.1 days (range 18-1494 days) and mean duration of between patient-reported symptom onset and initial presentation was 56.7 ± 16.8 days. Delayed presentation (> 60 days between symptom onset and presentation) was seen in 20.7% (n=12) of patients and 50.0% (n=29) experienced a significant treatment delay of > 90 days between 1st presentation and CRS-HIPEC. Common causes for treatment delays were healthcare provider-related i.e. delayed or inappropriate referrals (43.1%) and delayed presentation to care (31.0%). Delayed presentation was a significantly associated with poorer disease free survival (DFS) (HR 4.67, 95% CI 1.11-19.69, p=0.036).ConclusionDelayed presentation and treatment delays are common and may have an impact on oncological outcomes. There is an urgent need to improve patient education and streamline healthcare delivery processes in the management of PSM.

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Distinguishing between acute appendicitis and appendiceal mucocele: is this possible preoperatively?

Cited by 8 publications

References 22 publications

Analysis of Clinical Characteristics of Low-Grade Appendiceal Mucinous Neoplasm (LAMN): A Retrospective Cohort Study of 51 LAMN Patients

Analysis of Clinical Characteristics of Low-Grade Appendiceal Mucinous Neoplasm (LAMN): A Retrospective Cohort Study of 51 LAMN Patients

The appropriate management of an appendiceal mucocele

Incidence and outcomes of delayed presentation and surgery in peritoneal surface malignancies

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