Investigation and management of suspected appendicitis during the COVID-19 pandemic

English, William; Bedwani, N Habib; Smith, Christopher C.; Shatkar, V

doi:10.1002/bjs.11787

Cited by 19 publications

(23 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, the usually low rate of very complicated cases of appendicitis does not allow an uncritical extrapolation of the current results to other surgical emergencies. A comparison with the international literature shows some parallels regarding a reduction in appendectomies [ 13 , 14 ], a later presentation, and an increased inflammatory reaction [ 5 , 15 – 18 , 20 , 31 ]. The international survey of Ielpo et al of more than 700 surgeons worldwide reported a decrease of appendicitis and an increase of complicated cases based on a questionnaire [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…Appendicitis represents the most common emergency diagnosis in abdominal surgery and can be used to examine the effects of the COVID-19 pandemic on general emergency surgery [ 9 – 12 ]. Initial reports, editorials, and smaller, mostly single-center studies have shown a decreasing number of clinically treated appendicitis cases [ 4 , 13 , 14 ] and an increase in disease severity [ 5 , 15 – 18 ]. There has been no sufficient explanation for this phenomenon, since the incidence and severity of acute appendicitis do not appear to be related to the current pandemic or to the imposition of social restrictions.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Appendicitis during the COVID-19 lockdown: results of a multicenter analysis in Germany

Willms

Oldhafer

Conze

et al. 2021

Langenbecks Arch Surg

View full text Add to dashboard Cite

Purpose The COVID-19 pandemic has transformed medical care worldwide. General surgery has been affected in elective procedures, yet the implications for emergency surgery are unclear. The current study analyzes the effect of the COVID-19 lockdown in spring 2020 on appendicitis treatment in Germany. Methods Hospitals that provided emergency surgical care during the COVID-19 lockdown were invited to participate. All patients diagnosed with appendicitis during the lockdown period (10 weeks) and, as a comparison group, patients from the same period in 2019 were analyzed. Clinical and laboratory parameters, intraoperative and pathological findings, and postoperative outcomes were analyzed. Results A total of 1915 appendectomies from 41 surgical departments in Germany were included. Compared to 2019 the number of appendectomies decreased by 13.5% (1.027 to 888, p= 0.003) during the first 2020 COVID-19 lockdown. The delay between the onset of symptoms and medical consultation was substantially longer in the COVID-19 risk group and for the elderly. The rate of complicated appendicitis increased (58.2 to 64.4%), while the absolute number of complicated appendicitis decreased from 597 to 569, ( p= 0.012). The rate of negative appendectomies decreased significantly (6.7 to 4.6%; p= 0.012). Overall postoperative morbidity and mortality, however, did not change. Conclusion The COVID-19 lockdown had significant effects on abdominal emergency surgery in Germany. These seem to result from a stricter selection and a longer waiting time between the onset of symptoms and medical consultation for risk patients. However, the standard of emergency surgical care in Germany was maintained. Supplementary Information The online version contains supplementary material available at 10.1007/s00423-021-02090-3.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Appendicitis during the COVID-19 lockdown: results of a multicenter analysis in Germany

Willms

Oldhafer

Conze

et al. 2021

Langenbecks Arch Surg

View full text Add to dashboard Cite

show abstract

“…In an attempt to avoid the risks of surgical intervention during the COVID-19 pandemic [ 6 ], non-operative management with antibiotics has been suggested as a treatment option [ 14 , 15 ]. Preliminary data from our single centre was encouraging, with those managed non-operatively having shorter length of stay (LOS) [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Suspected appendicitis and COVID-19, a change in investigation and management—a multicentre cohort study

English

Bedwani

Smith

et al. 2020

Langenbecks Arch Surg

Self Cite

View full text Add to dashboard Cite

“…This has caused new challenges for healthcare systems, including those associated with the management of surgical emergencies. Changes in the epidemiology, diagnosis and treatment of appendicitis during the pandemic also deserve attention ( Table 1 ) 1–9 .…”

mentioning

confidence: 99%

Acute appendicitis during the COVID-19 lockdown: never waste a crisis!

Podda

Pata

Pellino

et al. 2021

British Journal of Surgery

View full text Add to dashboard Cite

1. Whilst the number of Covid-19 cases increases, fewer patients present with appendicitis to the emergency department, and those who do, present with more advanced disease. 2. These findings are consistent with the hypothesis of a pre-hospital selection, with high rates of successful resolution of uncomplicated appendicitis following patients self-medication with antibiotics at home. 3. Patients admitted with suspected appendicitis during the pandemic are more likely to undergo preoperative imaging, which possibly explains the fall in negative appendectomy rate, especially in the UK.

show abstract

Investigation and management of suspected appendicitis during the COVID-19 pandemic

Cited by 19 publications

References 7 publications

Appendicitis during the COVID-19 lockdown: results of a multicenter analysis in Germany

Appendicitis during the COVID-19 lockdown: results of a multicenter analysis in Germany

Suspected appendicitis and COVID-19, a change in investigation and management—a multicentre cohort study

Acute appendicitis during the COVID-19 lockdown: never waste a crisis!

Contact Info

Product

Resources

About