Prospective nationwide outcome audit of surgery for suspected acute appendicitis

Rossem, Charles C. van; Bolmers, Matthijs D M; Schreinemacher, M. H. F.; Geloven, A. A. W. van; Bemelman, Willem A.

doi:10.1002/bjs.9964

Cited by 93 publications

(87 citation statements)

References 19 publications

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“…In our study, only one patient had laparoscopic appendectomy. The perforation rate on histology 12 was 16.8% and this is comparable to report but higher than 6 the report published in the literature and in that study, 2,13 perforation was found in 11.0%. Reports have shown higher 14 rate of perforation.…”

Section: Morbidity and Mortality Most Common Complication Was Surgicasupporting

confidence: 80%

“…SSI was the most common complication seen in 12.6% of patients 15 2 comparable to the report and lower than the report . The median length of the hospital stay was 8 days and this is higher 6 than the report . For the 17 patients who developed Superficial SSI, median length of hospital stay was 10 days and for the 4 patients who developed deep SSI, the median length of hospital stay was 12.5 days.…”

Section: Morbidity and Mortality Most Common Complication Was Surgicacontrasting

confidence: 64%

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Audit of Surgery For Acute Appendicitis in National Medical College and Teaching Hospital, Birgunj

Yadav

Bhatt

NathMishra

et al. 2017

J. Nepalgunj Med. College

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Background: Acute appendicitis is one of the most common surgical emergencies in the world. The purpose of this study is to know clinical profile and outcome of surgery in patients with acute appendicitis. Materials and methods: This retrospective study was done in National Medical college and Teaching Hospital, Birgunj, Nepal from 2013 April to 2016 April. A total of 184 patients with suspected appendicitis who underwent surgery were included in the study. Patient's demographics, clinical features, white blood cell count, operative findings, histology report and outcome of surgery were recorded on patient's proforma. Results: Among 184 nd patients, 115 were males (62.5%) and 69 were females (37.5%). The majority of our patients were in the 2 decade (36.4%) followed rd by 3 decade (33.2%) with only 41.3% presenting within 24 hours of onset of symptoms. The most common symptoms were abdominal pain (100%), vomiting (68.5%), fever (37.5%) and history of migration of pain was present in 60.9%. Localized and generalized abdominal tenderness were present in 91.8% and 8.2% respectively. The most common incisions were gridiron (64.1%) and Lanz (27.2%). The negative appendicectomy rate was 9.2%. Acute appendiceal inflammation and gangrenous appendicitis was present in 69% and 4.9% respectively. The perforation rate was 16.8%. Post operative complications included surgical site infection (12.6%), complete wound dehiscence (1.1%) and chest infection (1.6%). The median length of hospital stay was 8 days. There was no mortality. Conclusion: Acute appendicitis is more commonly seen in young adults. Majority of patients present late in hospital. This delay presentation increases morbidity and treatment cost.

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Section: Morbidity and Mortality Most Common Complication Was Surgicasupporting

confidence: 80%

Section: Morbidity and Mortality Most Common Complication Was Surgicacontrasting

confidence: 64%

Audit of Surgery For Acute Appendicitis in National Medical College and Teaching Hospital, Birgunj

Yadav

Bhatt

NathMishra

et al. 2017

J. Nepalgunj Med. College

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“…ultrasound, CT or MRI) in cases of suspected appendicitis has significantly reduced the incidence of a normal appearing appendix encountered during surgery [136]. Macroscopic distinction between a normal appendix and appendicitis during surgery can be difficult [137, 138].…”

Section: Intra-operative Proceduresmentioning

confidence: 99%

Diagnosis and management of acute appendicitis. EAES consensus development conference 2015

et al. 2016

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Unequivocal international guidelines regarding the diagnosis and management of patients with acute appendicitis are lacking. The aim of the consensus meeting 2015 of the EAES was to generate a European guideline based on best available evidence and expert opinions of a panel of EAES members. After a systematic review of the literature by an international group of surgical research fellows, an expert panel with extensive clinical experience in the management of appendicitis discussed statements and recommendations. Statements and recommendations with more than 70 % agreement by the experts were selected for a web survey and the consensus meeting of the EAES in Bucharest in June 2015. EAES members and attendees at the EAES meeting in Bucharest could vote on these statements and recommendations. In the case of more than 70 % agreement, the statement or recommendation was defined as supported by the scientific community. Results from both the web survey and the consensus meeting in Bucharest are presented as percentages. In total, 46 statements and recommendations were selected for the web survey and consensus meeting. More than 232 members and attendees voted on them. In 41 of 46 statements and recommendations, more than 70 % agreement was reached. All 46 statements and recommendations are presented in this paper. They comprise topics regarding the diagnostic work-up, treatment indications, procedural aspects and post-operative care. The consensus meeting produced 46 statements and recommendations on the diagnostic work-up and management of appendicitis. The majority of the EAES members supported these statements. These consensus proceedings provide additional guidance to surgeons and surgical residents providing care to patients with appendicitis. Electronic supplementary materialThe online version of this article (doi:10.1007/s00464-016-5245-7) contains supplementary material, which is available to authorized users.

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“…Surgical treatment of acute cholecystitis or appendicitis, is known to be associated with a higher risk of late abscess formation, due to retained stones in the abdominal cavity/wall or contamination of the wound at the time of surgery, respectively[5,6]. The differential diagnosis of a non-healing sinus includes tuberculosis, malignancy, presence of foreign bodies and communication with abdominal organs to the skin surface.…”

Section: Discussionmentioning

confidence: 99%

Intra-abdominal abscess and intractable sinus - a rare late complication after splenectomy

Shrestha

Hampton

2017

WJCC

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Intra-abdominal abscess and an intractable abdominal wall sinus forty years after splenectomy is rare, which has not been described previously in the surgical literature. We report the management of a patient who had presented with an intractable sinus on his left hypochondrium forty years after having undergone splenectomy and cholecystectomy, which persisted for more than two years despite repeated surgery and courses of antibiotics and compromised quality of life significantly from pain. A sinogram and computerised tomographic scan followed by exploration and laying open of the sinus delivered multiple silk sutures used for ligation of splenic pedicle, led to complete resolution of the sinus. It is important to avoid using non-absorbable silk sutures during splenectomy when splenectomy is undertaken in a contaminated field. Appropriate imaging and exploration is mandatory for its resolution.

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Prospective nationwide outcome audit of surgery for suspected acute appendicitis

Cited by 93 publications

References 19 publications

Audit of Surgery For Acute Appendicitis in National Medical College and Teaching Hospital, Birgunj

Audit of Surgery For Acute Appendicitis in National Medical College and Teaching Hospital, Birgunj

Diagnosis and management of acute appendicitis. EAES consensus development conference 2015

Intra-abdominal abscess and intractable sinus - a rare late complication after splenectomy

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