Risk factors for gastric distension in patients with acute appendicitis: a retrospective cohort study

Kimura, Yoshinobu; Yamauchi, M.; Inoue, Hirokazu; Kimura, Saori; Yamakage, Michiaki; Aimono, Mako; Sumita, Shinichi

doi:10.1007/s00540-012-1353-2

Cited by 1 publication

(3 citation statements)

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“…The incidence was higher in younger patients and those with a longer duration of abdominal pain [5]. A subsequent ultrasound study conducted in a mixed adult-paediatric population with acute appendicitis found that 62% of patients had an empty stomach before surgery, for which the probability increased with the duration of fasting [6].…”

Section: Discussionmentioning

confidence: 97%

“…The incidence was higher in younger patients and those with a longer duration of abdominal pain [5]. A subsequent ultrasound study conducted in a mixed adult–paediatric population with acute appendicitis found that 62% of patients had an empty stomach before surgery, for which the probability increased with the duration of fasting [6]. Finally, in a recent study comparing pre‐operative gastric contents of adults with uncomplicated acute appendicitis with those of controls (adults scheduled for elective non‐abdominal surgery), gastric ultrasound showed that only 18% of patients had at‐risk gastric contents after 6 h of fasting, which was not significantly different from controls [7].…”

Section: Discussionmentioning

confidence: 99%

“…This hypothesis is based on the likelihood of delayed gastric emptying due to numerous physiological factors, including ileus, pain and anxiety [2,3], which is potentially aggravated by the administration of opioid analgesics [4]. There is, however, increasing evidence that only a small proportion of adults with acute appendicitis have gastric contents comporting a significant risk of pulmonary aspiration [5][6][7]. The real incidence of such gastric contents in children with the same pathology has, to our knowledge, never been specifically studied.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound assessment of gastric contents in children before general anaesthesia for acute appendicitis

et al. 2022

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Summary There is increasing evidence that a minority of adults with acute appendicitis have gastric contents, posing an increased risk of pulmonary aspiration. This study aimed to evaluate the proportion of children with acute appendicitis who have gastric contents considered to pose a higher risk of pulmonary aspiration. We analysed point‐of‐care gastric ultrasound data routinely collected in children before emergency appendicectomy in a specialist paediatric hospital over a 30‐month period. Based on qualitative and quantitative antral assessment in the supine and right lateral decubitus positions, gastric contents were classified as ‘higher‐risk’ (clear liquid with calculated gastric fluid volume > 0.8 ml.kg−1, thick liquid or solid) or ‘lower‐risk’ of pulmonary aspiration. The 115 children studied had a mean (SD) age of 11 (3) years; 37 (32%; 95%CI: 24–42%) presented with higher‐risk gastric contents, including 15 (13%; 95%CI: 8–21%) with solid/thick liquid contents. Gastric contents could not be determined in 13 children as ultrasound examination was not feasible in the right lateral decubitus position. No cases of pulmonary aspiration occurred. This study shows that gastric ultrasound is feasible in children before emergency appendicectomy. This technique showed a range of gastric content measurements, which could contribute towards defining the risk of pulmonary aspiration.

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Section: Discussionmentioning

confidence: 97%