Systematic review of nonoperative versus operative treatment of uncomplicated appendicitis

Gorter, Ramon R.; Gorter-Stam, Marguerite; Eker, Hasan Hüseyin; Bakx, Roel; Lee, Johanna H. van der; Heij, Hugo A.

doi:10.1016/j.jpedsurg.2017.04.005

Cited by 44 publications

(24 citation statements)

References 26 publications

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“…The idea of interval appendectomy or nonoperative management for acute appendicitis has recently become popular in the field of pediatrics [24]. The indications for this approach are expanding, and some institutes perform interval appendectomy in both perforated and nonperforated cases.…”

Section: Discussionmentioning

confidence: 99%

Torsion of vermiform appendix: case report and review of the literature

et al. 2020

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Background: Torsion of the vermiform appendix is a rare disease with symptoms very similar to those of acute appendicitis. We herein report a case of torsion of the vermiform appendix diagnosed by intraoperative findings. Case presentation: A 4-year-old boy presented to our hospital because of abdominal pain and vomiting. Laboratory data revealed a C-reactive protein level of 0.08 mg/dL and white blood cell count of 19,300/μL (neutrophils, 88.9%). Abdominal ultrasound showed a target sign-like finding in the ileocecal region. A computed tomography scan showed swelling of the appendix. We performed an emergency operation under suspicion of acute appendicitis. Laparoscopic examination showed that the appendix had twisted 720°in the clockwise direction. Appendectomy was performed, and the postoperative course was uneventful. Conclusions: Although torsion of the vermiform appendix is a very rare disease and difficult to differentiate from appendicitis, an inappropriate treatment plan could lead to necrosis and perforation of the appendix. It is important to consider this disease as a differential diagnosis in patients with right lower abdominal pain.

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Section: Discussionmentioning

confidence: 99%

Torsion of vermiform appendix: case report and review of the literature

et al. 2020

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“…NOM avoided an appendectomy in 62-81% of children after 1-year follow-up. The authors concluded that NOM can avoid an appendectomy in a large majority of children after 1-year follow-up but evidence was insufficient to suggest NOM in all children with uncomplicated AA [121].…”

Section: Q22: Is Non-operative Management With or Without Antibiotimentioning

confidence: 98%

Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

et al. 2020

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Background and aims: Acute appendicitis (AA) is among the most common causes of acute abdominal pain. Diagnosis of AA is still challenging and some controversies on its management are still present among different settings and practice patterns worldwide. In July 2015, the World Society of Emergency Surgery (WSES) organized in Jerusalem the first consensus conference on the diagnosis and treatment of AA in adult patients with the intention of producing evidence-based guidelines. An updated consensus conference took place in Nijemegen in June 2019 and the guidelines have now been updated in order to provide evidence-based statements and recommendations in keeping with varying clinical practice: use of clinical scores and imaging in diagnosing AA, indications and timing for surgery, use of nonoperative management and antibiotics, laparoscopy and surgical techniques, intra-operative scoring, and perioperative antibiotic therapy.

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“…The effectiveness of antibiotics has been reported for the treatment of SA in children, . A meta‐analysis showed that initial antibiotic treatment of SA was comparable with appendectomy, with a high rate of success, and treatment with antibiotics alone was not associated with increased complications .…”

Section: Discussionmentioning

confidence: 99%

“…Despite its high incidence, it is sometimes difficult to make an accurate diagnosis of appendicitis . The effectiveness of antibiotics has been reported for the treatment of simple appendicitis (SA) in children . To select the appropriate therapy, it is important to accurately distinguish between SA and complicated appendicitis (CA).…”

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confidence: 99%

Usefulness of the pediatric appendicitis score for assessing the severity of acute appendicitis in children

Fujii

Tanaka

Katami

et al. 2020

Pediatrics International

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Background: We investigated relationships between the Pediatric Appendicitis Score (PAS) and pathological progression and disease severity in pediatric acute appendicitis. Methods: We retrospectively evaluated 72 children who underwent surgery for acute appendicitis. We divided them into groups: simple appendicitis (n = 28) or complicated appendicitis (n = 44). We compared the influence of age, body temperature, blood test findings, hospitalization period, number of complications, and PAS between the groups. We calculated the sensitivity, specificity, positive predictive value, and negative predictive value of the PAS for diagnosing complicated appendicitis. A receiver operating characteristic curve was constructed to evaluate the cut-off value for diagnosing complicated appendicitis. To assess the severity of acute appendicitis, we divided the patients into groups according to that cut-off value. Results: There were statistically significant differences in the PAS between simple appendicitis and complicated appendicitis (5.8 versus 7.9). The receiver operating characteristic curve indicated a PAS cut-off value of 8. A PAS ≥ 8 had a sensitivity of 73%, a specificity of 89%, a positive predictive value of 91%, and a negative predictive value of 68%. A PAS ≥ 8 was associated with significantly longer hospitalization and more complications than a PAS < 8. Conclusions: The PAS may be associated with pathological progression and disease severity in appendicitis.

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Systematic review of nonoperative versus operative treatment of uncomplicated appendicitis

Cited by 44 publications

References 26 publications

Torsion of vermiform appendix: case report and review of the literature

Torsion of vermiform appendix: case report and review of the literature

Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

Usefulness of the pediatric appendicitis score for assessing the severity of acute appendicitis in children

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