Diagnostic Value of C-Reactive Protein and the Influence of Visceral Fat in Patients With Obesity and Acute Appendicitis

Castro, Adham do Amaral e; Skare, Thelma Larocca; Yamauchi, Fernando Ide; Tachibana, Adriano; Ribeiro, Suheyla Pollyana Pereira; Fonseca, Eduardo Kaiser Ururahy Nunes; Sakuma, Andressa Tamy; Peixoto, Milena Rocha; Rodrigues, Mariana Athaniel Silva; Barreiros, Maria Angela M.

doi:10.1590/0102-672020180001e1339

Cited by 6 publications

(8 citation statements)

References 26 publications

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“…However, the modern understanding of the pathogenesis of acute appendicitis suggests that mechanical factors leading to direct lumen obstructions are likely exceptions. The most recent theories regarding the pathogenesis of acute appendicitis involve complex genetic and environmental factors ( 19 - 21 ) . To our knowledge, our study is the first to look for mechanical factors that could be associated with acute appendicitis in an accessible way (via abdominal CT).…”

Section: Discussionmentioning

confidence: 99%

Morphologic criteria of vermiform appendix on computed tomography and a possible risk of developing acute appendicitis

et al. 2019

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Objective: To evaluate the correlation of morphological criteria of the cecal appendix using computed tomography (CT) and the possible risk of developing acute appendicitis. Materials and Methods: Cases were defined as patients with surgically confirmed acute appendicitis who had undergone CT at least twice: at diagnosis and at least one month prior. Controls were defined as emergency patients with abdominal pain who had undergone abdominal CT that excluded acute appendicitis and had also undergone CT at least one month before. Results: 100 cases and 100 controls were selected for inclusion in the final analysis. Comparisons between the cases and controls revealed the following: mean transverse diameter of 0.6 cm (range, 0.4-1.0 cm) versus 0.6 cm (range, 0.6-0.8 cm; p = 0.37); mean length of 6.6 cm (range, 3.5-9.7 cm) versus 6.6 cm (range, 4.5-8.3 cm; p = 0.87); mean angle of 100° (range, 23-178°) versus 86° (range, 43-160°; p = 0.01); vertical descending orientation in 56% versus 45% (p = 0.2); absence of gas in 69% versus 77% (p = 0.34); and presence of an appendicolith in 17% versus 8% (p = 0.08). Conclusion: Hypothetical risk factors for obstruction of the vermiform appendix detected on CT were not associated with acute appendicitis. That suggests that factors other than those related to mechanical obstruction are implicated in the pathogenesis of acute appendicitis.

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Section: Discussionmentioning

confidence: 99%

Morphologic criteria of vermiform appendix on computed tomography and a possible risk of developing acute appendicitis

et al. 2019

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“…The final diagnosis is usually based on clinical history, physical examination, and related laboratory and imaging tests 6,17. Early diagnosis of AA is essential for reducing morbidity and mortality associated with advanced stages of the disease. Therefore, imaging tests such as ultrasound (US) and tomography are often used to clarify the diagnosis of AA 2,3 . However, performing routine imaging tests for patients with abdominal pain can mean an increase in hospital costs and the length of stay of patients in the emergency care units, until the definitive conduct 13,14 .…”

Section: Introductionmentioning

confidence: 99%

“…Does the drop in portal pressure after esophagogastric devascularization and splenectomy variation of variceal calibers and the rebleeding rates in schistosomiasis in late follow-up? Walter de Biase SILVA-NETO1 , Claudemiro QUIRESE 1 , Eduardo Guimarães Horneaux de MOURA 2 , Fabricio Ferreira COELHO 3 , Paulo HERMAN3 …”

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confidence: 99%

“…A comparação entre a queda de pressão portal e as taxas de ressangramento, também evidenciar se apenas a terapia endoscópica, ou operações menos complexas poderão controlar o sangramento das varizes.Evolução do calibre das varizes no período pré e pósoperatório precoce e tardioMensagem centralA desconexão ázigo-portal e esplenectomia apresenta importante impacto na diminuição precoce do calibre das varizes esofágicas na esquistossomose; entretanto, parece que a associação com a terapia endoscópica é a maior responsável pelo controle da recidiva hemorrágica.instagram.com/revistaabcd/ twitter.com/revista_abcd facebook.com/Revista-ABCD-109005301640367 linkedin.com/company/revista-abcd 1/4 ABCD Arq Bras Cir Dig 2022;35:e1686 Perspectives The use of Appendicitis Inflammatory Response (AIR) score reduced the waiting time for the diagnosis of acute appendicitis, decreased the number of imaging tests, and increased diagnostic specificity of the disease.Central MessageEarly diagnosis of acute appendicitis is essential for reducing morbidity and mortality associated with advanced stages of the disease. Therefore, imaging tests such as ultrasound and tomography are often used to clarify the diagnosis of acute appendicitis[2,3]. However, performing routine imaging tests for patients with abdominal pain can mean an increase in hospital costs and the length of stay of patients in the emergency care units, until the definitive conduct.AIR: Appendicitis Inflammatory Response; USG: ultrasonography/CT: computed tomography.…”

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confidence: 99%

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The Appendicitis Inflammatory Response Score for Acute Appendicitis: Is It Important for Early Diagnosis?

DEBONI

ROSA

Lima

et al. 2022

ABCD, arq. bras. cir. dig.

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- BACKGROUND: The use of Appendicitis Inflammatory Response clinical score in patients with suspected acute appendicitis makes the diagnosis more objective and accurate. AIMS: The aim of this study was to prospectively compare two groups with suspected acute appendicitis, analyzing the number of imaging tests requested, waiting time in the emergency department, until definition of conduct, as well as the sensitivity and specificity of this diagnostic method. METHODS: This is a prospective randomized study comparing 55 patients submitted to clinical-radiological diagnosis according to the routine of the service (control group), with another 55 patients submitted to the Appendicitis Inflammatory Response score flowchart (intervention group). RESULTS: Waiting time for defining the intervention group’s conduct was 1.5 h shorter than the control group (p=0.02). Computed tomography was performed in 42 patients in the control group, compared with 25 in the intervention group (p=0.001). The impact of the flowchart based on the Appendicitis Inflammatory Response score of the cases compared to the control group was the reduction of appendectomies with a normal-appearing appendix from 5 to 1 and an increase in the exclusion of appendicitis diagnoses. The use of the Appendicitis Inflammatory Response score resulted in a diagnostic specificity of 92%, compared to 29% in the control group. CONCLUSIONS: The use of the Appendicitis Inflammatory Response score reduced the waiting time for the diagnosis of acute appendicitis, decreased the number of imaging tests, and increased diagnostic specificity of the disease.

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“…Diagnosing appendicitis is not always simple. The typical clinical presentation with migration of pain to the lower right quadrant of the abdomen or localized peritonitis is only found in less than half of the patients with acute appendicitis (7,8). Besides el-Objective.…”

Section: Introductionmentioning

confidence: 99%

Retrospective Evaluation of the Diagnostic Accuracy of the Modified Alvarado Scoring System (MASS) in a Croatian Hospital

Bakula¹,

Biljak

Bakula

et al. 2019

ama

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Objective. Diagnosing acute appendicitis (AA) is challenging and this has stimulated surgeons to develop scoring systems that could potentially decrease the rate of misdiagnosis in patients with suspected appendicitis. One of the most widely used today is the Modified Alvarado scoring system (MASS), however its sensitivity and specificity varies a great deal between studies. As a result, we wanted to assess the diagnostic accuracy of MASS retrospectively at our institution to achieve the highest possible value of sensitivity and decrease the number of false negative patients.Material and Methods. We retrospectively calculated MASS for all subsequent patients who had undergone an appendectomy at our institution between July 2015 and March 2017.Results. In 118 out of 146 operated patients, AA was confirmed intraoperatively. There was a statistically significant difference between the average MASS score in the positive and negative appendectomy groups (6 v. 4, respectively, P<0.001), with a significantly higher number of females among the negative appendectomies (P<0.001). When lowering the cut-off to a value as low as ≥3, the sensitivity of the MASS score increased to 97.45% (95% CI: 92.7 – 99.5), thus obtaining a very low false negative rate of merely 2.55%.Conclusion. This retrospective diagnostic accuracy study confirmed the higher average MASS score in the group of patients with confirmed AA diagnosis. A MASS score above the proposed low cut-off value (≥3) can be a useful tool to help surgeons ruling in patients with AA in order to reduce the risk of missing diagnosis.

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Diagnostic Value of C-Reactive Protein and the Influence of Visceral Fat in Patients With Obesity and Acute Appendicitis

Cited by 6 publications

References 26 publications

Morphologic criteria of vermiform appendix on computed tomography and a possible risk of developing acute appendicitis

Morphologic criteria of vermiform appendix on computed tomography and a possible risk of developing acute appendicitis

The Appendicitis Inflammatory Response Score for Acute Appendicitis: Is It Important for Early Diagnosis?

Retrospective Evaluation of the Diagnostic Accuracy of the Modified Alvarado Scoring System (MASS) in a Croatian Hospital

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